In-Home Mobility Frequency and Stability in Older Adults Living Alone With or Without MCI: Introduction of New Metrics
Open accessAbstract
Background: Older adults spend a considerable amount of time inside their residences; however, most research investigates out-of-home mobility and its health correlates. We measured indoor mobility using room-to-room transitions, tested their psychometric properties, and correlated indoor mobility with cognitive and functional status. Materials and Methods: Community-dwelling older adults living alone (n = 139; age = 78.1 ± 8.6 years) from the Oregon Center for Aging & Technology (ORCATECH) and Minority Aging Research Study (MARS) were included in the study. Two indoor mobility features were developed using non-parametric parameters (frequency; stability): Indoor mobility frequency (room-to-room transitions/day) was detected using passive infrared (PIR) motion sensors fixed on the walls in four geographic locations (bathroom; bedroom; kitchen; living room) and using door contact sensors attached to the egress door in the entrance. Indoor mobility stability was estimated by variances of number of room-to-room transitions over a week. Test-retest reliability (Intra-class coefficient, ICC) and the minimal clinically important difference (MCID) defined as the standard error of measurement (SEM) were generated. Generalized estimating equations models related mobility features with mild cognitive impairment (MCI) and functional status (gait speed). Results: An average of 206 days (±127) of sensor data were analyzed per individual. Indoor mobility frequency and stability showed good to excellent test-retest reliability (ICCs = 0.91[0.88–0.94]; 0.59[0.48–0.70]). The MCIDs of mobility frequency and mobility stability were 18 and 0.09, respectively. On average, a higher indoor mobility frequency was associated with faster gait speed (β = 0.53, p = 0.04), suggesting an increase of 5.3 room-to-room transitions per day was associated with an increase of 10 cm/s gait speed. A decrease in mobility stability was associated with MCI (β = −0.04, p = 0.03). Discussion: Mobility frequency and stability in the home are clinically meaningful and reliable features. Pervasive-sensing systems deployed in homes can objectively reveal cognitive and functional status in older adults who live alone.
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Recent advances in DHTs have allowed researchers to observe individuals with mild cognitive impairment (MCI) structuring their days differently than those with normal cognition.
“Recent advances in DHTs have allowed researchers to observe individuals with mild cognitive impairment (MCI) structuring their days differently than those with normal cognition, 36 , 37”
From Developing digital health technologies for frontotemporal degeneration (2025) · cites this paper as [37]
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- Authors
- Wu, C.-Y., Dodge, H. H., Reynolds, C., Barnes, L. L., Silbert, L. C., Lim, M. M., Mattek, N., Gothard, S., Kaye, J. A., & Beattie, Z.
- Affiliations
- Oregon Health & Science University (US)
- Rush University Medical Center (US)
- Corresponding author
- Wu, Chao-Yi
- ORCID
- Venue
- Frontiers in Digital Health
- Publisher
- Frontiers Media SA
- Published
- 2021-10-26
- Volume
- 3
- Pages
- 764510-764510
- ISSN
- 2673-253X (ISSN-L)
- PMC
- PMC8575720
- OpenAlex
- W3209003316
- Cited by
- 19
- References
- 53
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 7 · 2022: 2
- FWCI
- 5.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Digital Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- OSTI OAI (U.S. Department of Energy Office of Scientific and Technical Information) (submittedVersion)
- Funders
- National Institute on Aging (P3010161, P30-AG008017, P30AG024978, P30AG024978-15, P30AG066518-01, P30AG066518-02, R01AG024059, R01AG17917, RF1AG22018, U2C AG054397)
- Health Services Research and Development (IIR 17-144)
- National Center for Advancing Translational Sciences (UL1 TR002369)
- Pacific Northwest National Laboratory (Hartford Gerontological Center Interprofessional Award)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- indoor mobility, elderly living alone, mild cognitive impairment, walking speed, passive infrared motion sensor, pervasive sensing, functional status, test-retest reliability, minimal clinically important difference
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