A Review of Approaches to Mobility Telemonitoring of the Elderly in Their Living Environment potx

Annals of Biomedical Engineering, Vol. 34, No. 4, April 2006 (
C 2006) pp. 547–563

DOI: 10.1007/s10439-005-9068-2

A Review of Approaches to Mobility Telemonitoring of the Elderly

in Their Living Environment

CLIODHNA N´I SCANAILL,

1 SHEILA CAREW,

2 PIERRE BARRALON,

3 NORBERT NOURY,

3

DECLAN LYONS,

2 and GERARD M. LYONS1

1Biomedical Electronics Laboratory, Department of Electronic and Computer Engineering, University of Limerick,

National Technological Park, Limerick, Ireland; 2Clinical Age Assessment Unit, Mid Western Regional Hospital,

Limerick, Ireland; and 3Laboratoire TIMC-IMAG, Faculte de M ´ edecine, 38706, La Tronche Cedex, France ´

(Received 10 May 2005; accepted 8 December 2005; published online: 21 March 2006)

Abstract—Rapid technological advances have prompted the de￾velopment of a wide range of telemonitoring systems to enable

the prevention, early diagnosis and management, of chronic con￾ditions. Remote monitoring can reduce the amount of recurring

admissions to hospital, facilitate more efficient clinical visits with

objective results, and may reduce the length of a hospital stay for

individuals who are living at home. Telemonitoring can also be

applied on a long-term basis to elderly persons to detect gradual

deterioration in their health status, which may imply a reduction

in their ability to live independently. Mobility is a good indicator

of health status and thus by monitoring mobility, clinicians may

assess the health status of elderly persons. This article reviews

the architecture of health smart home, wearable, and combina￾tion systems for the remote monitoring of the mobility of elderly

persons as a mechanism of assessing the health status of elderly

persons while in their own living environment.

Keywords—Activity, Remote, Review, Health smart home,

Wearable, Telemedicine.

ABBREVIATIONS

ANN Artificial Neural Network

BP Blood Pressure

BUS Binary Unit System

CAN Controller Area Network

ECG Electrocardiogram

GPRS General Packet Radio Service

GSM Global System for Mobile communications

IR Infrared

PIR Passive InfraRed

ISDN Integrated Services Digital Network

LAN Local Area Network

PDA Personal Digital Assistant

POTS Plain Old Telephone System

PSTN Public Switched Telephone Network

Address correspondence to Cliodhna N´ı Scanaill, Biomedical Elec￾tronics Laboratory, Department of Electronic and Computer Engineering,

University of Limerick, National Technological Park, Limerick, Ireland.

Electronic mail: [email protected]

RF Radio Frequency

SMS Short Message Service

WLAN Wireless Local Area Network

WPAN Wireless Personal Area Network

INTRODUCTION

The western world is experiencing a so-called “greying

population” (Fig. 1).49 In 2001, 17% of the European Union

(EU) was over 65 and it is estimated that by the year 2035

this figure will have reached 33%. This demographic trend

is already posing many social and economic problems as

the care ratio (the ratio of the number of persons aged

between 16 and 65 to those aged 65 and over) is in decline.

This trend suggests that there will be less people to care for

elderly, as well as a decreased ratio of tax paying workers

(who fund the health services) to elderly people (using the

health services). This problem is compounded further by the

fact that elderly place proportionally greater demands on

health services than any other population grouping, outside

of newborn babies (Fig. 2).49 Healthcare delivery meth￾ods will need to be adapted to meet the challenges posed

by this aging population and to care for this group while

constrained by limited resources, but maintaining the same

high standards. It is generally expected that the use of tech￾nology will be required to create an efficient healthcare

delivery system.9

One such technology, telemonitoring, can be used to

monitor elderly and chronically ill patients in their own

community, which has been shown to be their preferred set￾ting.29 Telemonitoring can lead to a significant reduction in

healthcare costs by avoiding unnecessary hospitalization,

and ensuring that those who need urgent care receive it

in a more timely fashion. Long-term telemonitoring pro￾vides clinically useful trend data that can allow physicians

to make informed decisions, to monitor deterioration in

chronic conditions, or to assess the response of a patient to a

treatment. Telemonitoring has the potential to provide safe,

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C 2006 Biomedical Engineering Society