Progress in ambient assisted systems for independent living by the elderly

SpringerPlus, May 2016

One of the challenges of the ageing population in many countries is the efficient delivery of health and care services, which is further complicated by the increase in neurological conditions among the elderly due to rising life expectancy. Personal care of the elderly is of concern to their relatives, in case they are alone in their homes and unforeseen circumstances occur, affecting their wellbeing. The alternative; i.e. care in nursing homes or hospitals is costly and increases further if specialized care is mobilized to patients’ place of residence. Enabling technologies for independent living by the elderly such as the ambient assisted living systems (AALS) are seen as essential to enhancing care in a cost-effective manner. In light of significant advances in telecommunication, computing and sensor miniaturization, as well as the ubiquity of mobile and connected devices embodying the concept of the Internet of Things (IoT), end-to-end solutions for ambient assisted living have become a reality. The premise of such applications is the continuous and most often real-time monitoring of the environment and occupant behavior using an event-driven intelligent system, thereby providing a facility for monitoring and assessment, and triggering assistance as and when needed. As a growing area of research, it is essential to investigate the approaches for developing AALS in literature to identify current practices and directions for future research. This paper is, therefore, aimed at a comprehensive and critical review of the frameworks and sensor systems used in various ambient assisted living systems, as well as their objectives and relationships with care and clinical systems. Findings from our work suggest that most frameworks focused on activity monitoring for assessing immediate risks, while the opportunities for integrating environmental factors for analytics and decision-making, in particular for the long-term care were often overlooked. The potential for wearable devices and sensors, as well as distributed storage and access (e.g. cloud) are yet to be fully appreciated. There is a distinct lack of strong supporting clinical evidence from the implemented technologies. Socio-cultural aspects such as divergence among groups, acceptability and usability of AALS were also overlooked. Future systems need to look into the issues of privacy and cyber security.

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Progress in ambient assisted systems for independent living by the elderly

Al‑Shaqi et al. SpringerPlus Progress in ambient assisted systems for independent living by the elderly Riyad Al‑Shaqi Al‑ 0 Monjur Mourshed 0 Yacine Rezgui 0 0 Cardiff School of Engineering, Cardiff University , Queen's Building, The Parade, Cardiff CF24 3AA, Wales , UK One of the challenges of the ageing population in many countries is the efficient delivery of health and care services, which is further complicated by the increase in neurological conditions among the elderly due to rising life expectancy. Personal care of the elderly is of concern to their relatives, in case they are alone in their homes and unforeseen circumstances occur, affecting their wellbeing. The alternative; i.e. care in nursing homes or hospitals is costly and increases further if specialized care is mobilized to patients' place of residence. Enabling technologies for independent living by the elderly such as the ambient assisted living systems (AALS) are seen as essential to enhancing care in a cost‑ effective manner. In light of significant advances in telecommunication, computing and sensor miniaturization, as well as the ubiquity of mobile and connected devices embodying the concept of the Internet of Things (IoT), endto‑ end solutions for ambient assisted living have become a reality. The premise of such applications is the continuous and most often real‑ time monitoring of the environment and occupant behavior using an event‑ driven intelligent system, thereby providing a facility for monitoring and assessment, and triggering assistance as and when needed. As a growing area of research, it is essential to investigate the approaches for developing AALS in literature to identify current practices and directions for future research. This paper is, therefore, aimed at a comprehensive and critical review of the frameworks and sensor systems used in various ambient assisted living systems, as well as their objectives and relationships with care and clinical systems. Findings from our work suggest that most frameworks focused on activity monitoring for assessing immediate risks, while the opportunities for integrating environmental factors for analytics and decision‑ making, in particular for the long‑ term care were often overlooked. The potential for wearable devices and sensors, as well as distributed storage and access (e.g. cloud) are yet to be fully appreciated. There is a distinct lack of strong supporting clinical evidence from the implemented technologies. Socio‑ cultural aspects such as divergence among groups, acceptability and usability of AALS were also overlooked. Future systems need to look into the issues of privacy and cyber security. Ambient assisted living; Independent living; Smart homes; Elderly; Ageing; Dementia Background The elderly population in the world is increasing as a result of the advancements in technology, public health, nutrition and medicine (Beard et  al. 2012; Aytac et  al. 1999) . Rising life expectancy, declining birth rates and infant mortality will continue to influence this significant shift in demographics around the world, although at varying degree and pace (United Nations 2013). People aged sixty or over were more than 11.5  % of the global population in 2012. By 2050, this percentage is expected to double to two billion, and around thirty-three countries will have more than ten million people each, aged sixty or over (Haub 2012) . The Organisation for Economic Co-operation and Development (2005) forecasted that during the first half of the twenty first century, its member countries would experience a drastic increase in the elderly population, as well as a steep decline in their working force population. For example, the percentage of the population aged 65 or over in the UK increased to 16 % of the total by 2009 while forecast suggests that 40 % of the country’s population will be aged fifty or over by 2026 (Winkler et al. 2007) . The demographic shift is not evenly distributed. Figure 1 illustrates the number of persons aged 65 years or over, per hundred children under 15  years in different regions between 1950 and 2050. The ageing of the population in the developed America and Europe is steep compared to Africa. Ageing in the Middle East is expected to rise rapidly over the next 35  years. In Asia, the Chinese population is aging rapidly, due to the onechild policy that the government enforces and the country’s lower mortality rate (Zhang and Goza 2006) . In the Middle East, the percentage of elderly to young people is low compared to western countries. However, the percentage of the aged population will increase throughout the region, with sharp increases in countries with declining fertility and extensive development. By 2050, around 22  % of the forecasted 1.1 billion people in the Middle East is expected to be of 60 years or over (United Nations Population Fund 2012) . Although this share will still be low, the pace of aging will rapidly increase and by 2030 i (...truncated)


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Riyad Al-Shaqi, Monjur Mourshed, Yacine Rezgui. Progress in ambient assisted systems for independent living by the elderly, SpringerPlus, 2016, pp. 624, Volume 5, Issue 1, DOI: 10.1186/s40064-016-2272-8