Evaluation of Smart Agitation Prediction and Management for Dementia Care and Novel Universal Village Oriented Solution for Integration, Resilience, Inclusiveness and Sustainability

Abstract

At present, the world is being faced with the challenge of an aging population, correlating to a growing number of seniors with dementia. With this uptick in persons with dementia (PWD), managing dementia-induced agitation, a behavior present in 90 precent of PWD characterized by physical aggression, verbal outburst, or other troubling behavior, is a pressing issue [1]. Caregiver burden associated with agitation is one of the leading causes a community-based PWD is institutionalized [2], so by supporting PWD-caregiver dyads, we improve individual quality of life and relieve stress placed on the global healthcare system. Use of AI technology, big data, and integrated networks of wearable and ambient sensors has enabled continuous monitoring of dementia care. However, most methods focus on data collection at the early stages of dementia. More research is needed on how novel technologies can empower PWD and their caregivers to take action to manage agitation and support them in the long term as symptoms progress. Moreover, current methods have not taken full advantage of the information obtained and do not provide personalized care. In this paper, we use the Universal Village (UV) perspective to evaluate the current status of smart technologies with the potential for use in preventing and mitigating agitation while providing support to the caregiver. We conduct evaluations based on the framework of a closed feedback control loop: data acquisition, communication, decision making, and action. We propose that a robust PWD agitation management system should take into consideration the interaction between the smart healthcare system and other seven smart city subsystems: smart home, intelligent transportation, urban planning and crowd management, smart energy management, smart city infrastructure, smart response system for city emergency, smart environmental protection and smart humanity, and also study how managing agitation would be affected by four major impacting factors of smart cities: information flow, material cycle, lifestyle, and community. This systematic study will help us explore in depth the complicated dynamic relationship between multiple impacting factors and propose a UV-oriented, integrated, resilient, inclusive, and sustainable development framework design. As such, the novel framework will improve PWD quality of life and reduce the care burden for formal and informal caregivers through continuous, unobtrusive monitoring, life-long agitation management throughout different stages of dementia, PWD-caregiver dyad-specific guidance, preventive healthcare, and timely treatment.