Recognition of Basic Activities of Daily Living Using Wearable Devices for Older Adults: Scoping Review

BackgroundTracking the performance of activities of daily living (ADLs) using ADL recognition has the potential to facilitate aging-in-place strategies, allowing older adults to live in their homes longer and enabling their families and caregivers to monitor changes in health...

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Main Authors: Samantha J Ray, Josh Cherian, Amanda Mae Liberty, Tracy Anne Hammond, Paula K Shireman
Format: Article
Language:English
Published: JMIR Publications 2025-05-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2025/1/e67373
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author Samantha J Ray
Josh Cherian
Amanda Mae Liberty
Tracy Anne Hammond
Paula K Shireman
author_facet Samantha J Ray
Josh Cherian
Amanda Mae Liberty
Tracy Anne Hammond
Paula K Shireman
author_sort Samantha J Ray
collection DOAJ
description BackgroundTracking the performance of activities of daily living (ADLs) using ADL recognition has the potential to facilitate aging-in-place strategies, allowing older adults to live in their homes longer and enabling their families and caregivers to monitor changes in health status. However, the ADL recognition literature historically has evaluated systems in controlled settings with data from younger populations, creating the question of whether these systems will work in real-world conditions for older populations. ObjectiveThis scoping review seeks to establish the state-of-the-art for recognizing basic ADLs using wearable sensors. This primary goal will identify literature gaps and research needed to make ADL tracking viable for aging-in-place solutions. In addition, this paper will quantify how many publications include older adults. This secondary goal assesses how often studies evaluate their system with older adult participants, enhancing the trustworthiness of the approach. MethodsWe conducted a scoping review using the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. We identify studies focused on basic ADL recognition using wearable sensors within the PubMed, Association of Computing Machinery Digital Library (ACM DL), and Google Scholar databases using papers published in the last 5 calendar years (2019-2024) to identify current trends given the rapid changes in wearable technology devices. Publications must include at least one of the basic ADLs (ie, bathing, dressing, toileting, transferring, continence, and feeding) and include some sort of wearable sensor or device. Studies focusing on instrumental ADLs, general physical activity tracking, fall detection, or only using environmental devices are excluded. Studies that include older adults in the design or evaluation of their ADL recognition system are highlighted. ResultsThe database search identified 695 papers; 164 papers passed title screening. A total of 58 studies satisfied the inclusion criteria; only 8 studies included older adults despite most studies identifying this population as a focus for their research. Most studies focused on eating (n=27), hygiene (n=24), drinking (n=20), or transitions (n=13). Few works included toileting (n=3), dressing (n=2), or bathing (n=1) activities. Of the 8 studies that included older adults, 5 focused on recognition performance while 3 focused on user experience and system acceptability. ConclusionsBasic ADLs are unevenly covered in the literature; more research is needed for recognizing bathing, dressing, and toileting activities. Despite all studies stating the importance of tracking ADLs in older adults, only 14% (8/58) of the included works involve older adult participants. A commonality between these outcomes is difficulty collecting or obtaining adequate training data for ADL recognition systems. Many works are predominantly concerned with proving system feasibility and do not assess usability or real-world deployment. For these systems to move from academic experiments to actual systems with clinical utility, ADL recognition systems must consider the design requirements of being part of remote health monitoring systems.
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spelling doaj-art-bcb7ab1ffc754723ab3f04876506eb592025-08-20T02:31:44ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-05-0127e6737310.2196/67373Recognition of Basic Activities of Daily Living Using Wearable Devices for Older Adults: Scoping ReviewSamantha J Rayhttps://orcid.org/0000-0003-3189-8899Josh Cherianhttps://orcid.org/0000-0002-7749-2109Amanda Mae Libertyhttps://orcid.org/0009-0002-5874-788XTracy Anne Hammondhttps://orcid.org/0000-0001-7272-0507Paula K Shiremanhttps://orcid.org/0000-0002-9701-5422 BackgroundTracking the performance of activities of daily living (ADLs) using ADL recognition has the potential to facilitate aging-in-place strategies, allowing older adults to live in their homes longer and enabling their families and caregivers to monitor changes in health status. However, the ADL recognition literature historically has evaluated systems in controlled settings with data from younger populations, creating the question of whether these systems will work in real-world conditions for older populations. ObjectiveThis scoping review seeks to establish the state-of-the-art for recognizing basic ADLs using wearable sensors. This primary goal will identify literature gaps and research needed to make ADL tracking viable for aging-in-place solutions. In addition, this paper will quantify how many publications include older adults. This secondary goal assesses how often studies evaluate their system with older adult participants, enhancing the trustworthiness of the approach. MethodsWe conducted a scoping review using the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. We identify studies focused on basic ADL recognition using wearable sensors within the PubMed, Association of Computing Machinery Digital Library (ACM DL), and Google Scholar databases using papers published in the last 5 calendar years (2019-2024) to identify current trends given the rapid changes in wearable technology devices. Publications must include at least one of the basic ADLs (ie, bathing, dressing, toileting, transferring, continence, and feeding) and include some sort of wearable sensor or device. Studies focusing on instrumental ADLs, general physical activity tracking, fall detection, or only using environmental devices are excluded. Studies that include older adults in the design or evaluation of their ADL recognition system are highlighted. ResultsThe database search identified 695 papers; 164 papers passed title screening. A total of 58 studies satisfied the inclusion criteria; only 8 studies included older adults despite most studies identifying this population as a focus for their research. Most studies focused on eating (n=27), hygiene (n=24), drinking (n=20), or transitions (n=13). Few works included toileting (n=3), dressing (n=2), or bathing (n=1) activities. Of the 8 studies that included older adults, 5 focused on recognition performance while 3 focused on user experience and system acceptability. ConclusionsBasic ADLs are unevenly covered in the literature; more research is needed for recognizing bathing, dressing, and toileting activities. Despite all studies stating the importance of tracking ADLs in older adults, only 14% (8/58) of the included works involve older adult participants. A commonality between these outcomes is difficulty collecting or obtaining adequate training data for ADL recognition systems. Many works are predominantly concerned with proving system feasibility and do not assess usability or real-world deployment. For these systems to move from academic experiments to actual systems with clinical utility, ADL recognition systems must consider the design requirements of being part of remote health monitoring systems.https://www.jmir.org/2025/1/e67373
spellingShingle Samantha J Ray
Josh Cherian
Amanda Mae Liberty
Tracy Anne Hammond
Paula K Shireman
Recognition of Basic Activities of Daily Living Using Wearable Devices for Older Adults: Scoping Review
Journal of Medical Internet Research
title Recognition of Basic Activities of Daily Living Using Wearable Devices for Older Adults: Scoping Review
title_full Recognition of Basic Activities of Daily Living Using Wearable Devices for Older Adults: Scoping Review
title_fullStr Recognition of Basic Activities of Daily Living Using Wearable Devices for Older Adults: Scoping Review
title_full_unstemmed Recognition of Basic Activities of Daily Living Using Wearable Devices for Older Adults: Scoping Review
title_short Recognition of Basic Activities of Daily Living Using Wearable Devices for Older Adults: Scoping Review
title_sort recognition of basic activities of daily living using wearable devices for older adults scoping review
url https://www.jmir.org/2025/1/e67373
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