Feasibility and efficacy of TouchCare system using application for older adults living alone: a pilot pre-experimental study

Background: With the number of older people living alone continuously rising, health-monitoring systems using information and communication technology (ICT) have been developed to manage their health issues. Life logging and human body communication sensor, types of ICT, have been adapted to manage and monitor health status of the elderly. However, its feasibility and efficacy remain unclear. This study aimed to examine the feasibility of TouchCare system which combined life logging with human body communication technology and its effect on the physical and psychological status of older adults living alone. Methods: The TouchCare system, which consisted of a wearable watch, touchpad sensors, TouchCare application, and context-aware artificial intelligence, was developed by DNX Co. Ltd and used by the participants for 5 months. Out of the 111 selected participants, 91 replied to the satisfaction survey, and 22 participated in further investigation regarding their physical and psychological status. Finally, health assessment from 14 participants and sensor data from 13 participants (mean age = 77.4; SD = 3.8) were analyzed to compare their health status and health-related behaviors before and after use of the system. Results: Out of the 91 participants who took the survey, 51.6% were satisfied with the system. Nutritional status (pre-intervention (10.6 +/- 2.0) vs. post-intervention (11.8 +/- 1.9), P = 0.04) and fall efficacy (pre-intervention (89.2 +/- 15.3) vs. post-intervention (99.9 +/- 0.5), P = 0.001) significantly improved after use of the system. Chronic pain (pre-intervention (4.8 +/- 2.5) vs. post-intervention (4.4 +/- 3.7), P = 0.78) and depressive symptoms (pre-intervention (5.7 +/- 3.9) vs. post-intervention (5.4 +/- 3.1), P = 0.60) reduced, while cognitive function (pre-intervention (4.1 +/- 1.4) vs. post-intervention (4.6 +/- 1.1), P = 0.15) and physical performance related to walking improved (pre-intervention (3.9 & PLUSMN; 0.2) vs. post-intervention (4.0 & PLUSMN; 0), P = 0.35), but were not significant. Behaviors related to physical activity and gait improved after use of the system; touch counts of refrigerator and microwave also increased with a decrease in night touch counts. Conclusions: The TouchCare system was acceptable to older people living alone, and it efficiently managed their daily living while promoting their health-related behaviors. Further experimental studies are required to verify the effectiveness of the system, and to develop the system which meet the individualized needs of older people living alone.