Journal of Medical Systems (2019) 43: 287 https://doi.org/10.1007/s10916-019-1417-z MOBILE & WIRELESS HEALTH A Systematic Review and Implementation of IoT-Based Pervasive Sensor-Enabled Tracking System for Dementia Patients Partha Pratim Ray1 & Dinesh Dash2 & Debashis De3 Received: 30 April 2019 /Accepted: 8 July 2019 /Published online: 17 July 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract In today’s world, 46.8 million people suffer from brain related diseases. Dementia is most prevalent of all. In general scenario, a dementia patient lacks proper guidance in searching out the way to return back at his/her home. Thus, increasing the risk of getting damaged at individual-health level. Therefore, it is important to track their movement in more sophisticated manner as possible. With emergence of wearables, GPS sensors and Internet of Things (IoT), such devices have become available in public domain. Smartphone apps support caregiver to locate the dementia patients in real-time. RF, GSM, 3G, Wi-Fi and 4G technology fill the communication gap between patient and caregiver to bring them closer. In this paper, we incorporated 7 most popular wearables for investigation to seek appropriateness for dementia tracking in recent times in systematic manners. We performed an in-depth review of these wearables as per the cost, technology wise and application wise characteristics. A case novel study i.e. IoT-based Force Sensor Resistance enabled System-FSRIoT, has been proposed and implemented to validate the effectiveness of IoT in the domain of smarter dementia patient tracking in wearable form factor. The results show promising aspect of a whole new notion to leverage efficient assistive physio-medical healthcare to the dementia patients and the affected family members to reduce life risks and achieve a better social life. Keywords Dementia . Tracking . Sensor system . Wearables . IoT Introduction Several key symptoms are found among the dementia pa- tients. Sudden memory loss, wandering with time/place, poor Dementia refers to the set of symptoms that cause sudden loss judgement, issues in solving problems and difficulty in com- of memory and mental abilities among patients. It is mainly pleting familiar tasks are to name a few [2]. According to caused by sudden damage and improper functioning of brain Alzheimer’s association (i.e. alz.org), these symptoms are cells while resulting into improper functioning of coordination currently incurable but mostly manageable with proper and efficient communication among several brain-lobes [1]. medication and behavioral care. Around 46.8 million people Such prevalence of insufficient signaling among brain-cells are currently affected by various types of dementia in five hamper regular livelihood activities such as: judgement, think- main continents [3]. The number is expected to reach 74.7 ing, movement, feelings and remembering an incident. million and 131.5 million in 2030 and 2050, respectively. Developing nations of Asia are currently at the highest risk This article is part of the Topical Collection on Mobile & Wireless Health prone zone on the chart whereas African people are the least suffers. The graph in Fig. 1 shows these facts among Africa, * Partha Pratim Ray Europe, Americas (north and south) and Asia. [email protected] Till now, several medical causes have been identified which in turn help into the assimilation of dementia. ’ 1 Department of Computer Applications, Sikkim University, Alzheimer s is the most common cause of dementia which is Gangtok, India observed among the 60–80% of registered cases in the world. ’ 2 Department of Computer Science and Engineering, NIT Patna, Parkinson s disease is another serious cause of dementia, upon Patna, India whose occurrence, affected patient suffers from normal move- – 3 Department of Computer Science and Engineering, MAKAUT, ment related issues [4 7]. Patients having vascular disease, are Kolkata, India found to be lingering with decision making, planning or 287 Page 2 of 21 J Med Syst (2019) 43: 287 come out with novel products to track dementia patients. This article provides an overview of some of these devices being offered to keep track of dementia patients. All of the wearable devices discussed in this study are either currently in market or will be launched very soon. All of the information on device’s features are inherited from respective manufacturer and cur- rently available on their website. This survey is not to be meant for any sorts of device specific analysis. As such, no critical discussion is included of how each manufacturer was effective while development of respective tracking device. The aim of this study is to review existing wearables that help Fig. 1 Prevalence of dementia patients around continents [3] dementia patients to track back to own home by him/her self and by caregivers through in-depth and comprehensive review organizing any event. In mixed dementia cases, sudden mem- of all aspects of surveyed wearables [13–16]. ory loss acts as addendum to the symptoms of the vascular The main contributions of this paper are as follows: inappropriateness. In contrary to this, frontotemporal demen- tia patients are often found to be more susceptive toward get- & To systematically review the most popular smart wearable ting affected with patientality and behavioral changes. Patients tracking devices for dementia patients’ location tracking; who suffer from cause like Dementia with Lewy Bodies & To perform an in-depth comparative study of the surveyed (DLB), are more prone toward sleep disturbances, visual hal- wearable devices in terms of cost, application, supportive- lucinations, slowness and movement. On the other hand, ness, user experience and technological enrichment; Normal Pressure Hydrocephalus (NPH) compels the patient & To propose a novel, low power consuming and cost- to suffer from the walking disability and uncontrolled. effective IoT-based wearable sensor system i.e. FSRIoT Similarly, the Huntington’s disease takes place due to the ab- to validate the comparative analysis toward catering the normality in a single defective gene, while resulting into the needs of efficient dementia patient tracking in real-life e- occurrence of irritability, depression and mood change among healthcare scenario. the victims. The Wernicke-Korsakoff syndrome (WK) is a & To discusses current technological gap in the surveyed wear- special cause of dementia that is occasionally seen among ables for dementia patient tracking and provide recommen- the alcohol-misusers. Finally, in Creutzfeldt-Jakob Disease dation to further uplift the quality of service in such cases. (CJD), patients get affected with fatal brain disorders. Figure 2 shows different causes of dementia as discusses Rest of the paper is organized as follows. Section II [8–10]. presents the preface to tracking devices. Section III rep- As comprehended from above, three most prevalent and resents the feature description of tracking devices for major challenges for the dementia patients are found as: ab- dementia. Section IV elaborates the user interfaces and normal wandering, sudden memory loss and severe fluctua- services in dementia tracking devices. Section V pre- tion in behavior. Generally, such patients forget to perform sents the various tracking techniques used in the sur- regular livelihood-activities, thus attracting risks into their veyed popular tracking devices. Section VI propose lives. There has been much interest towards development and implements the FSRIoT system model as a proof- and dissemination of relevant technology that can tackle de- of-concept case study to validate the cost-effective mentia patients. Most commonly, tracking solutions for de- tracking device development for dementia patients. mentia patients have been worked upon [11, 12]. Existence Section VII discusses the important technology gaps of these technologies have enabled wearable market players to Fig. 2 Various causes of dementia Various Causes of Dementia DLB Vascular Alzheimer’s Parkinson's CJD Disease Disease Mixed NPH Huntington's Fronto- temporal WK Syndrome J Med Syst (2019) 43: 287 Page 3 of 21 287 and future recommendation to improve current state of Table 1 Wearable device pricing and availability dementia tracking devices. Section VIII concludes the Device Price* Availability article. GPS Smart Sole US$299.00 ξ Available now Freedom GPS Locator Watch US$599.99ϕ Available now Related works to tracking devices Safelink US$149.99 Available now US$199.99ψ ¥ Consumers have shown growing interest in e-health and Mindme Locate US$199.99 Available now – MX-LOCare™ US$129.99 Available now telecare services in recent past [17 31]. Advancement in € fields of Internet of Things (IoT), smart body sensors iTraq3 US$129.00 Pre-order £ and cloud platforms, has embarked into creation of a PocketFinder+ US$159.00 Available now – ξ wearables industry [32 39]. This industry has witnessed *Prices are retrieved from each manufacturer’s web site, US$29.95/ uplift in terms of offering from relatively new comer moth monitoring service extra, ϕ US$10.00 or 35.00 apply per month ψ such as Fitbit, alongside renowned companies like as airtime charge, GS-TRACK price, SL-12 price, ¥ monthly sub- € £ Apple, Sony, Motorola and Garmin [40–51]. Wearable scription US$20.00, monthly subscription US$5.90, monthly subscrip- tion US$12.95 products from these vendors allow consumers to gain knowledge of his/her health and fitness status in real- time. While, most of these