{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:45:36Z","timestamp":1787028336390,"version":"build-2736575974"},"reference-count":46,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T00:00:00Z","timestamp":1639526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>With the global trend toward an aging population, the increasing number of dementia patients and elderly living alone has emerged as a serious social issue in South Korea. The assessment of activities of daily living (ADL) is essential for diagnosing dementia. However, since the assessment is based on the ADL questionnaire, it relies on subjective judgment and lacks objectivity. Seven healthy seniors and six with early-stage dementia participated in the study to obtain ADL data. The derived ADL features were generated by smart home sensors. Statistical methods and machine learning techniques were employed to develop a model for auto-classifying the normal controls and early-stage dementia patients. The proposed approach verified the developed model as an objective ADL evaluation tool for the diagnosis of dementia. A random forest algorithm was used to compare a personalized model and a non-personalized model. The comparison result verified that the accuracy (91.20%) of the personalized model was higher than that (84.54%) of the non-personalized model. This indicates that the cognitive ability-based personalization showed encouraging performance in the classification of normal control and early-stage dementia and it is expected that the findings of this study will serve as important basic data for the objective diagnosis of dementia.<\/jats:p>","DOI":"10.3390\/ijerph182413235","type":"journal-article","created":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T09:02:19Z","timestamp":1639558939000},"page":"13235","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Automated Classification of Normal Control and Early-Stage Dementia Based on Activities of Daily Living (ADL) Data Acquired from Smart Home Environment"],"prefix":"10.3390","volume":"18","author":[{"given":"Lee-Nam","family":"Kwon","sequence":"first","affiliation":[{"name":"Convergence Research Center for Diagnosis, Treatment and Care System of Dementia, Korea Institute of Science and Technology, Seoul 02792, Korea"},{"name":"Future Information Research Center, Korea Institute of Science and Technology Information, Seoul 02456, Korea"},{"name":"Department of Computer Science and Engineering, Chungnam National University, Daejeon 34134, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6931-7469","authenticated-orcid":false,"given":"Dong-Hun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Data and HPC Science, University of Science and Technology, Daejeon 34113, Korea"},{"name":"Artificial Intelligence Technology Research Center, Korea Institute of Science and Technology Information, Daejeon 34141, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6251-6139","authenticated-orcid":false,"given":"Myung-Gwon","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Data and HPC Science, University of Science and Technology, Daejeon 34113, Korea"},{"name":"Artificial Intelligence Technology Research Center, Korea Institute of Science and Technology Information, Daejeon 34141, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo-Jin","family":"Lim","sequence":"additional","affiliation":[{"name":"Convergence Research Center for Diagnosis, Treatment and Care System of Dementia, Korea Institute of Science and Technology, Seoul 02792, Korea"},{"name":"Future Information Research Center, Korea Institute of Science and Technology Information, Seoul 02456, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8329-9348","authenticated-orcid":false,"given":"Young-Kuk","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Engineering, Chungnam National University, Daejeon 34134, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Gyum","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwang-Hee","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Biomedical Research Center, Korea University Anam Hospital, Seoul 02841, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong-Woo","family":"Chun","sequence":"additional","affiliation":[{"name":"Convergence Research Center for Diagnosis, Treatment and Care System of Dementia, Korea Institute of Science and Technology, Seoul 02792, Korea"},{"name":"Future Information Research Center, Korea Institute of Science and Technology Information, Seoul 02456, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun-Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,15]]},"reference":[{"key":"ref_1","unstructured":"(2021, June 01). Percent of Population Ages 65 and Older, 2020 World Population Data Sheet. Available online: http:\/\/prb.org."},{"key":"ref_2","unstructured":"World Health Organisation (2020). Global Action Plan on the Public Health Response to Dementia 2017\u20132025, WHO. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/dementia."},{"key":"ref_3","unstructured":"Ministry of Health and Welfare (2021). 2020 Korean Dementia Observatory."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1080\/1061186X.2018.1474361","article-title":"Drug development for Alzheimer\u2019s disease: Review","volume":"27","author":"Lao","year":"2019","journal-title":"J. Drug Target."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1136\/jnnp.2008.148346","article-title":"Early intervention for mild cognitive impairment: A randomised controlled trial","volume":"80","author":"Kinsella","year":"2009","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jalz.2010.04.005","article-title":"Alzheimer\u2019s Disease Neuroimaging Initiative. Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer\u2019s disease","volume":"7","author":"Marshall","year":"2011","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1212\/WNL.0000000000004826","article-title":"Practice guideline update summary: Mild cognitive impairment report of the guideline development, dissemination, and implementation","volume":"90","author":"Petersen","year":"2018","journal-title":"Neurology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"235","DOI":"10.3233\/JAD-2005-7306","article-title":"Mild cognitive impairment (MCI) represents early-stage Alzheimer\u2019s disease","volume":"7","author":"Morris","year":"2005","journal-title":"J Alzheimer\u2019s Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1111\/j.1600-0447.2008.01326.x","article-title":"Rate of progression of mild cognitive impairment to dementia\u2014Meta-analysis of 41 robust inception cohort studies","volume":"119","author":"Mitchell","year":"2009","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/01.wad.0000213849.51495.d9","article-title":"MCI is associated with deficits in everyday functioning","volume":"20","author":"Farias","year":"2006","journal-title":"Alzheimer Dis. Assoc. Disord."},{"key":"ref_11","unstructured":"(2021, June 02). CENSUS 2019, Available online: https:\/\/data.census.gov\/cedsci\/table?q=living%20alone&tid=ACSDP1Y2019.DP02."},{"key":"ref_12","unstructured":"(2021, June 10). Statistics Korea KOSIS (2019). Available online: https:\/\/kosis.kr."},{"key":"ref_13","unstructured":"(2021, June 03). Ministry of Health and Welfare 2019, Available online: http:\/\/www.mohw.go.kr\/react\/index.jsp."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1177\/0891988718774425","article-title":"Living Alone and Dementia Incidence: A Clinical-Based Study in People With Mild Cognitive Impairment","volume":"31","author":"Grande","year":"2018","journal-title":"J. Geriatr. Psychiatry Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1111\/j.0002-8614.2004.52404.x","article-title":"Risk factors for harm in cognitively impaired seniors who live alone: A prospective study","volume":"52","author":"Tierney","year":"2004","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"(2011). Clinical practice guideline for dementia by Clinical Research Center for Dementia of South Korea. J. Korean Med. Assoc., 54, 861\u2013875.","DOI":"10.5124\/jkma.2011.54.8.861"},{"key":"ref_17","first-page":"179","article-title":"Assessment of older people: Self-maintaining and instrumental activities of daily living","volume":"9","author":"Lawton","year":"1969","journal-title":"Gerontology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1001\/jama.1963.03060120024016","article-title":"Studies of illness in the aged: The index of ADL: A standardized measure of biological and psychosocial function","volume":"185","author":"Katz","year":"1963","journal-title":"JAMA J. Am. Med Assoc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1212\/01.wnl.0000264897.13722.53","article-title":"Activities of daily living in frontotemporal dementia and Alzheimer disease","volume":"68","author":"Mioshi","year":"2007","journal-title":"Neurology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1002\/gps.1168","article-title":"A longitudinal study of Alzheimer\u2019s disease: Rates of cognitive and functional decline","volume":"19","author":"Suh","year":"2004","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Takechi, H., Kokuryu, A., Kubota, T., and Yamada, H. (2012). Relative preservation of advanced activities in daily living among patients with mild-to-moderate dementia in the community and overview of support provided by family caregivers. Int. J. Alzheimer\u2019s Dis., in press.","DOI":"10.1155\/2012\/418289"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.jalz.2016.07.151","article-title":"Progression from normal cognition to mild cognitive impairment in a diverse clinic-based and community-based elderly cohort","volume":"13","author":"Chen","year":"2017","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1111\/jgs.14835","article-title":"Early functional limitations in cognitively normal older adults predict diagnostic conversion to mild cognitive impairment","volume":"65","author":"Farias","year":"2017","journal-title":"J. Amer. Geriatr. Soc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"505","DOI":"10.3233\/JAD-160087","article-title":"Daily function as predictor of dementia in cognitive impairment no dementia (CIND) and mild cognitive impairment (MCI): An 8-year follow-up in the ILSA study","volume":"53","author":"Baldereschi","year":"2016","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1080\/13607863.2014.915920","article-title":"Activities of daily living and quality of life across different stages of dementia: A UK study","volume":"19","author":"Giebel","year":"2015","journal-title":"Aging Ment. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/j.1532-5415.1988.tb01776.x","article-title":"Direct assessment of activities of daily living in Alzheimer\u2019s disease; A controlled study","volume":"36","author":"Skurla","year":"1988","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1093\/geronb\/gbq095","article-title":"Intelligent systems for assessing aging changes: Home-based, unobtrusive, and continuous assessment of aging","volume":"66","author":"Kaye","year":"2011","journal-title":"J. Gerontol. B-Psychol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1017\/S135561771200149X","article-title":"Naturalistic assessment of everyday activities and prompting technologies in mild cognitive impairment","volume":"19","author":"Seelye","year":"2013","journal-title":"J. Int. Neuropsychol. Soc."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Mohamed, A., Novais, P., Pereira, A., Villarrubia Gonz\u00e1lez, G., and Fern\u00e1ndez-Caballero, A. (2015). A Sensor-Based Framework to Support Clinicians in Dementia Assessment: The Results of a Pilot Study. Ambient Intelligence\u2014Software and Applications. Advances in Intelligent Systems and Computing, Springer.","DOI":"10.1007\/978-3-319-19695-4"},{"key":"ref_30","first-page":"1","article-title":"Clinical application of the experimental ADL test for patients with cognitive impairment: Pilot study","volume":"11","author":"Lim","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1109\/JBHI.2015.2445754","article-title":"Automated Clinical Assessment from Smart home-based Behavior Data","volume":"20","author":"Dawadi","year":"2016","journal-title":"IEEE J Biomed Health Inform."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1109\/JBHI.2018.2798062","article-title":"Smart home-based prediction of multi-domain symptoms related to Alzheimer\u2019s Disease","volume":"22","author":"Alberdi","year":"2018","journal-title":"IEEE J. Biomed. Health Inform."},{"key":"ref_33","unstructured":"Kim, D.K., Kim, J.-H., and Ku, H.M. (2006). Assessment of Instrumental Activities of Daily Living, Seoul-Instrumental Activities of Daily Living, INPSYT."},{"key":"ref_34","unstructured":"(2020, January 06). Mobius Open Platform. Available online: http:\/\/developers.iotocean.org\/archives\/module\/mobius-open-platform."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1093\/biomet\/52.3-4.591","article-title":"An analysis of variance test for normality (complete samples)","volume":"52","author":"Shapiro","year":"1965","journal-title":"Biometrika"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1214\/aoms\/1177730491","article-title":"On a test of whether one of two random variables is stochastically larger than the other","volume":"18","author":"Henry","year":"1947","journal-title":"Ann. Math. Stat."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Myers, J.L., and Well, A.D. (2003). Research Design and Statistical Analysis, Lawrence Erlbaum. [2nd ed.].","DOI":"10.4324\/9781410607034"},{"key":"ref_38","unstructured":"Brown, T.B., Mann, B., Ryder, N., Subbiah, M., Kaplan, J., Dhariwal, P., Neelakantan, A., Shyam, P., Sastry, G., and Askell, A. (2020). Language models are few-shot learners. Advances in Neural Information Processing Systems, Neural Information Processing Systems Foundation, Inc."},{"key":"ref_39","unstructured":"Choi, E., Bahadori, M.T., Kulas, J.A., Schuetz, A., Stewart, W.F., and Sun, J. (2016). RETAIN: An interpretable predictive model for healthcare using reverse time attention mechanism. Advances in Neural Information Processing Systems, Neural Information Processing Systems Foundation, Inc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1038\/s41586-021-03819-2","article-title":"Highly accurate protein structure prediction with AlphaFold","volume":"596","author":"Jumper","year":"2021","journal-title":"Nature"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Karras, T., Laine, S., Aittala, M., Hellsten, J., Lehtinen, J., and Aila, T. (2020, January 16\u201318). Analyzing and improving the image quality of stylegan. Proceedings of the IEEE Computer Society Conference on Computer Vision and Pattern Recognition, Seattle, WA, USA.","DOI":"10.1109\/CVPR42600.2020.00813"},{"key":"ref_42","unstructured":"Kipf, T.N., and Welling, M. (2017, January 24\u201326). Semi-supervised classification with graph convolutional networks. Proceedings of the 5th International Conference on Learning Representations, ICLR 2017\u2014Conference Track Proceedings, Toulon, France."},{"key":"ref_43","first-page":"187","article-title":"Application of random forests to corporate credit rating prediction","volume":"32","author":"Kim","year":"2016","journal-title":"J. Ind. Innov."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1023\/A:1010933404324","article-title":"Random forests","volume":"45","author":"Breiman","year":"2001","journal-title":"Mach. Learn."},{"key":"ref_45","first-page":"4766","article-title":"A Unified Approach to Interpreting Model Predictions","volume":"2017","author":"Lundberg","year":"2017","journal-title":"Adv. Neural Inf. Process. Syst."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Lim, S.J., Lee, Z., Kwon, L.N., and Chun, H.W. (2021). Medical Health Records-Based Mild Cognitive Impairment (MCI) Prediction for Effective Dementia Care. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18179223"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/24\/13235\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:48:51Z","timestamp":1760168931000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/24\/13235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,15]]},"references-count":46,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["ijerph182413235"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182413235","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,15]]}}}