BMJ Open (May 2023)

Using home monitoring technology to study the effects of traumatic brain injury on older multimorbid adults: protocol for a feasibility study

  • Paresh Malhotra,
  • David J Sharp,
  • Yuchen Zhao,
  • Michael David,
  • David Sharp,
  • Michael Fertleman,
  • Lenny Naar,
  • Sarah Daniels,
  • Ramin Nilforooshan,
  • Derk-Jan Dijk,
  • Claire Norman,
  • Greg Scott,
  • Ian Williams,
  • John Patterson,
  • Neil Graham,
  • David Wingfield,
  • Mara Golemme,
  • Melanie Dani,
  • Sanara Raza,
  • Lucia M Li,
  • Sumit Dey,
  • Eyal Soreq,
  • Payam Barnaghi,
  • Martina Del Giovane,
  • Magdalena Kolanko,
  • Ciro Della Monica,
  • Helen Lai,
  • Tong Wu,
  • Megan E Parkinson,
  • Danielle Wilson,
  • Zaynab Ismail,
  • Paul Freemont,
  • Ravi Vaidyanathan,
  • Tim Constandinou,
  • Naomi Hassim,
  • Mark Crook Rumsey,
  • Emma Jane Mallas,
  • Alina-Irina Serban,
  • Alan Bannon,
  • Shlomi Haar,
  • Charalambos Hadjipanayi,
  • Ghena Hammour,
  • Bryan Hsieh,
  • Adrien Rapeaux,
  • Maowen Yin,
  • Maria Lima,
  • Maitreyee Wairagkar,
  • Nan Fletcher-Lloyd,
  • Hamed Haddadi,
  • Valentinas Janeiko,
  • Anna Joffe,
  • Samaneh Kouchaki,
  • Viktor Levine,
  • Honglin Li,
  • Amer Marzuki,
  • Francesca Palermo,
  • Mark Woodbridge,
  • Alexander Capstick,
  • Severin Skillman,
  • Loren Cameron,
  • Michael Crone,
  • Kirsten Jensen,
  • Anne Skeldon,
  • Kevin Wells,
  • Ullrich Bartsch,
  • Kiran G R Kumar,
  • Damion Lambert,
  • Sara Mohammadi Mahvash,
  • Thalia Rodriguez Garcia,
  • Martin Tran,
  • Thomas Adam,
  • Vikki Revell,
  • Giuseppe Atzori,
  • Lucinda Grainger,
  • Hana Hassanin,
  • James Woolley,
  • Iris Wood-Campar,
  • Janetta Rexha,
  • Sophie Horrocks,
  • Brian Quan,
  • Jessica True,
  • Olga Balazikova,
  • Emily Beale,
  • Vaiva Zarombaite,
  • Lucy Copps,
  • Olivia Knight,
  • Gaganpreet Bangar,
  • Chelsea Mukonda,
  • Jessica Hine,
  • Luke Mallon,
  • Anesha Patel,
  • Ruby Lyall,
  • Pippa Kirby,
  • Mike Law,
  • Andy Kenny

DOI
https://doi.org/10.1136/bmjopen-2022-068756
Journal volume & issue
Vol. 13, no. 5

Abstract

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Introduction The prevalence of traumatic brain injury (TBI) among older adults is increasing exponentially. The sequelae can be severe in older adults and interact with age-related conditions such as multimorbidity. Despite this, TBI research in older adults is sparse. Minder, an in-home monitoring system developed by the UK Dementia Research Institute Centre for Care Research and Technology, uses infrared sensors and a bed mat to passively collect sleep and activity data. Similar systems have been used to monitor the health of older adults living with dementia. We will assess the feasibility of using this system to study changes in the health status of older adults in the early period post-TBI.Methods and analysis The study will recruit 15 inpatients (>60 years) with a moderate-severe TBI, who will have their daily activity and sleep patterns monitored using passive and wearable sensors over 6 months. Participants will report on their health during weekly calls, which will be used to validate sensor data. Physical, functional and cognitive assessments will be conducted across the duration of the study. Activity levels and sleep patterns derived from sensor data will be calculated and visualised using activity maps. Within-participant analysis will be performed to determine if participants are deviating from their own routines. We will apply machine learning approaches to activity and sleep data to assess whether the changes in these data can predict clinical events. Qualitative analysis of interviews conducted with participants, carers and clinical staff will assess acceptability and utility of the system.Ethics and dissemination Ethical approval for this study has been granted by the London-Camberwell St Giles Research Ethics Committee (REC) (REC number: 17/LO/2066). Results will be submitted for publication in peer-reviewed journals, presented at conferences and inform the design of a larger trial assessing recovery after TBI.