An Intelligent Assistive Tool for Alzheimer’s Patient

Kazi Shahrukh Omar1 , Afia Anjum2 , Tahrima Oannahary, Md. Rezaul Karim Rizvi, Diana Shahrin,
Tasmiah Tamzid Anannya, Sanjida Nasreen Tumpa, Md Mahboob Karim, Muhammad Nazrul Islam,
Md Fazle Rabbi
Department of Computer Science and Engineering, Military Institute of Science and Technology (MIST), Dhaka-1216, Bangladesh
Email: {1 qshahrukh41, 2 afia.anjum70}@gmail.com

Abstract—Alzheimer’s Disease (AD) is a chronic neurodegen- these necessary states of patients will be delivered to their
erative disease that causes to develop dementia. Alzheimer’s family members and caretakers through a mobile application.
patients find it hard to remember recent events, reason and The rest of the paper is organized as follows. Section II
even to recognize people they know. As the disease advances,
symptoms can include difficulty with language, disorientation discusses the related researches previously done in this area.
including getting lost, mood swings, loss of motivation, lack of Section III presents the conceptual framework of the system.
self-awareness and overall behavior. Though a limited number The detail implementation of the proposed system is discussed
of IT based solutions exist to provide support for Alzheimer’s in Section IV followed by the evaluation of the system in
patients, but most of these provide very isolated services either for section V. Finally, section VI concludes the article.
the patients or for the caregivers. The objective of this research
is to propose an assistive tool for Alzheimer’s patients and their II. L ITERATURE R EVIEW
caregivers to provide support like health monitoring, assist to
find lost items, provide reminder to take medicine and assist to A significant number of research has been carried on the
monitor patient’s location. A light-weighted evaluation study was design, development and evaluation of the assistive tool for
carried out with 15 participants. The evaluation study showed the special need people, blind persons, aging population, and
that the proposed system was effective and usable for the patients for the Alzheimer’s patients [6]–[9]. This section will briefly
and their caregivers.
Keywords—Alzheimer, mobile application, heart rate, assistive introduce some work focusing to the development of assistive
tool, intelligent system, sensors. tool for Alzheimer’s patients.
A limited number of papers were conducted focusing to
I. I NTRODUCTION mobile applications and software systems. In [10], Yamagat
Alzheimer’s disease is a progressive disease in which et al. showed that tablets and iPads could be utilized with
the destruction of memory cells causes slow depreciation Alzheimer’s patients portraying favorite music and family
in memory, thinking and reasoning skills. A great deal of photographs, as it helped them remember. In another study,
difficulties are faced by an Alzheimer’s patient including short Armstrong et al. [11] highlighted the potential explicit and
term memory loss, aggression, loss of communication skill, implicit interaction techniques for Alzheimer’s patients to
repetitive behaviour, anxiety, agitation etc [1]. receive care using smart phone buttons, touch screens, motion
According to [2], 24.3 million people have Alzheimer’s sensing and voice recognition. Similarly, in [9], Donnelly
disease today, with 4.6 million new cases every year (one et al. developed a mobile application to provide a virtual
new case every 7 seconds). The number of people affected caregiver which would give frequent memory cues through
will get doubled every 20 years to 81.1 million by 2040. The video reminders for mild AD patients. A medicine dispensing
increasing rate of Alzheimer’s patient is not uniform for all system is proposed in [12] that reminded the user to take
over the world. The experts have forecast the increasing rate medicine at the predetermined time interval and informed
by 100% between 2001 and 2040 for the developing countries caregiver if they had taken the medicine or not. Some other
whereas the rate is more than 300% for India, China, and studies [13]–[15] discussed the smart medication systems that
their south Asian and western Pacific neighbors. The number would help patients who require medications several times a
of patients facing dementia caused by Alzheimer’s Disease is day. These devices would deliver medication in the proper
increasing in the entire world including Asian subcontinent chronological order and at correct time intervals.
[3]. Again some studies were conducted focusing on hardware
With the advancement of technology, it is seen that, tech- systems. For example, an IOT based wearable ECG wire-
nology plays a vital role as caregivers for those people who less sensor system was proposed in [16] which monitors
cannot take care of themselves [4], [5]. Therefore, the objective whereabouts of Alzheimer’s patients and triggers alarms to
of this research is to develop an intelligent assistive tool for caretakers in case of emergencies. The use of pervasive
Alzheimer’s patients to ease their daily life by measuring computing technology to provide better live-at home facility
their heart rate, locate their personal belongings, monitor for the elderly citizens are discussed in [17] and [18]. However,
medication taking status and find their current location, while their system neglected the possibility of the outdoor experience
and specific cases of visiting outdoor by the old people. In
 TABLE I
S UMMARY OF PREVIOUS WORKS

References Technology Objective

[9] Internet based technology To give video reminder about daily activities to the patient
Real time clock, timer, sensor to detect presence
[12] To work as a medication reminder and overdose safeguard
of bottle, audible alert
[13] Computer controlled medication dispensing system To ensure the proper medication and timing
[15] Mechanical technology To indicate the number of pills that has been taken
To monitor whereabouts of Alzheimer’s patients and trigger
[16] IOT based wearable ECG wireless sensor
alarm in case of emergencies
Voice interface, smart phone, ultrasonic location To make the patient do their daily works and taking care
[17]
interface of patient’s medication
Multi-agent systems together with the use of RFID To guarantee that patient is getting the right care from
[19]
technology the assigned nurse and doctor
[20] Electronic pedometer To monitor a person’s movement and show heart rate
[21] Sensors, wireless communication To record the patient’s movement and daily behavior
[22] GPS and GSM technology To track the location of patient
[23] Microchip Wireless Technology Tracks patient in a range

[19], researchers presented an autonomous intelligent agent III. C ONCEPTUAL F RAMEWORK

for monitoring Alzheimer’s patient’s health properly. In [20], A conceptual framework was proposed to develop an in-
a fitness monitoring device was proposed that included a telligent assistive tool for Alzheimer’s patients as shown in
wireless heart rate monitor which was coupled to the electronic Fig. 1. The framework consists of four modules: heart rate
pedometer without any wiring. The wireless heart rate monitor monitoring, lost item finder, smart medicine box and lost
provided a heartbeat signal indicative of an exertion level patient locator. The functionalities of these modules can be
of the user, while a visual display was provided to display accessed/used from a single mobile application that can be
the pedometer functions and the heart rate signal. In [21], used by the patient’s caregiver or nurse. Each of these modules
a device was described, which was attached to the patient’s will perform independently to help Alzheimer’s patients.
body, monitoring the movement and behaviour of the patient
and informing the caregivers whenever unexpected or alarming A. Heart Rate Monitoring
incidents occurred. According to [22], real-time GPS-GSM The heart monitoring device allows to monitor the heart
tracking could be helpful for dementia patients to ensure their rate of the patient and notify the concerned person in case
safety when they go outside of their house. In [23], authors of irregular heart rate. If the heart rate of the patient rises
emphasized on memory loss of an Alzheimer’s patient who above a threshold value, the nurse/concerned person will be
tends to forget things and came up with the solution of Wifi informed about the patient’s condition. Based on the situation
and wearable technologies. Google map-based tracking system the nurse will take first aid measures and call on doctor in
and notification to caretaker was an efficient way to help these case of emergency (see Fig. 2).
people.
A summary of the previous works is shown in Table I. B. Lost Items Finder
In sum, the previous studies suggested separate modules to It is hard for Alzheimer’s patients to keep track of their
assist the patients from different angles. It is certain that important things like spectacles, keys, wallet. So, a tracker is
no collaborative system was developed to help the patients attached to their important accessories so that whenever they
integrated with physical health monitoring, smart medication lose something, they can find it using a mobile application
system, smart tracker for lost items and locating patient both which will buzz an alert to that accessory (see Fig. 3).
inside and outside home. In addition, inclusion of caregiver
C. Smart Medicine Box
and smart phones were also missing parts of the puzzle. Thus,
this research aimed to develop an autonomous system integrat- Alzheimer’s patients might forget to take their medicines on
ing all necessary features (constant monitoring, reminder for time. Thus, continuous monitoring of patient’s medication is
taking medicine, monitoring heart condition and finding lost another vital thing. Whenever the patient will take medication,
items) including relatives and caregiver to make Alzheimer’s smart medicine box will activate a WiFi module and send
patient’s life easier. data of medicine intake to server. If the patient does not
take medication on time, then a text alert will be sent to the
concerned person/nurse (see Fig. 4).
 Fig. 1. Conceptual framework of the proposed assistive tool.

D. Lost Patient Locator rate monitor and lost items finder. Fig. 7(a) portrays the home
If Alzheimer’s patient goes out of home unattended, he/she screen of Alzheimer’s assistant application.
might get lost. The GPS-WiFi tracking system will always (a) Patient locator - The GPS tracking system was used to
keep track of the patient’s whereabouts. If the patient goes keep track of Alzheimer’s patient’s movements. The tracking
out of boundary line of the house or is far away from their system was divided into phases. In the first phase, if the patient
caretaker, the caretaker will be notified by a text alert and will goes outside of home with his/her caretaker and gets lost, the
be able to continuously monitor patient’s location through a caretaker can know the patient’s location through a mobile
mobile application (see Fig. 5). application (see Fig. 7(b)). The GPS module continuously
The four individual modules creates such a system envi- fetches the location of the patient with latitude and longitude
ronment for the Alzheimer’s patients so that their medication and sends the data to caretaker’s mobile application via WiFi
and health is on check, they can easily find necessary items if module.
lost and their whereabouts and location can be tracked. It also
TABLE II
helps the caretaker of the patient as the system makes sure the R EQUIRED C OMPONENTS OF THE S YSTEM
patient is always within reach and does not get lost which is
a common scenario in case of Alzheimer’s patient.
Module Components
IV. D EVELOPING T HE A SSISTIVE T OOL Esp8266 12e,Pulse sensor, OLED display,Battery,
Heart Rate Monitor
Wires
The assistive tool was developed in two parts: hardware Esp8266 12e,Servo Motor,Batteries and other
Smart Pill Box
(see Fig. 6) and a mobile application. The required hardware power sources,OLED display,Wires
components are shown in Table II. The Ubidots cloud platform Lost Items Finder
Piezo buzzer, Hc-05 Bluetooth module,Arduino
was used to develop the mobile application. The mobile Uno,Battery
Lost Patient Locator Esp8266 12e,Neo 6m GPS tracker,Battery
application holds the monitoring and assistive control of four
features that include patient locator, smart medicine box, heart
 Fig. 2. Heart rate monitor

Fig. 4. Smart medicine box

Fig. 3. Lost item finder

The second phase is that, if the patient goes outside of their

home alone, the caretaker will be informed through a text alert
and can see the patient’s location through the application. This
is done by an ESP-12E Wifi module which is also connected
to the home Wifi. Whenever the patient steps outside of their Fig. 5. Lost patient locator
home, the Wifi module will try to connect with caretaker’s
mobile network. If it fails to connect, it assumes that the
patient has gone outside alone and so it sends a message to medicine box will automatically open. Also, a buzzer will
the caretaker’s mobile to notify him/her. make sound to remind the patient that it is pill intake time. If
(b) Smart medicine box - A smart medicine box was the patient still does not take medicine, then an alert message
developed to keep track of the pill intakes by the patient. will be sent to patient’s caregiver. After the patient takes
Whenever it is time for the patient to take medicine, the medicine, the box will be closed again. It will again open
 With the help of the application and by following the sound
the lost items can be found.
V. D EMONSTRATION AND E VALUATION
A Focus Group Discussion (FGD) [24] was carried out
to evaluate the performance and usability of the proposed
assistive tool. The FGD session was replicated with randomly
selected 10 final year under-graduate students and 5 faculty
members. During the FGD: firstly, the proposed tool was
demonstrated; after that we gave them opportunity to explore
and use the tool for 20-30 minutes. At the end, partici-
pants were asked to provide their opinion about the system’s
functionality, usability and usefulness. 13 out of 15 (87%)
participants found that the system performs accurately each
function, while all of them (100%) were opined that the system
was easy-to use. Some of them suggested to include more
features related to patient’s health, while few other participants
suggested to improve the safety of the device by putting the
circuits inside a box.

Fig. 6. Hardware parts of the proposed system

VI. C ONCLUSION
In this paper, an assistive tool was designed and developed
for Alzheimer’s patients. In respect to the earlier works,
when the next pill intake time will come. An OLED display this research contributed in two folds: firstly, several features
is also attached with the medicine box that displays the time are integrated in a single system, and secondly, a mobile
remaining for next pill intake. application was developed to utilize those features effectively
(c) Heart rate monitor - The heart monitoring system takes from a single platform. Thus the proposed system provides
the pulse rate of the patient through pulse sensor attached to an integrated round the clock service to the patients both in
patient’s fingertip. If the Heart rate exceeds a threshold value home and outdoor. Alzheimer’s patients and the caregivers of
(e.g. 150 BPM) immediately a message will be sent to the patients will be greatly benefited from the system, since the
caretaker. system will provide support for constant monitoring, provide
(d) Lost items finder - Alzheimer’s patient loses their assistance for taking medicine, look after the heart condition
belongings very easily. The object finder helps the patient to of the patient, and help to find patient’s belongings whenever
find the lost items. If the lost items are at Bluetooth range of needed.
their mobile, the application (see Fig. 7(c)) will ring a buzzer.

Fig. 7. Alzheimer’s assistant app

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