High-Accuracy Indoor Positioning and Smart Home Technologies for Assessing and Monitoring Frailty in Older Adults

Frailty assessment and monitoring are essential for supporting independent living and preventing adverse outcomes among older adults. This study aimed to develop and evaluate the concurrent validity of a high-accuracy home-monitoring system for assessing and tracking frailty in older adults. The system integrated off-the-shelf, zero-effort technologies, including ultra-wideband (UWB) indoor positioning, a smart scale, a connected hand dynamometer, and a Bluetooth speakerphone, to measure the five components of Fried's Frailty Phenotype criteria. Twenty-one participants (aged 21-90 years) completed frailty assessments using both traditional clinical measures and the sensor-based system within a simulated home environment within a major rehabilitation hospital. The developed system demonstrated very strong and statistically significant correlations between the sensor-based system and the Fried's Frailty Phenotype criteria, strong correlations with the Clinical Frailty Scale, and moderate-to-strong correlations with the Edmonton Frailty Scale, confirming the system's strong concurrent validity. These findings indicate that high-accuracy, home-based monitoring technologies can provide reliable, objective, and non-invasive assessment of frailty in older adults, supporting early detection and continuous monitoring. This approach shows promise for future integration into smart home environments to enhance proactive frailty management and aging-in-place strategies.