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Background: Out-of-home mobility refers to the realization of trips outside the home, by foot or by other means of transportation. Although out-of-home mobility is important for the well-being of older people with cognitive impairment, its importance for their caregivers is not clear. This study aims to clarify the relationship between caregiving burden and out-of-home mobility of care-recipients using Global Positioning Systems (GPS) technology.Methods: Seventy-six dyads (care-recipients and caregivers) were recruited from a psychogeriatric center, where they underwent cognitive assessment, followed by psychosocial interviews at home. Care-recipients received GPS tracking kits to carry for a period of four weeks, whenever they left home. Mobility data and diagnostic and psychosocial data were examined in relation to caregiver burden.Results: The strongest predictors of burden were care-recipients' lower cognitive status and more time spent walking out-of-home. An interaction was found between cognitive status and time spent walking in relation to caregiver burden. The relationship between walking and burden was stronger among caregivers of care-recipients with dementia than caregivers of care-recipients with no cognitive impairment or mild cognitive impairment. Care-recipients' behavioral and emotional states were also positively related to caregiver burden.Conclusions: The findings stress the importance of maintaining older persons' out-of-home mobility during cognitive decline. [ABSTRACT FROM AUTHOR]

Abstract Background One of the more common behavioral manifestations of dementia-related disorders is severe problems with out-of-home mobility. Various efforts have been attempted to attain a better understanding of mobility behavior, but most studies are based on institutionalized patients and the assessment usually relies on reports of caregivers and institutional staff, using observational approaches, activity monitoring, or behavioral checklists. The current manuscript describes the research protocol of a project that measures mobility in Alzheimer's disease and related cognitive disorders in an innovative way, by taking advantage of advanced tracking technologies. Methods/design Participants are 360 demented persons, mildly cognitively impaired persons, and unimpaired controls aged ≥ 65 in Israel and Germany. Data regarding space-time activities will be collected via a GPS tracking kit for a period of 4 weeks in 3 waves (one year apart) with the same participants (using a repeated measures design). Participants will be interviewed by use of a battery of instruments prior to and following GPS data collection. Further, a family member will complete a questionnaire both before and after data tracking. Statistical analyses will strive to explain differences in mobility based on a wide range of socio-structural, clinical, affect-related and environmental variables. We will also assess the impact of the use of advanced tracking technology on the quality of life of dementia patients and care givers, as well as its potential as a diagnostic tool. Systematic assessment of ethical issues involved in the use of tracking technology will be an integral component of the project. Discussion This project will be able to make a substantial contribution to basic as well as applied and clinical aspects in the area of mobility and cognitive impairment research. The innovative technologies applied in this study will allow for assessing a range of dimensions of out-of-home mobility, and provide better quality data.

Background: The issue of using advanced tracking technologies such as Global Positioning Systems (GPS) is part of a wider debate on the acceptability of assistive technology to older people with dementia. The use of GPS can enhance the personal safety of older people by alerting caregivers to potential dangers or adverse events that might threaten the individual's health and safety, but at the same time it raises ethical concerns. This study examines the attitudes of cognitively intact older people toward the use of tracking devices for people with dementia., Methods: The analysis is based on quantitative data from a convenience sample (n = 42) and qualitative data gathered from two focus groups of cognitively intact older people in Israel., Results: Whereas cognitively intact older people clearly differentiate between themselves and people with dementia, they support the use of tracking devices when dementia is either formally diagnosed or its signs are evident. They value the safety of people with dementia above preserving their autonomy. Although they perceive the decision to use tracking devices as an intra-family issue, they expect guidance from professional caregivers of people with dementia. The acceptability of tracking devices is dependent on their appropriate weight, size and ease of use., Conclusions: Cognitively intact older people favor the idea of tracking people with dementia. To facilitate family decision-making on the use of tracking devices, structured meetings guided by professionals and including persons with dementia and their family caregivers are suggested.