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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Using multi-sensor tracking data to analyze the mobility and activity behavior of older adults</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Hoda Allahbakhshi</string-name>
          <email>Hoda.Allahbakhshi@geo.uzh.ch</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Robert Weibel</string-name>
          <email>Robert.Weibel@geo.uzh.ch</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>University of Zurich, Department of Geography</institution>
          ,
          <addr-line>Winterthurerstrasse 190, 8057 Zurich</addr-line>
          ,
          <country country="CH">Switzerland</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>The increase in the older adult population has been occurring at unprecedented and accelerating rates in recent decades.Healthy ageing as the process of maintaining the functional mobility is therefore important. In order to understand how functional mobility in daily life is associated with health in older adults, such behaviour needs to be studied in real-life conditions, which can be done using sensor-based ambulatory assessment methods. The aim of this study is to contribute to developing a full, individualized description of human mobility behavior considering different spatio-temporal patterns, and link such personal mobility profiles to psychological resources available to an individual. The participants are healthy older adults above 65 years old from MOASIS study, who will collect the data during 4 weeks of their everyday life. The multi-sensor data will be used for the movement analysis. Pattern recognition and classification algorithms are proposed methodologies to achieve the aim of this study. This paper is quite useful for understanding of individual movement through the use of new sensing devices.</p>
      </abstract>
      <kwd-group>
        <kwd>movement analysis</kwd>
        <kwd>ambulatory assessment</kwd>
        <kwd>real-life</kwd>
        <kwd>older adults</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>-</title>
      <p>
        Projections indicate that by 2050 the elderly population will
reach 2 billion people worldwide (Toledo &amp; Barela, 2010)
Along with these demographic changes, medical conditions
associated with aging will represent a burden to society, for
example by an increase in demand for health services. Because
older adults demand more from the health service
infrastructure, efforts have been made to understand the factors
that contribute to healthy aging (Toledo &amp; Barela, 2010). The
WHO, in its “World Report on Ageing and Health”, defines
healthy aging as the process of maintaining the “functional
ability” of individuals through a dynamic interplay between an
individual’s biological and physiological endowments,
abilities, skills, diseases, subjective evaluations, traits,
environments, and real-life activities
        <xref ref-type="bibr" rid="ref21">(Sugawara &amp; Nikaido,
2014)</xref>
        .
      </p>
      <p>To describe and analyse functional mobility, then, one needs
to measure all mobility-related biological and physiological
endowments, mobility-related abilities, skills, diseases,
subjective evaluations, traits, contexts, and activities, as
potentially these are all equally relevant parts of an individual’s
functional mobility profile, uniquely characterizing an
individual. Research on some of these elements of a mobility
profile has been carried out in mobility laboratories or in
clinical and experimental studies. The advantages of laboratory
experimentation have a price, however, as the laboratory
setting by definition isolates research participants from their
everyday concerns and activities and subjects them to an
artificial environment in which nearly all contextual factors –
for example physical features, goals, or other persons involved
– are determined by the experimenter (Mehl &amp; Conner, 2012).</p>
      <p>In field settings (i.e. real-life contexts), in contrast, the
physical and social environment is substantially cluttered,
people must choose for themselves which tasks to pursue and
how to engage them and the option of changing the setting and
tasks is usually available. All of these can, of course, alter the
results of the research (Mehl &amp; Conner, 2012). In essence, we
find the inverse of the laboratory situation, that is, a high
ecological validity of the results at the price of reduced internal
validity.</p>
      <p>
        There is some flexibility in what counts as a method for
studying daily life. Among the terms used for studying daily
life we find, among others, the term ambulatory assessment
(AA). Alternative labels for this methodology are ecological
momentary assessment and experience sampling methodology
        <xref ref-type="bibr" rid="ref4">(Brose &amp; Ebner-Priemer, 2015)</xref>
        .
      </p>
      <p>The aim of this study is by utilizing ambulatory assessment
methods to contribute to developing a full, individualized
description of human mobility behavior considering different
spatio-temporal patterns, and link such personal mobility
profiles to psychological resources available to an individual.
To do so, we aim to address the following research questions:</p>
    </sec>
    <sec id="sec-2">
      <title>What are the main movement behaviors expressed in people’s movement using multi-sensor data?</title>
    </sec>
    <sec id="sec-3">
      <title>What types of movement patterns do the individuals show considering different temporal granularities (daily, weekdays, weekends, and particular days, weekly)?</title>
    </sec>
    <sec id="sec-4">
      <title>To what extent does context/environment play a role in the human movement behavior at the micro and macro level? And can we find patterns that match certain psychological trait.</title>
      <p>2</p>
      <sec id="sec-4-1">
        <title>Background</title>
        <p>
          The WHO in its “World Report on Ageing and Health” defines
healthy aging as the process of maintaining the “functional
ability” of individuals through a dynamic interplay between an
individual’s biological and physiological endowment
          <xref ref-type="bibr" rid="ref21">(Sugawara &amp; Nikaido, 2014)</xref>
          . Therefore, on the one hand, to
describe and analyse functional mobility, one needs to measure
all mobility-related biological and physiological endowments,
and on the other hand, to achieve the ecologically valid
measurements needs considering real-life contexts, which can
be realized using ambulatory assessment methods. Most
existing examples of ambulatory assessment fall into one of the
two broad categories below:
        </p>
        <p>
          The first and most common category includes self-reports.
Self-reports provide information that no one but the respondent
knows including goals, emotions, thoughts etc., which is why
many theories about human behavior and interventions focus
on them
          <xref ref-type="bibr" rid="ref20 ref20 ref4 ref4">(Brose et al. 2015; Ebner-Priemer et al., 2013a;
EbnerPriemer et al., 2013b; Niermann et al., 2016)</xref>
          .
        </p>
        <p>
          The second and newer category includes more technically
oriented methods for capturing diverse, non-self-reported
aspects of everyday experience, such as the auditory
environment, physiological status, the physical location or
proximity to particular other persons etc., all of which can be
provided by using different sensors including Bluetooth, RFID,
GPS, accelerometer, heart rate sensors, audio sensors, etc.
These instruments provide extensively detailed data that can be
used to examine the operation of social, psychological, and
physiological processes within their natural contexts
          <xref ref-type="bibr" rid="ref17 ref22 ref27">(Verlaan
et al., 2015; Zisko et al., 2015; Reichert et al., 2016)</xref>
          .
        </p>
        <p>
          There is much research that shows that two of the most
frequent sensors used in movement analysis are GPS and
accelerometer
          <xref ref-type="bibr" rid="ref11 ref20">(Kaghyan 2013; Spink et al. 2013)</xref>
          . In addition
to sensing different aspects of a person’s life (GPS = position,
spatial activity; accelerometer = physical activity), each of
these two sensors also provides us information about different
scales of movement. For example, by extracting information
from an accelerometer we may explore human activity at the
micro-scale (e.g. physical activity mode, body motion, number
of steps, gesture change, intensity, duration, etc.), while by
analyzing GPS data we get to know about the macro-scale of
human movement (e.g. point of interest, transportation modes,
displacement, speed, etc.).
        </p>
        <p>Using GPS devices and accelerometers together provides the
most complete information about human mobility in
community environments. Although combined GPS and
accelerometer technologies have been used successfully to
gather detailed information about discrete bouts of outdoor
activity (physical endeavors, as well as driving), the same
success has not been realized in studies that have attempted to
monitor functional everyday human movement over an
extended period of time. These technologies, however, would
offer the potential to accurately monitor mobility patterns in
older adults (Webber &amp; Porter, 2009).</p>
        <p>
          In order to study the movement behavior of moving objects,
it is important to understand what types of movement patterns
can be identified from their movement (Dodge et al. 2008).
Among different movement pattern detection methods,
periodic pattern mining (PPM) can be used for discovering the
intrinsic behavior of moving objects, compressing movement
data
          <xref ref-type="bibr" rid="ref1">(Agrawal &amp; Srikant, 1995)</xref>
          , predicting future movements
of objects (Jeung et al. 2008), and detecting abnormal events.
Mining periodic behaviors can bridge the gap between raw data
and semantic understanding of the data
          <xref ref-type="bibr" rid="ref14">(Li et al., 2010)</xref>
          .
        </p>
        <p>
          It is difficult to study human mobility without considering its
temporal nature. It has been shown that both the ordering of
visits and the timing of visits
          <xref ref-type="bibr" rid="ref19">(Song et al. 2010)</xref>
          contains
information that can be used to build powerful predictors of
future behavior. Furthermore, human behavior is driven by
daily and weekly routines (
          <xref ref-type="bibr" rid="ref18 ref26">(Williams et al., 2012; Scellato et
al., 2010)</xref>
          . Although this form of temporal structure is a rich
source of information about individual behavior, there has been
little work to examine the regularity in individual visiting
patterns. Factors such as wealth, profession, lifestyle, and
health affect an individual’s routine, and therefore his or her
mobility patterns. This is likely to give rise to diversity in the
population’s visiting patterns and regularity
          <xref ref-type="bibr" rid="ref26">(Williams et al.
2012)</xref>
          .
        </p>
        <p>The literatures show that there is still little research on using
real-life datasets for movement analysis and compared to
selfreported ambulatory assessment using sensor-based
ambulatory assessment in mobility and activity analysis is
limited. Considering temporal information in human
movement pattern is also a topic that requires further studies.
3</p>
      </sec>
      <sec id="sec-4-2">
        <title>Dataset</title>
        <p>The Mobility, Activity and Social Interaction Study (MOASIS)
collects individualized everyday-life health-related data in
older adults. MOASIS started in August 2015 and ultimately
aims to develop computational models to measure, analyze, and
improve health behaviors and health outcomes in the everyday
life of aging individuals (Bereuter et al., 2016). The mobile
sensor uTrail is used for the data collection, assuming no prior
technical knowledge by the participants. uTrail, a tracker
specifically developed for this study, measures the mobility
(spatial activity) with GPS, physical activity with a 3-axis
accelerometer and social interaction with a microphone using
the electronically activated recorder (EAR) method (Mehl &amp;
Conner, 2012).</p>
        <p>The MOASIS initialization phase started in November 2015
including initial device testing and ethical approval. After that
a first pilot study with 5 participants during 14 days took place
in December 2015, focusing primarily on testing and
improving the sensor device.</p>
        <p>The second pilot study ran from March to April 2016 with 27
participants during 30 days. Further testing and refinement of
the device, as well as the data collection protocol sampling
rates, and observation length were included in this stage. The
main data collection with 150 participants during 30 days will
take place in the first half of 2018.</p>
        <p>The impact of context on behavior is fundamental. To
understand behavior, one had to first understand what sorts of
behavior the setting – its context – was likely to evoke. Thus,
there is a need to identify regularities in the properties of
behavior setting (e.g. home, social activity places, medical
offices or roadways) and the behavioral patterns that they evoke
(Mehl &amp; Conner, 2012).
4</p>
      </sec>
      <sec id="sec-4-3">
        <title>Proposed methodology and discussion 5 References</title>
        <p>To address the research questions, the methodologies below are
proposed:</p>
        <p>1. What are the main movement behaviors expressed in
regular patterns of people’s movement using multi-sensor data
and how do they interrelate with each other?</p>
        <p>Travel behavior and physical activity (PA) are two important
movement behaviors in older adults’ daily routine. To figure
out how variable or predictable older adults are in their
routines, one way is to investigate their movement patterns by
answering the questions of when, how and where they go
during the day (travel behavior) and what they do meanwhile
(physical activity). Having this, the association between
movement patterns and the way it affects older adults’ physical
and mental well-being can be distinguished.</p>
        <p>2. What types of regular or irregular patterns do the
individuals show considering different temporal granularities
(daily, weekdays, weekends, and particular days, weekly)?</p>
        <p>
          In order to study the movement behaviors of moving objects,
it is important to understand what types of movement patterns
can be identified from their movement. A considerable number
of works have shown that human mobility is regular,
predictable and unique in both the temporal and spatial domains
          <xref ref-type="bibr" rid="ref13 ref20 ref23">(De Montjoye et al., 2013; Kim et al. 2007; Wang et al. 2011)</xref>
          .
Observable regular movements among a few frequented
locations, such as home and work
          <xref ref-type="bibr" rid="ref14 ref5">(Eagle &amp; Pentland, 2009; Li
et al., 2010)</xref>
          embody the regularity and predictability of human
mobility.
        </p>
        <p>
          It is claimed that human trajectories show a high degree of
temporal and spatial regularity, each individual being
characterized by a time independent characteristic travel
distance and a significant probability to return to a few highly
frequented locations (
          <xref ref-type="bibr" rid="ref15">Liang et al. 2012</xref>
          ;
          <xref ref-type="bibr" rid="ref10">González et al., 2008</xref>
          ).
Even older adults without cognitive problems feel safer and less
anxious when they do not have to worry about ‘the unknown’
or what is coming next
          <xref ref-type="bibr" rid="ref16">(Lythgoe, 2016)</xref>
          in their mobility. It is
easier to cope with memory and cognitive issues when as many
activities as possible are predictable. Even though a person with
cognitive problems might not be aware of the routine or even
of the time passing, having a routine helps them feel more
grounded and secure
          <xref ref-type="bibr" rid="ref16">(Lythgoe, 2016)</xref>
          , and consequently
maintain their mental health. The one way to address this
research question is to apply human movement pattern
recognition methods and see what types of patterns could be
derived from the dataset considering temporal information.
        </p>
        <p>3. To what extent does context/environment play a role
in the human movement behavior at the micro and macro level?
And can we find patterns that match certain psychological
traits?</p>
      </sec>
    </sec>
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