The need for early detection and intervention for age-related health deterioration via home-based health monitoring systems is growing with global population aging. Health deterioration is typically evaluated using questionnaires, but obtaining frequent responses is difficult. Although stair walking involving a high physical load is suitable for assessing health deterioration, uniform assessment using home-based systems is difficult because different stair designs result in different movements. There is currently insufficient research on differences in evaluation performance between different stair designs. The current study aimed to develop an objective index to assess difficulties in activities of daily living (ADLs) as an indicator of health deterioration by observing stair walking, and to investigate the effects of stair dimensions on the relationship between the index and health deterioration. We hypothesized that knee joint positions during stair ascent would be associated with health deterioration, and developed the “Stepping in Level” index, reflecting the knee joint position when stepping in, obtained using a markerless depth information-based system. Seventy elderly people ascended two types of stairs (steep: 33.7°; shallow: 28.2°) and completed a questionnaire regarding ADL difficulty. We used a generalized linear mixed model to investigate the ability of “Stepping in Level” to explain ADL difficulty. The results revealed that “Stepping in Level” was able to explain ADL difficulty, and steep stairs were more suitable than shallow stairs for assessment. Our system enables daily assessment of difficulty in ADLs and detection of subtle changes in daily life. The current findings could inform design guidelines for health monitoring.
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