COVID-19 Early Detection Tool for Elder Abuse during Epidemics, Digital Analysis of Color Tone on the Surface of the Skin in Elderly People

The purpose of this study was to attempt a digital analysis of body color tone of elderly subjects, thus demonstrating that nurses and caregivers can easily and reliably record changes in body color tone. This cross-sectional study took place between April 1, 2017 and March 31, 2019. A workshop was set up where observers received explanations from researchers on how to use color charts and recording forms. Measurement instruments (digital cameras) were also standardized in this effort. While the elderly subjects targeted by this study suffered from dementia, they were able to converse and understood the purpose of the study, and the study was conducted with their and their families’consent. In addition, after receiving approval from a research ethics examination from an affiliated university, the target facility gaining this consent was subjected to an ethical review, after which we implemented the study in accordance with ethical guidelines for medical research on humans. Consent was obtained from 30 subjects (20 female (66.7%), 8 male (26.7%) and 2 for which the gender was unknown; average age- 87.8 years (minimum 80 years, maximum 100 years)). We were able to perform digital image analysis of the lesion site and unaffected parts, and present numerical values. Evaluations by observers were significantly different depending on the individual, and subjectivity greatly influenced comparisons with the color chart based on visual evaluations. It was confirmed that numerical evaluation of images taken in hospitals and nursing homes could also be performed using general-purpose software.