Assessing Physical Frailty and Fall-Risk Indicators with Social Robots: An in situ Evaluation with Older Adults

Abstract

Frailty assessments are crucial to evaluate the risk of adverse events and the health and social care needs of older adults, yet their administration remains resource-intensive and typically relies on coarse clinical outcomes, such as task completion times, which may overlook biomechanical indicators of functional decline. To address this, we present a robotic framework that guides older adults through standardised frailty and fall-risk tests while capturing clinical scores and additional frailty-related metrics, offering a deeper insight into a user's condition. The system uses a Behaviour Tree architecture that coordinates perception, decision-making, interaction, and measurement modules. Using vision-based skeleton tracking, the robot evaluates established clinical tests, including the Short Physical Performance Battery (SPPB) and the Timed Up and Go (TUG). The framework was co-designed with healthcare professionals and evaluated in situ during six months in a rehabilitation centre's research lab with N=81 older adults. Robot-derived measurements were compared against therapist assessments and clinical reference instruments, including a gait analysis walkway and an inertial measurement unit (IMU). Results showed excellent agreement for most test completion times and gait-related parameters ($ICC > 0.9$). And, substantial agreement for the overall SPPB score comparing the robot and the therapist ($k = 0.67$) and moderate agreement comparing the robot and the IMU ($k=0.55$). The findings highlight that social robots can provide reliable and objective frailty assessments in healthcare settings while enabling the collection of relevant mobility indicators beyond conventional outcomes.