Extended, continuous measures of functional status in community dwelling persons with Alzheimer's and related dementia: Infrastructure, performance, tradeoffs, preliminary data, and promise

Autor: Angela D. Bowhay, Bruce L. Miller, Stephen J. Bonasera, George Netscher, Julien Jacquemot, Alexandre M. Bayen, Michael Schaffer, Bradley Zylstra, Tamara L. Braley, Galen Shen, Katherine L. Possin, A. Katrin Schenk
Rok vydání: 2018
Předmět:
Gerontology
Male
Aging
020205 medical informatics
Applied psychology
02 engineering and technology
Neurodegenerative
Alzheimer's Disease
0302 clinical medicine
7.1 Individual care needs
Health care
Activities of Daily Living
0202 electrical engineering
electronic engineering
information engineering
80 and over
Psychology
030212 general & internal medicine
Reliability (statistics)
Aged
80 and over
General Neuroscience
Middle Aged
Health Services
Mobile Applications
Telemedicine
Scale (social sciences)
Scalability
Neurological
Female
Cognitive Sciences
Independent Living
Smartphone
Lifespace
Alzheimer’s disease
Monitoring
Monitoring
Ambulatory
Article
Smartwatch
03 medical and health sciences
Wearable Electronic Devices
Alzheimer Disease
Clinical Research
Ambulatory
Behavioral and Social Science
medicine
Acquired Cognitive Impairment
Dementia
Leverage (statistics)
Humans
Aged
Neurology & Neurosurgery
business.industry
Neurosciences
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)
Functional status
medicine.disease
Activity
Brain Disorders
Systems architecture
Management of diseases and conditions
Generic health relevance
business
Popis: Background The past decades have seen phenomenal growth in the availability of inexpensive and powerful personal computing devices. Efforts to leverage these devices to improve health care outcomes promise to remake many aspects of healthcare delivery, but remain in their infancy. New method We describe the development of a mobile health platform designed for daily measures of functional status in ambulatory, community dwelling subjects, including those who have Alzheimer’s disease or related neurodegenerative disorders. Using Smartwatches and Smartphones we measure subject overall activity and outdoor location (to derive their lifespace). These clinically-relevant measures allow us to track a subject’s functional status in their natural environment over prolonged periods of time without repeated visits to healthcare providers. Functional status metrics are integrated with medical information and caregiver reports, which are used by a caregiving team to guide referrals for physician/APRN/NP care. Comparison with Existing Methods We describe the design tradeoffs involved in all aspects of our current system architecture, focusing on decisions with significant impact on system cost, performance, scalability, and user-adherence. Results We provide real-world data from current subject enrollees demonstrating system accuracy and reliability. Conclusions We document real-world feasibility in a group of men and women with dementia that Smartwatches/Smartphones can provide long-term, relevant clinical data regarding individual functional status. We describe the underlying considerations of this system so that interested organizations can adapt and scale our approach to their needs. Finally, we provide a potential agenda to guide development of future systems.
Databáze: OpenAIRE
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