An Innovative Platform for Objective Monitoring of Instrumental Activities of Daily Living

ABSTRACT With a Phase I II STTR grant award from NIABioSensics in collaboration with Baylor College of MedicineBCMsuccessfully developed and commercialized an advanced physical activity monitoring systemPAMSysfor older adultsPAMSys enables continuous remote monitoring of physical activityfall riskand fall incidentsThe fall detection technology of PAMSys has become the gold standard in the medical alert industry through multiple licensing agreementsTo datemore thanmedical alert devices with BioSensics technology have been sold by our licensing partnersHoweverPAMSys is not capable of monitoring Instrumental Activities of Daily LivingIADLsuch as cookingshoppingand managing medicationMonitoring IADL is essential for timely diagnosis of dementiamonitoring disease progressionand determining when additional care services are neededIn one of our pilot clinical studies using PAMSyswe identified specific activity patternse gtransitions between different posturesshort walking boutsin individuals with cognitive impairment who were monitored during activities of daily livingIn additionBioSensics has developed an initial prototype of a smart wireless devicecalled CliQthat enables interactions with objects at homewhile also simplifying the user interaction with smart home devices and smartphone appsArmed with this technical expertise and pilot clinical datawe propose to design and commercialize a platform for continuous monitoring of IADLThis innovative solutioncalled IADLSysis based on the following three technologies that will work collectively to provide crucial insight into deterioration in cognitive status and trajectory toward loss of independencewireless tags that are attached to various objects of interest in the user s living environmenta wearable sensor that measures physical activityas well as proximity to the wireless tagsandsoftware that unobtrusively monitors the usage of applications associated with daily functioning and social engagement to provide a picture of the user s virtual IADL to complement the monitoring of their physical IADLusage time onlyno private application data is monitoredIADLSys also includes a hub to transfer all data to a secure backend server that will be used for data storage and processingIn Phase Iwe will design an initial version of IADLSys and examine the feasibility of the proposed platform for identifying IADL of interestincluding using a telephonepreparing a mealdoing laundrytaking medicationvacuumingand others in the target populationIn Phase IIwe will complete the development of IADLSys including implementation of live uploading protocols and the cloud computing backend to host collected dataA robust data security architecture will be implemented to protect patient s privacyIn additionwe will carry out a clinical study to evaluate if the data gathered and analyzed by IADLSys can discriminate those with Mild Neurocognitive Disorderpreviously termed Mild Cognitive Impairmentand Major Neurocognitive Disorder due to Alzheimer s DiseaseADwith mild severityfrom cognitively intact aged matched healthy individuals Project Narrative Assessment of Instrumental Activities of Daily LivingIADLincluding cookingshoppingand managing medication is essential for timely diagnosis of dementiamonitoring disease progressionand determining when additional care services are neededTypicallyIADL assessments are subjectiveonly done at initial diagnosisand rarely performed remotelyThis grant application proposes the design and commercialization of a robust platform for objective and continuous remote monitoring of IADL in older adults at risk for dementia or Alzheimer s disease