Precise Wearable System for Accurate Continuous Gait Monitoring to Indicate Health Decline in Black Adults with Alzheimer's Disease and Related Dementias

Project Abstract Roughly 6.9 million Americans over age 65 have Alzheimer’s disease and related dementias (ADRD). Black Americans have ADRD at twice the rate of White Americans. Many Black adults are underdiagnosed or diagnosed later in disease progression, which limits their treatment and support options. As well documented disparities in healthcare and clinical access show, Black adults also have less in-home caregiving, resulting in less monitoring of individuals’ health status, greater caregiver burnout, higher costs, and worse health outcomes. Current methodologies for treatment of Alzheimer’s disease (AD) indicate the critical importance of ongoing monitoring of functional status and disease progression to inform care and intervention decisions. Therefore, capabilities for continuous assessment in the home with remote clinician access to these insights are being pursued to help clinicians responsively target appropriate approaches to care for more patients. Gait measures such as stride and speed are exemplary in predicting ADRD risk, health decline, and mortality. However, current methods to measure gait require a clinic visit and dedicated laboratory hardware, exacerbating healthcare disparities. Recent gait measurement and analysis systems show promise, but are not designed for easy, long-term, and home-based telehealth, and would neither be accepted by patients with Mild Cognitive Impairment (MCI) or ADRD, nor alleviate access disparities. There exists an unmet need to provide a precise monitoring sensor solution optimized to measure gait patterns throughout the day that would assist medical professionals and caregivers with an early indication of health decline in older Black adults. ASTER Labs, Inc. proposes to design and construct a novel, unobtrusive device to continuously measure and analyze the precise relative ranges between the feet, gauging gait during ambulation. The data will be shared with clinicians to monitor patients for subtle or sudden changes indicating increased risk of AD onset, declining health, or mortality. This practical, real-time, low-cost solution will easily operate within the familiarity of patients’ homes to enhance the accuracy and availability of patient health metrics to caregivers, and improve care and treatment planning. The system will be informative in course of care decisions between patients, caregivers, and clinicians. The wearable device is discrete and comfortably worn as an insole in the patient’s shoe. The system design uses an innovative set of radio frequency and magnetic field sensors integrated with patented relative foot positioning algorithms that will provide continuous and precise results compared to current capabilities. This novel, technically-advanced gait evaluation solution will provide Black persons with dementia (PWD) and their care providers with regular on-demand access to accurate and comprehensive information that can enable choices on interventions and improve quality of life.