Development of novel digital biomarkers for proactive detection and treatment of functional decline

PROJECT SUMMARY By age sixty-five, 1 in 4 Americans will experience functional decline, a “silent killer” defined by life altering loss of independence and limitations performing activities of daily living (ADLs). Poor health outcomes and skyrocketing costs linked to functional decline cut across many diagnoses, leading to national expenditures projected to exceed $1 trillion annually. Routine functional screening assessments are the gold-standard for addressing this condition. However, due to numerous barriers, most older adults are cared for in settings where screening is poor, inaccurate, or not conducted at all. As a result, functional decline often goes unnoticed until obvious disability and adverse outcomes occur. Leaders in geriatrics have long recognized obstacles addressing functional decline and have called for improved screening and treatment approaches. Meanwhile, ownership, adoption, and usage of digital devices has climbed sharply among older adults, particularly during the pandemic. Smyl Fitness Rx, LLC (Smyl) has identified a novel method to use these devices to address functional decline. This Phase I SBIR proposes development of a mobile application powered by technology that will offer a scalable solution to automate functional screening assessments, compute novel digital biomarkers of functional decline, and deliver evidence-based fitness prescriptions with behavior modification features to facilitate ongoing treatment and prevention. Smyl developed a framework for the application in consultation with key opinion leaders from the American Medical Association’s (AMA’s) Exercise Is Medicine (EIM) advisory board been and tested it with older adults. Commercialization will focus on addressing key pain points and unmet needs identified during Smyl’s market research. Aim 1 will focus on developing machine learning models that use computer vision technology to automate routine functional assessments. Computer vision technology has shown to be effective for use among older adults, including those with dementia. Aim 2 will consist of developing analytic models that use parameters from the automated assessment to compute novel digital biomarkers of functional decline. These digital biomarkers will indicate the presence or future risk of functional decline, ongoing severity, and response to treatment. In Aim 3 Smyl will develop a movement quality and fitness prescription model to facilitate safe and effective exercise prescriptions shown to address functional decline. Phase II efforts will focus on optimizing the technology for home use, developing data-driven fitness prescriptions, and enhancing the platform for use among people living with Alzheimer's disease and Alzheimer's disease-related Dementias (AD/ADRD). The scientific and technology developments of this project have the potential to impact over 34 million middle and older age adults. Implementation of the proposed innovation could reduce the loss of independence, poor health outcomes, and skyrocketing health costs associated with functional decline.