A practical platform for in-home remote monitoring of cognitive-frailty

AbstractCognitive frailtythe combined presence of physical frailty and cognitive impairmentis a strong and independent predictor of cognitive declineThe International Association of Gerontology and Geriatrics and the International Academy on Nutrition and Aging have recommended the use of cognitive frailty assessment to track the progression of mild cognitive impairmentMCItowards dementiaAlzheimerandapos s diseaseADand loss of independenceHoweverthere is no practical assessment tool for measuring cognitive frailty remotelysuch as during a telehealth visitTelehealth video conferencing between patient and physician is growing in popularityis increasingly accepted by healthcare payersand is especially attractive to older adults who may not easily be able to travel to the clinicThereforethere is an unmet need for a software based solution for remote assessment of cognitive frailty that can be integrated into existing telehealth systemsBased on a Direct Phase II SBIR grant award from the National Institute on AgingNIABioSensics LLC and Baylor College of Medicine developed and commercialized Frailty MeterFMa novel wearable technology for frailty assessmentFM works by quantifying frailty phenotypes including weaknessslownessrange ofmotionand exhaustion during asecond rapid repetitive elbow flexion extension taskWhen applied under dual task conditionse gwhile performing a working memory taskFM can be used to assess cognitive impairmentFM is well suited for use in a clinical environment because it is simple to administer andunlike other measures of frailtyit does not require a walking testHoweverbecause FM is based on wearable sensors there are technicallogisticaland cost associated challenges associated with its usage in a telehealth settingTo address these limitationswe propose to develop a video based solution that uses image processing algorithms to replicate the measurements taken by the wearable sensor in FMTo increase market penetrationthis software solution will be provided as a plug in module that developers can easily integrate into their video based telehealth platformregardless of whether the system runs on a tablet or a custom developed telehealth kioskDuring Phase Iwe will develop image processing algorithms to enable real time motion tracking of the upper arm and forearm during the FM taskFrom this data we will extract elbow rotational velocitythe measurement needed for FM analysisand validate this measure against the sensor based deviceWe will also develop a prototype tablet platform for video conferencing and remote cognitive frailty assessment that we can use in our planned clinical studies during Phase IIThe clinical studies in Phase II will validate the effectiveness of this platform for tracking longitudinal changes in cognitive motor impairment as a marker of dementia severity and the progression from MCI toward AD Project Narrative Cognitive frailtythe combined presence of physical frailty and cognitive impairmentis a strong and independent predictor of cognitive decline over timeHoweveravailable screening tools are either unable to monitor cognitive frailty or are impractical for clinical useparticularly in a telehealth settingThis application proposes a practical and easy to use platform for in home remote monitoring of cognitive frailty and its subtle changes over time based on a simple and clinically validated dual task elbow flexion extension test