Feasibility of the CART In‐Home Technology Platform in a Pilot Study of Hispanic Older Adults Residing in South Texas

Abstract

AbstractBackgroundAs Alzheimer’s disease (AD) prevalence rises, the development of effective screening tools is necessary to aid in earlier AD diagnosis. In the USA, Hispanic and Non‐Hispanic Black adults are at a disproportionately higher risk of developing dementia than non‐Hispanic whites but are poorly represented in AD research. A digital assessment system ‐ the Collaborative Aging Research using Technology (CART) platform, has been developed to remotely and continuously detect early declines in cognition by analyzing changes in everyday activity levels. Although the platform is promising, installing digital technology in a home can cause concerns over privacy and user friendliness, especially in older adults. In our CART pilot study at UTHSCSA, we sought to determine the feasibility of deploying the CART platform in an underrepresented, mostly Hispanic population and to gain insight from their experiences.MethodSeven cognitively intact participants were enrolled in our year‐long pilot study. The CART platform consisted of a watch‐actigraph, digital scale, electronic pillbox, bed mat (measuring sleep), and wall‐mounted motion sensors. Participants completed weekly online surveys including mood assessments, the UDS3 neuropsychological battery at baseline and one‐year follow‐up, and an end‐of‐study user experiences survey. Wilcoxon signed rank exact tests were used to determine significance.ResultOur cohort consisted of five Hispanic, one non‐Hispanic Black, and one non‐Hispanic white participant, ages 65‐80. There were no significant changes in cognition, daily steps, sleep, weight, or heart and respiratory rate measured during sleep over the course of the study (p>0.05). Self‐reported depressive symptoms decreased (p = 0.034) (Figure 1J). Weekly survey results supported this finding because self‐reported feelings of loneliness and “blue mood” also decreased. Responses to the user experience survey demonstrated that participants found the technology installation satisfactory (43%) or very satisfactory (57%) and thought that their privacy concerns were addressed satisfactorily (43%) or very satisfactorily (57%) (Figure 2).ConclusionOur results suggest that the CART platform was widely accepted by our mostly Hispanic older adult participants and that they were comfortable with the study devices. The findings support the feasibility of increasing representation of diverse older adults in dementia prevention research using digital devices.