Instrumental Activities of Daily Living (IADL) as a Digital Biomarker of Cognitive Decline in Older Adults (P6-6.003)

Abstract

<h3>Objective:</h3> The aim of this study is to evaluate the feasibility and validate the novel technology-based platform, known as IADLSys, for home-based remote monitoring of IADL. <h3>Background:</h3> Alzheimer’s disease, the most common form of dementia, entails cognitive and functional decline with age. An assessment of instrumental activities of daily living (IADLs) is essential for the diagnosis and staging of dementia. However, the current assessment of IADLs is subjective and cannot be conducted remotely. <h3>Design/Methods:</h3> IADLSys consists of three major components: (1) wireless physical tags (pTAG) attached to objects of interest, (2) a pendant–sensor to monitor physical activities and detect interaction with pTAGs, and (3) an interactive tablet as a gateway to transfer data to a secured cloud. If a pTAG is activated near the pendant and provokes accelerations, the IADL interaction data is recorded via Bluetooth on the pendant sensor. To demonstrate the feasibility of the IADLSys, four sub-studies were conducted: (1) proximity detection test, (2) sensitivity and specificity for detection accuracy, (3) acceptability for the IADLSys, and (4) case report regarding the severity of cognitive impairment in representative two cases. <h3>Results:</h3> IADLSys data were successfully collected under 4.57 m, and the accuracy of IADL detection showed 83.3 to 100.0% in an indoor environment. The acceptability level exhibited agree to strongly agree on the convenience, ease to use, and privacy in five older adults with cognitive impairment. Exploratory tests in two cases with severe and mild cognitive impairment, respectively, revealed that a case with severe cognitive impairment either overestimated or underestimated the frequency of performed IADLs, whereas self-reporting and objective IADL were comparable for the case with mild cognitive impairment. <h3>Conclusions:</h3> The smart-home concept to remotely monitor IADL may assist in providing personalized support to people with cognitive impairment, while tracking the decline in both physical and cognitive function. <b>Disclosure:</b> Dr. Lee has nothing to disclose. Dr. Mishra has received personal compensation for serving as an employee of Biosensics. Dr. York has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for RAD-PD. The institution of Dr. York has received research support from Michael J. Fox Foundation. The institution of Dr. York has received research support from NIH. The institution of Dr. York has received research support from Takeda. Mark Kunik has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for County probate courts and attorneys. The institution of Mark Kunik has received research support from VA. The institution of Mark Kunik has received research support from NIH. Mr. Barchard has received personal compensation for serving as an employee of BioSensics, LLC. Dr. Vaziri has received personal compensation for serving as an employee of Biosensics. Prof. Najafi has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for BioSensics. Prof. Najafi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Mölnlycke Health Care . Prof. Najafi has received intellectual property interests from a discovery or technology relating to health care. Prof. Najafi has received intellectual property interests from a discovery or technology relating to health care. Prof. Najafi has received intellectual property interests from a discovery or technology relating to health care.