Sharing History through Active Reminiscence and Photo‐imagery‐SHARP: Feasibility and acceptability of digital biomarker technology among older Black adults

Abstract

AbstractBackgroundMore nuanced data collection beyond pre/post measures can detect real‐time changes in activity levels, sleep, and other factors that may signal transition in cognitive health.MethodNine Black adults (n = 4 healthy, mean age 71.1; n = 5 mildly cognitively impaired (MCI), mean age 79.2) tested the feasibility of adding digital biomarker technology to the SHARP walking study in Portland, Oregon. Up to 8 weeks, participants wore an actigraphy watch that captured continuous activity data, used an under‐the‐mattress sensor that captured daily sleep data, and completed online health forms that captured weekly changes. The second 4‐8 weeks and in triads, participants walked and conversationally reminisced together on three 1‐mile routes/week using the SHARP smartphone application. Means were calculated from group aggregated data (MCI/healthy). Content analysis of group discussions assessed technology acceptability.ResultWatch step data was collected on average 60.4±51.2 days per participant, representing on average 75.0±29.2% of the days step data was collected. Watch sleep data was collected on average 47.6±40.5 days per participant, representing on average 62.5±33.7% of the days sleep data was collected. Under‐the‐mattress sensor sleep data was collected on average 79.3±42.9 days per participant, representing on average 79.0±24.8% of the days sensor data was collected. MCI participants had lower mean daily step count at 1140 compared to 2570 steps for healthy participants, and lower mean sleep time at 5.07 hours compared to 6.71 hours for healthy participants. MCI had lower mean survey response rates, even with weekly reminders, at 60% compared to 91% for healthy participants, and notably longer mean response times at 472 seconds compared to 195 seconds for healthy participants. Participants generally accepted technology, with caveats: more explanation of technology, better watch step count displays, and watch band options as silicone was uncomfortable in heat and water, prompting discontinuous wear.ConclusionUsing digital biomarker technology for more continuous data capture with older adults including those with MCI is feasible. However, teams should anticipate increased support for MCI participants and potentially longer technology deployment and set‐up. More continuous data reveal real‐time changes that may signal transitions in cognitive health, allowing for a timelier response from healthcare partners.