Monitoring Health in Older Adults Using mHealth Technology: Framingham Offspring Study

使用移动医疗技术监测老年人的健康状况：弗雷明汉后代研究

• 批准号: 10627872
• 负责人: JOANNE M MURABITO
• 金额: $ 62.58万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10627872
• 关键词: Adherence; Adult; Affect; Age; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Anxiety; Apple watch; Behavior; Brain; COVID-19; COVID-19 pandemic; Cellular Phone; Clinical; Cognition; Cognitive; Cognitive deficits; Cohort Studies; Communities; Data; Dementia; Devices; Digital biomarker; Elderly; Electronics; Eligibility Determination; Event; Fatigue; Framingham Heart Study; Fright; Health; Health Technology; Health behavior; Heart Rate; Hippocampus; Home; Hospitalization; Impaired cognition; Individual; Knowledge; Language; Life; Link; Magnetic Resonance Imaging; Maintenance; Measures; Memory; Methods; Monitor; Moods; Motor Skills; Neuropsychological Tests; Older Population; Outcome; Pain; Participant; Patient Outcomes Assessments; Personal Satisfaction; Persons; Phenotype; Physical Performance; Physical activity; Physical assessment; Pilot Projects; Population; Prevalence; Public Health; Recommendation; Research; Research Personnel; Rest; Risk; Risk Factors; Sleep; Social Distance; Social isolation; Social support; Surveys; System; Task Performances; Technology; Visuospatial; White Matter Hyperintensity; adverse outcome; aged; aging brain; brain health; brain magnetic resonance imaging; brain volume; cardiovascular health; cognitive function; cohort; digital; digital measure; disorder risk; executive function; experience; falls; frailty; heart rate variability; high risk; innovation; insight; mHealth; magnetic resonance imaging biomarker; middle age; mortality risk; novel; offspring; pre-clinical; preservation; prospective; remote monitoring; sex; smart watch; smartphone application; tool; virtual

Abstract How to engage and retain older adults in longitudinal mHealth research is virtually unknown. This is of great public health importance as many older adults have barriers to obtaining health care that technology may overcome by permitting in-home monitoring of health including cognitive function. Using mHealth technologies to obtain data more frequently and in real life settings, vs. research center examinations that occur years apart presents a transformational opportunity for cohort studies and may lead to practical methods for monitoring risk of Alzheimer’s disease and related disorders (ADRD). We previously developed an innovative, scalable digital cardiovascular health monitoring system, the “electronic Framingham Heart Study” (eFHS)8 for use in middle- aged adults, thus providing foundational experience that will support this proposal. We will extend eFHS to enhance a smartphone app tailored for older participants. The app will capture patient-reported outcomes, cognition, physical performance, social support, and health events (falls, hospitalizations). We plan to investigate the usefulness of the mHealth system for monitoring health-related behaviors and we will relate the digital data to brain aging including preclinical ADRD using in-person research grade neuropsychological (NP) testing and brain MRI data. Specific Aims: Aim 1. Enhance engagement strategies and identify factors associated with successful use of the smartphone app and smartwatch among older adults at 3 months and 6 months. Successful use will be defined based on adherence, including: 1) app-based completion of surveys and cognitive and performance tasks (n=850); 2) wearing the smartwatch daily (n≈500). We will identify participant (e.g., age, sex, cognitive status) and system-related factors (e.g., user-interface, navigation), that affect adherence over 3 and 6 months. Aim 2. Compare the smartphone app-based data to research grade measures of brain health (NP testing batteries, brain MRIs) collected in the FHS Research Center on the same participants. We will compare the app-based measures with measures of brain health, including NP test measures (global cognition and 4 domains: executive function, memory, language, visuospatial) and brain MRI markers (total brain volume, hippocampal volume, white matter hyperintensity volume). Sub Aim 2a: Construct a digital frailty phenotype. Aim 3. Examine measures of physical activity and heart rate from the Apple Watch over 90 days with research grade measures of brain health (see Aim 2). Our application will provide critically needed knowledge on how older adults engage with mHealth devices and will provide insights on the benefit of mHealth data to monitor the health of older adults in clinical and research settings. Digital biomarkers may be powerful tools to monitor risk factors/behaviors for ADRD and to identify older adults at risk for cognitive and physical decline.

抽象的 如何在纵向MHealth研究中参与和留住老年人实际上是未知的。这很棒 公共卫生重要性是许多老年人有障碍获得技术可能的医疗保健 通过允许在家中监测健康（包括认知功能）来克服。使用MHealth技术 为了更频繁地获取数据，在现实生活环境中，与研究中心相距几年进行的考试 为队列研究提供了变革的机会，并可能导致监测风险的实用方法 阿尔茨海默氏病和相关疾病（ADRD）。我们以前开发了创新的，可扩展的数字 心血管健康监测系统，“电子弗雷明汉心脏研究”（EFHS）8用于中间 老年人，因此提供了支持该提案的基本经验。我们将把EFH扩展到 增强针对老年参与者的智能手机应用程序。该应用将捕获患者报告的结果， 认知，身体绩效，社会支持和健康事件（跌倒，住院）。我们计划 调查MHealth系统对监测与健康相关行为的有用性，我们将将 用于大脑衰老的数字数据，包括使用亲自研究级神经心理学（NP）的临床前ADRD 测试和大脑MRI数据。具体目的： 目标1。加强参与策略并确定与成功使用的因素 3个月零6个月的老年人智能手机应用程序和智能手表。成功使用将是 根据依从性定义，包括：1）基于应用程序的调查完成，认知和性能 任务（n = 850）; 2）每天戴智能手表（N≈500）。我们将确定参与者（例如，年龄，性别，认知 状态）和与系统相关的因素（例如，用户界面，导航），影响了3个月和6个月的依从性。 AIM 2。将基于智能手机应用的数据与研究等级的大脑健康等级进行比较（NP 在FHS研究中心收集了有关同一参与者的FHS研究中心的测试电池MRI）。我们将 将基于应用的措施与大脑健康的度量进行比较，包括NP测试措施（全球认知 和4个领域：执行功能，记忆，语言，视觉）和大脑MRI标记（总脑部 体积，海马体积，白质高强度体积）。 子目标2a：构建数字脆弱表型。 AIM 3。在90天内检查Apple Watch的体育活动和心律的措施 研究等级的大脑健康措施（请参阅目标2）。 我们的应用将提供有关老年人如何与MHealth设备互动的急需知识 并将提供有关MHealth数据益处的见解，以监测临床和 研究环境。数字生物标志物可能是监视ADRD的风险因素/行为的强大工具和 确定老年人有认知和身体下降的风险。