Development of novel digital biomarkers for proactive detection and treatment of functional decline

项目概要 到 65 岁时，四分之一的美国人将经历功能衰退，这是改变生活的“无声杀手” 日常生活活动 (ADL) 的独立性和限制。健康状况不佳和 与功能衰退相关的费用飙升影响了许多诊断，导致国家支出增加 预计每年将超过 1 万亿美元。常规功能筛查评估是黄金标准 解决这个问题。然而，由于存在诸多障碍，大多数老年人都在环境中得到照顾 筛查质量差、不准确或根本没有进行的地方。结果，功能衰退经常发生 直到出现明显的残疾和不良后果之前才被注意到。老年病学领域的领导者早已认识到 解决功能衰退的障碍，并要求改进筛查和治疗方法。 与此同时，老年人中数字设备的拥有量、采用率和使用率急剧上升， 尤其是在疫情期间。 Smyl Fitness Rx, LLC (Smyl) 已经确定了一种使用这些的新方法 解决功能衰退的设备。第一阶段 SBIR 建议开发移动应用程序 由技术提供支持，该技术将提供可扩展的解决方案来自动化功能筛选评估， 计算功能衰退的新型数字生物标志物，并提供基于证据的健身处方 行为矫正功能有助于持续治疗和预防。 Smyl 开发了一个框架 与美国医学会 (AMA) 的主要意见领袖协商后提出申请 运动是医学（EIM）咨询委员会已经对老年人进行了测试。商业化将重点 解决 Smyl 市场研究期间发现的关键痛点和未满足的需求。目标 1 将重点关注 开发使用计算机视觉技术实现日常功能自动化的机器学习模型 评估。计算机视觉技术已被证明对老年人有效，包括 患有痴呆症的人。目标 2 将包括开发使用自动化参数的分析模型 评估以计算功能衰退的新型数字生物标志物。这些数字生物标记将表明 功能衰退的存在或未来风险、持续的严重程度以及对治疗的反应。在《瞄准3》中，斯米尔将 开发运动质量和健身处方模型，以促进安全有效的运动处方 显示可以解决功能衰退问题。第二阶段的工作重点是优化家用技术， 开发数据驱动的健身处方，并增强患者使用的平台 阿尔茨海默病和阿尔茨海默病相关痴呆症 (AD/ADRD)。科学技术 该项目的发展有可能影响超过 3400 万中老年人。 实施拟议的创新可以减少独立性的丧失、不良的健康结果和 与功能衰退相关的健康成本飙升。

PROJECT SUMMARY By age sixty-five, 1 in 4 Americans will experience functional decline, a “silent killer” defined by life altering loss of independence and limitations performing activities of daily living (ADLs). Poor health outcomes and skyrocketing costs linked to functional decline cut across many diagnoses, leading to national expenditures projected to exceed $1 trillion annually. Routine functional screening assessments are the gold-standard for addressing this condition. However, due to numerous barriers, most older adults are cared for in settings where screening is poor, inaccurate, or not conducted at all. As a result, functional decline often goes unnoticed until obvious disability and adverse outcomes occur. Leaders in geriatrics have long recognized obstacles addressing functional decline and have called for improved screening and treatment approaches. Meanwhile, ownership, adoption, and usage of digital devices has climbed sharply among older adults, particularly during the pandemic. Smyl Fitness Rx, LLC (Smyl) has identified a novel method to use these devices to address functional decline. This Phase I SBIR proposes development of a mobile application powered by technology that will offer a scalable solution to automate functional screening assessments, compute novel digital biomarkers of functional decline, and deliver evidence-based fitness prescriptions with behavior modification features to facilitate ongoing treatment and prevention. Smyl developed a framework for the application in consultation with key opinion leaders from the American Medical Association’s (AMA’s) Exercise Is Medicine (EIM) advisory board been and tested it with older adults. Commercialization will focus on addressing key pain points and unmet needs identified during Smyl’s market research. Aim 1 will focus on developing machine learning models that use computer vision technology to automate routine functional assessments. Computer vision technology has shown to be effective for use among older adults, including those with dementia. Aim 2 will consist of developing analytic models that use parameters from the automated assessment to compute novel digital biomarkers of functional decline. These digital biomarkers will indicate the presence or future risk of functional decline, ongoing severity, and response to treatment. In Aim 3 Smyl will develop a movement quality & fitness prescription model to facilitate safe and effective exercise prescriptions shown to address functional decline. Phase II efforts will focus on optimizing the technology for home use, developing data-driven fitness prescriptions, and enhancing the platform for use among people living with Alzheimer's disease and Alzheimer's disease-related Dementias (AD/ADRD). The scientific and technology developments of this project have the potential to impact over 34 million middle and older age adults. Implementation of the proposed innovation could reduce the loss of independence, poor health outcomes, and skyrocketing health costs associated with functional decline.