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

项目总结 到65岁时，每4个美国人中就有1人将经历功能衰退，这是一个被定义为改变生活的丧失的“沉默的杀手” 执行日常生活活动(ADL)的独立性和局限性。健康状况不佳， 与功能衰退相关的飞涨成本影响了许多诊断，导致国家支出 预计每年将超过1万亿美元。常规功能筛查评估是 解决这一问题。然而，由于障碍众多，大多数老年人在环境中得到照顾 筛查很差、不准确或根本没有进行的地方。因此，功能衰退通常会 直到出现明显的残疾和不良后果时才被注意到。老年医学的领袖们早就认识到 解决功能衰退的障碍，并呼吁改进筛查和治疗方法。 与此同时，老年人对数字设备的拥有率、采用率和使用率大幅上升， 特别是在大流行期间。Smyl Fitness Rx，LLC(Smyl)已经确定了一种新的方法来使用这些 解决功能衰退问题的设备。此第一阶段SBIR建议开发移动应用程序 该技术将提供可扩展的解决方案，以实现功能筛选评估的自动化， 计算新的功能衰退的数字生物标志物，并提供基于证据的健身处方 行为矫正功能，便于持续治疗和预防。SMYL开发了一个框架 在咨询美国医学会(AMA)主要意见领袖后提出的申请 运动是医学(EIM)顾问委员会已经在老年人中进行了测试。商业化将专注于 解决在SMYL市场研究中发现的关键痛点和未得到满足的需求。目标1将专注于 开发使用计算机视觉技术自动化日常功能的机器学习模型 评估。计算机视觉技术被证明在老年人中使用是有效的，包括 那些痴呆症患者。目标2将包括开发分析模型，这些模型使用自动化的 对计算新的功能衰退数字生物标记物的评估。这些数字生物标志物将指示 存在或未来存在功能衰退的风险、持续的严重性和对治疗的反应。在Aim 3中，Smyl将 开发运动质量和健身处方模式，促进安全有效的运动处方 显示可解决功能衰退的问题。第二阶段的努力将集中在优化家用技术上， 开发数据驱动的健身处方，并增强平台在生活在 阿尔茨海默病和阿尔茨海默病相关痴呆(AD/ADRD)。科学与技术 该项目的发展有可能影响3400多万中老年人。 实施拟议的创新可以减少独立性的丧失、不良的健康结果，以及 与功能衰退相关的飞涨的医疗成本。

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.