CareBand: A Collaborative Pilot Study to Optimize a Life-Space Performance Metric for Monitoring and Early Detection of Alzheimer's Disease and Related Dementias in Rural and Indigenous Communities

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Project Summary/Abstract Despite having higher rates of ADRD, increased caregiver stress and a lack of accessible healthcare services compared to urban counterparts, rural and Indigenous populations are grossly underrepresented in dementia research, especially in technology development. This R21 project, titled CareBand: A Collaborative Pilot Study to Optimize a Life-Space Performance Metric for Monitoring and Early Detection of ADRD in Rural and Indigenous Communities addresses urgent dementia disparities by developing aging-in-place technology to monitor dementia-related behaviours. This project brings together the University of Minnesota’s Memory Keepers - Medical Discover Team (MK-MDT) with an Industry partner, CareBand Inc., to digitize and expand existing metrics for the recording and analysis of movement through personal (in-home) and community environments, called life-space, using CareBand’s already available and proven, unobtrusive wearable wristband device. CareBand uses LoRa technology making it accessible to those without Internet or cellular services. This research will develop a new metric, a life-space performance (LSP) score, that will capture mobility through the exact calculation of distance based on amount, frequency and speed and as well as quality of movements (stability, falls, speed) across any clinically relevant period of time. Our long-term goal is to use LSP metrics to track cognitive decline from pre-clinical subjective cognitive complaints through all stages of ADRD among geographically and culturally diverse populations. Our overall hypothesis is that culture and geography are significant factors in determining one’s life-space and that the accurate measure of LSP in Indigenous and rural populations can be achieved by developing measures that account for their unique contexts. Using a community-based participatory research approach, we will partner with Indigenous and rural communities to pilot CareBand allowing us to collect data on rural and Indigenous life-space utilization to produce a LSP score that will benefit PWD and their caregivers. Our research has three specific aims. First, we will conduct depth interviews to generate qualitative data to inform the LSP data model by identifying and prioritizing the most critical life-space behaviors for directing care decisions. Second, the CareBand will be piloted for 12 weeks in rural and Indigenous with 20 People with Dementia caregivers, to capture location, movement and speed of movement inside and outside the home. Third, we will develop a set of algorithms by analyzing the qualitative and quantitative results captured in Aims 1 and 2 to create an LSP Score. This research will digitize life-space measures into a LSP score which includes indicators appropriate to rural and Indigenous populations and will lay the groundwork for a subsequent R01 application to validate the context specific LSP metrics against existing gold standards. The culturally appropriate LSP measure will contribute to health equity through improved early detection, diagnosis and care for rural and Indigenous populations.