Using moment-to-moment sensors, mobile technology, and stimulated cytokine responses to identify physical and mental health risk among Alzheimer's spousal caregivers

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ABSTRACT The proposed three-year K25 will launch Dr. Akane Sano’s independent research career in the field of aging and physical and mental health where she will endeavor to identify physical and mental health disease risks; understand the role of physiological and behavioral factors in physical and mental health outcomes; and leverage her engineering background to develop personalized health measurement and interventions using biobehavioral sensors and mobile technologies. In particular, Dr. Sano will address a gap in Alzheimer’s Disease (AD) research by studying how mobile sensors and technologies may help identify spousal caregivers’ health risk and reduce their stress while promoting resilience. Spousal caregivers of AD patients are a burgeoning population impacted by the stress of caretaking so much so that they are susceptible to devastating diseases, especially those related to inflammatory cytokines. Dr. Sano will attend to this public health concern via the following aims: Aim 1. Determine the relationships between caregivers’ daily moment-to-moment behaviors and physiological responses from mobile phones and wearable sensors, self-reported psychological and physiological health, and cytokine responses. Aim 2. Identify preferences, strategies, and barriers to design digital phenotyping tools and personalized mobile and/or wearable health interventions. Dr. Sano is an expert in quantitative analysis and modeling of physiological and behavioral mobile and wearable sensor data for mental health; however, she requires training to be an independent PI in biobehavioral, aging, and mobile health research to provide novel information about the mechanisms and predictors that underlie physical and mental health risks; yet, she must also procure interdisciplinary mentorship crucially in (1) understanding biobehavioral mechanisms that underlie physical and health and disease in older adulthood, including psychoneuroimmunology (PNI), (2) understanding aging and dementia, and acquiring expertise required for developing digital phenotyping and interventions for older adult dementia spousal caregivers, and (3) advanced longitudinal and Bayesian statistical/modelling methods. Coupling mentorship and her expertise, Dr. Sano proposes a study that will identify physiological and behavioral responses and content for interventions. During the award period, Dr. Sano will 1) collect data for one month via a study of 110 spousal caregivers using wearable sensors and smartphones to measure physical activity/sleep, heart rate, skin conductance, and self-reported mood and stress; 2) sample blood at baseline and post 6-month visits; and 3) conduct a qualitative interview about caregivers’ experience, needs, and stress coping strategies for a subset of the participants after the 6-month visits. Drawing on Dr. Sano’s expertise in human sensing, data analysis, and application development for health while leveraging the mentorship of a team at the forefront of aging and biobehavioral science, the proposed research and training will equip Dr. Sano with extensive knowledge of biobehavioral mechanisms in stress, physical and mental health in older adulthood, aging and dementia, and the skills to devote her career to studying biobehavioral health risks and contributing factors while developing real-time intervention strategies using mobile technologies in older adulthood and caregiving.