A novel wearable platform to assess cognitive-motor performance

摘要 阿尔茨海默病(AD)临床研究最近从临床诊断转向目标 开发神经保护疗法突显了对强大和快速给药的认知 能够识别认知衰退最早阶段的个体并进行测量的评估工具 随着时间的推移，认知运动性能的微妙变化。在这种情况下，身体虚弱与 认知障碍(称为“认知脆弱”)被证明是一种强有力的独立的预测因子。 随着时间的推移，认知能力会下降。国际老年学和老年医学协会，以及 国际营养和老龄化学会建议将认知脆弱性测量用于 确定MCI进展为痴呆症/AD和丧失独立性的途径。 我们最近开发了一种新的认知脆弱性测量工具，它基于 可穿戴传感器连接到患者的胫骨和虚拟现实软件。使用此工具进行的评估 平台是仪表化跟踪任务或iTMT。这一创新工具可实现客观和同步 运动和认知能力的评估是用来检查患者执行 在虚拟环境中的试探任务。评估是基于对执行时间和用户的测量 在多种任务中的表现，包括视觉搜索、扫描、处理速度、心理灵活性、 和执行功能。在执行每项任务时，通过测量脚踝速度来量化运动性能 认知表现通过评估运动规划错误、工作记忆和所需时间来量化 来完成这项任务。在我们最近发表在《老年学》杂志上的初步研究中，我们证明了 ITMT可以用来评估老年人的认知运动表现，并识别老年人的MCI和AD。 此外，我们还展示了iTMT确定脆弱状态的能力。ITMT可以被用作 双任务步行测试的另一种测试，用于评估和量化老年人的认知脆弱程度。这个 拟议平台的独特好处包括客观性、低成本、节省时间、多方面评估、 并且易于使用。 这项STTRI期研究旨在将这项创新和专利技术从贝勒学院 医学到BioSensics有限责任公司的进一步开发、临床测试和商业化。生物传感是一种 一家私人持股的生物医药公司，专门从事医疗保健的可穿戴技术， 迅速将政府研究资金转化为商业化的医疗器械和技术。 此处建议的iTMT产品将被添加到当前的护理点评估工具系列中 由BioSensics商业化，包括步态和跌倒风险(LEGSys)、平衡(BalanSens)设备 和脆弱(脆弱米)。

ABSTRACT The recent shift in Alzheimer’s disease (AD) clinical research from clinical diagnosis toward the goal of developing neuroprotective therapies has highlighted the need for a robust and rapidly-administered cognitive assessment tool capable of identifying individuals in the earliest stages of cognitive decline and measuring subtle changes in cognitive-motor performance over time. In this context, physical frailty together with cognitive impairment (known as ‘cognitive frailty’) is shown to be a strong and independent predictor of cognitive decline over time. The International Association of Gerontology and Geriatrics, as well as The International Academy on Nutrition and Aging have recommended the use of cognitive frailty measurement for determining pathways of MCI progression toward dementia/AD, and loss of independence. We have recently developed a novel cognitive frailty measurement tool that is based on a combination of a wearable sensor attached to patient’s shin and virtual reality software. The assessment performed using this platform is the Instrumented Trail Making Task or iTMT . This innovative tool for objective and simultaneous assessment of both motor and cognitive performance is used to examine the ability of the patient to execute a trail-making task in a virtual environment. The assessment is based on measuring the execution time and user performance during multiple tasks that involve visual search, scanning, speed of processing, mental flexibility, and executive function. In performing each task, motor performance is quantified by measuring ankle velocity and cognitive performance is quantified by assessing motor-planning error, working memory, and time needed to complete the task. In our pilot study, which was recently published in Gerontology, we demonstrated that iTMT can be used to assess cognitive-motor performance and identify aMCI and AD in older adults. Furthermore, we have demonstrated the ability of iTMT to determine frailty status. The iTMT could be used as an alternative test to the dual-task walking test to assess and quantify cognitive frailty in older adults. The unique benefits of the proposed platform include objectivity, low cost, time-savings, multifaceted assessment, and being easy to use. This STTR Phase I study aims to transfer this innovative and patented technology from Baylor College of Medicine to BioSensics LLC for further development, clinical testing, and commercialization. BioSensics is a privately-held biomedical firm specialized in wearable technologies for healthcare, with a proven record of rapidly transitioning governmental research funding into commercialized medical devices and technologies. The iTMT product proposed here will be added to the current line of point-of-care assessment tools commercialized by BioSensics, which includes devices for gait and fall risk (LEGSys), balance (BalanSens) and Frailty (Frailty Meter).