Monitoring Health in Older Adults Using mHealth Technology: Framingham Offspring Study

使用移动医疗技术监测老年人的健康状况：弗雷明汉后代研究

• 批准号: 10627872
• 负责人: JOANNE M MURABITO
• 金额: $ 62.58万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10627872
• 关键词: Adherence; Adult; Affect; Age; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Anxiety; Apple watch; Behavior; Brain; COVID-19; COVID-19 pandemic; Cellular Phone; Clinical; Cognition; Cognitive; Cognitive deficits; Cohort Studies; Communities; Data; Dementia; Devices; Digital biomarker; Elderly; Electronics; Eligibility Determination; Event; Fatigue; Framingham Heart Study; Fright; Health; Health Technology; Health behavior; Heart Rate; Hippocampus; Home; Hospitalization; Impaired cognition; Individual; Knowledge; Language; Life; Link; Magnetic Resonance Imaging; Maintenance; Measures; Memory; Methods; Monitor; Moods; Motor Skills; Neuropsychological Tests; Older Population; Outcome; Pain; Participant; Patient Outcomes Assessments; Personal Satisfaction; Persons; Phenotype; Physical Performance; Physical activity; Physical assessment; Pilot Projects; Population; Prevalence; Public Health; Recommendation; Research; Research Personnel; Rest; Risk; Risk Factors; Sleep; Social Distance; Social isolation; Social support; Surveys; System; Task Performances; Technology; Visuospatial; White Matter Hyperintensity; adverse outcome; aged; aging brain; brain health; brain magnetic resonance imaging; brain volume; cardiovascular health; cognitive function; cohort; digital; digital measure; disorder risk; executive function; experience; falls; frailty; heart rate variability; high risk; innovation; insight; mHealth; magnetic resonance imaging biomarker; middle age; mortality risk; novel; offspring; pre-clinical; preservation; prospective; remote monitoring; sex; smart watch; smartphone application; tool; virtual

Abstract How to engage and retain older adults in longitudinal mHealth research is virtually unknown. This is of great public health importance as many older adults have barriers to obtaining health care that technology may overcome by permitting in-home monitoring of health including cognitive function. Using mHealth technologies to obtain data more frequently and in real life settings, vs. research center examinations that occur years apart presents a transformational opportunity for cohort studies and may lead to practical methods for monitoring risk of Alzheimer’s disease and related disorders (ADRD). We previously developed an innovative, scalable digital cardiovascular health monitoring system, the “electronic Framingham Heart Study” (eFHS)8 for use in middle- aged adults, thus providing foundational experience that will support this proposal. We will extend eFHS to enhance a smartphone app tailored for older participants. The app will capture patient-reported outcomes, cognition, physical performance, social support, and health events (falls, hospitalizations). We plan to investigate the usefulness of the mHealth system for monitoring health-related behaviors and we will relate the digital data to brain aging including preclinical ADRD using in-person research grade neuropsychological (NP) testing and brain MRI data. Specific Aims: Aim 1. Enhance engagement strategies and identify factors associated with successful use of the smartphone app and smartwatch among older adults at 3 months and 6 months. Successful use will be defined based on adherence, including: 1) app-based completion of surveys and cognitive and performance tasks (n=850); 2) wearing the smartwatch daily (n≈500). We will identify participant (e.g., age, sex, cognitive status) and system-related factors (e.g., user-interface, navigation), that affect adherence over 3 and 6 months. Aim 2. Compare the smartphone app-based data to research grade measures of brain health (NP testing batteries, brain MRIs) collected in the FHS Research Center on the same participants. We will compare the app-based measures with measures of brain health, including NP test measures (global cognition and 4 domains: executive function, memory, language, visuospatial) and brain MRI markers (total brain volume, hippocampal volume, white matter hyperintensity volume). Sub Aim 2a: Construct a digital frailty phenotype. Aim 3. Examine measures of physical activity and heart rate from the Apple Watch over 90 days with research grade measures of brain health (see Aim 2). Our application will provide critically needed knowledge on how older adults engage with mHealth devices and will provide insights on the benefit of mHealth data to monitor the health of older adults in clinical and research settings. Digital biomarkers may be powerful tools to monitor risk factors/behaviors for ADRD and to identify older adults at risk for cognitive and physical decline.

抽象的 如何让老年人参与纵向移动医疗研究并留住他们实际上是未知的。这是伟大的 公共卫生的重要性，因为许多老年人在获得医疗保健方面存在障碍，而技术可能会阻碍这一点 通过允许家庭健康监测（包括认知功能）来克服这一问题。使用移动医疗技术 在现实生活中更频繁地获取数据，而不是相隔数年进行的研究中心检查 为队列研究提供了一个转型机会，并可能带来监测风险的实用方法 阿尔茨海默氏病及相关疾病（ADRD）。我们之前开发了一种创新的、可扩展的数字 心血管健康监测系统，即“电子弗雷明汉心脏研究”(eFHS)8，用于中年 老年人，从而提供支持该提案的基础经验。我们将把 eFHS 扩展到 增强专为老年参与者量身定制的智能手机应用程序。该应用程序将捕获患者报告的结果， 认知、身体表现、社会支持和健康事件（跌倒、住院）。我们计划 研究移动医疗系统在监测健康相关行为方面的有用性，我们将把 使用现场研究级神经心理学 (NP) 的大脑衰老数字数据，包括临床前 ADRD 测试和脑部 MRI 数据。具体目标： 目标 1. 加强参与策略并确定与成功使用 3 个月和 6 个月大的老年人中的智能手机应用程序和智能手表。成功使用将会 根据遵守情况定义，包括：1) 基于应用程序完成调查以及认知和表现 任务（n=850）； 2）每天佩戴智能手表（n≈500）。我们将识别参与者（例如年龄、性别、认知能力） 状态）和系统相关因素（例如用户界面、导航），这些因素会影响 3 到 6 个月的依从性。 目标 2. 将基于智能手机应用程序的数据与大脑健康的研究级测量（NP FHS 研究中心收集的相同参与者的测试电池、脑部 MRI 数据。我们将 将基于应用程序的测量与大脑健康测量进行比较，包括 NP 测试测量（全局认知 和 4 个领域：执行功能、记忆、语言、视觉空间）和脑 MRI 标记（全脑 体积、海马体积、白质高信号体积）。 子目标 2a：构建数字脆弱表型。 目标 3. 通过 Apple Watch 检查 90 天内的体力活动和心率测量值 大脑健康的研究级测量（参见目标 2）。 我们的应用程序将提供有关老年人如何使用移动医疗设备的急需知识 并将提供关于移动医疗数据在临床和临床监测老年人健康方面的好处的见解 研究设置。数字生物标志物可能是监测 ADRD 风险因素/行为并 识别有认知和身体衰退风险的老年人。