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

项目摘要/摘要 尽管ADRD的发生率较高，但照顾者压力增加，缺乏可获得的医疗服务 与城市同行相比，农村和土著人口在痴呆症中的比例严重偏低 研究，特别是在技术开发方面。这个名为CareBand的R21项目：协作性先导研究 优化农村和农村居民ADRD监测和早期发现的生活空间绩效指标 土著社区通过开发就地老龄化技术来解决紧迫的痴呆症差距 监测与痴呆症相关的行为。这个项目汇集了明尼苏达大学的记忆 Keepers-医疗发现团队(MK-MDT)与行业合作伙伴CareBand Inc.合作实现数字化和扩展 记录和分析个人(居家)和社区活动的现有指标 环境，称为生活空间，使用CareBand已有的、经过验证的、不引人注目的可穿戴设备 腕带装置。CareBand使用Lora技术，使那些没有互联网或手机的人可以访问它 服务。这项研究将开发一种新的衡量标准，生活空间绩效(LSP)分数，它将捕获 通过根据数量、频率和速度准确计算距离以及 任何临床相关时间段的运动质量(稳定性、跌倒、速度)。我们的长期目标是 使用LSP指标跟踪从临床前主观认知症状到ALL的认知下降 在地理和文化不同的人群中，ADRD的发展阶段。我们的总体假设是文化 和地理是决定一个人的生活空间的重要因素，而准确测量一个人的生活空间 土著和农村人口可以通过制定措施来实现，这些措施考虑到了土著和农村人口的独特之处 上下文。利用以社区为基础的参与性研究方法，我们将与土著和农村组织合作 社区试点CareBand，使我们能够收集关于农村和土著生活空间利用的数据 制定有利于残障人士及其照顾者的LSP评分。我们的研究有三个具体目标。首先，我们 将进行深度访谈，以生成定性数据，通过确定和 优先考虑最关键的生活空间行为，以指导护理决策。其次，CareBand将成为 在农村和土著地区与20名痴呆症患者照顾者进行了12周的试点，以捕捉地点， 室内和室外的移动和移动速度。第三，我们将通过以下方式开发一套算法 分析目标1和目标2中捕获的定性和定量结果，以创建LSP分数。这 研究将把生活空间测量数字化为LSP分数，其中包括适合农村和 并将为随后的R01应用程序奠定基础，以验证上下文 对照现有黄金标准的特定LSP指标。文化上适当的LSP措施将有助于 通过改善对农村和土著居民的早期发现、诊断和护理，实现卫生公平。

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.