In this Phase I SBIR project, ASTER Labs will develop and evaluate an innovative system to automatically andaccurately detect Activities of Daily Living (ADL) performed by persons with Alzheimer's disease and relateddementias. It will address a current need to equip caregivers and health care providers, including physiciansand cognitive rehabilitation therapists, with reliable information on patients' ongoing abilities to perform theseimportant activities. The confirmation of these abilities will directly support the capability of a functioningindependent lifestyle, while producing informed decisions on interventions and level of care based on diseaseprogression. An estimated 5.8 million Americans in 2020 live with Alzheimer's dementia. Nearly a third of theseindividuals live alone and are more likely to experience poorer health outcomes than cohabitating persons.Ongoing assessment of ADL is highly recommended for establishing diagnosis of dementia and progression ofthe disease over time. Existing and proposed approaches to automate this assessment in the home haveranged from cameras or vision-based sensors to beacon-based signal processing techniques. However, theseapproaches have been subject to limitations and critique due to privacy concerns, poor accuracy, limitedcoverage, and requirements of significant infrastructure alterations. Common commercial activity trackers haveconcentrated primarily on fitness activities, and typically rely on non-discreet wearable devices that, due tounfamiliarity, may be unacceptable to dementia patients. Clinical research has indicated interventions involvingcompensatory memory techniques and devices may help prevent or delay dementia onset, and preservefunctional independence. Use of both manual and digital memory notebooks to help patients record when theyperformed certain activities have shown significant promise. However, seniors with memory impairment anddementia may risk inaccurate recollection of activities performed throughout the day, and have faced difficultyinteracting with recent digital implementations of these interventions. An unmet need exists in the ability ofthose caring for these individuals to receive verifiable information on whether the activity was completed at thetime reported by the patient, or at all. ASTER Labs' proposed Activlog system leverages intelligent processingof WiFi, GPS, inertial, and audio sensor data from a small hardware suite concealed in a shoe insole,unnoticeable to the wearer, that uses high-precision location and multi-sensor association to accurately andcontinuously monitor and detect ADL. In Phase I, the prototype system will be assembled, with feasibilitydemonstrated by functional evaluation conducted through a focus group study with caregivers, physicians, andcognitive rehabilitation therapists of patients with dementia. Activity classification accuracy of the device will bedetermined in timed experiments by ASTER Labs' engineers wearing the prototype insoles. Phase I testing willprovide the success criteria for the start of the Phase II program, which will include a human study of the fully-operational system in home and independent living settings to establish the efficacy of this approach.
Public Health Relevance Statement: Project Narrative
Rapid increases in America's elderly population suffering from dementia have increased focus on assisting
these individuals maintain functional independence, and ongoing assessment of Activities of Daily Living is
recommended for evaluating individual patients' progression of the disease over time. Clinical research has
shown the benefits of compensatory memory techniques and interventions involving ADL and other healthy
behaviors in helping prevent or delay dementia onset and preserve these functional abilities. The proposed
research addresses an unmet need to automatically, accurately, and continuously monitor, record, and verify
ADL completion by developing a comprehensive activity detection and determination device, which will equip
remotely-located caregivers, physicians, and cognitive rehabilitation therapists with reliable information to
promote informed decisions on diagnosis, interventions, and level of care.
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