AI-powered point-of-care system for motor function assessment to determine MCI, frailty, and fall risk

Awardee Organization(s): University of Missouri
Principal Investigator(s): Trent M. Guess, PhD
Official Project Title: Motor Function Assessment for Mild Cognitive Impairment, Frailty, and Fall Risk
AITC Partner: PennAITech
Website(s):

Homepage


https://mizzoumotioncenter.com/

Fall risk, mild cognitive impairment (MCI), and frailty are three interrelated health conditions that diminish quality of life for older adults and put them at higher risk for adverse outcomes, including hospitalization, disability, and death. A common characteristic shared by these conditions is a decline in motor function, most often manifested by degradation in balance and gait performance. Comprehensive early detection of motor declines may offer our best chance of addressing these geriatric conditions. While there is growing interest in using sensors to measure movement and balance, currently available technologies are prohibitively expensive or do not capture multiple aspects of movement. As a solution, we have developed the Mizzou Point-of-Care Assessment System (MPASS), which integrates measurements from multiple sensors to provide an objective, comprehensive dataset of human movement and cognitive performance. The total cost of the testing platform is under $1,500 and MPASS motor function assessments typically take less than 15 minutes. Our goal is to integrate the MPASS with artificial intelligence (AI) approaches to translate the system into a clinically effective tool that quickly, affordably, and accurately assesses risk for falling, MCI, and frailty, in real-world clinical and community settings. Specifically, we will collect data on MPASS motor function, cognitive testing, fall history, and frailty for 30 persons with MCI and 50 community dwelling adults. We will then employ AI to develop prediction algorithms that distinguish persons with MCI, fall risk, and frailty. Finally, we will develop clinically usable outputs based on the prediction algorithms.

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AI-powered web app using computer vision to analyze knee joint space in older adults using only plain radiographs

Awardee Organization(s): University of Georgia
Principal Investigator(s): Soheyla Amirian, PhD
Official Project Title: AI-Powered Web Application to Analyze Knee Joint Space for Aging Population
AITC Partner: PennAITech
Website(s): https://engineering.uga.edu/team_member/soheyla-amirian/

Osteoarthritis (OA) stands as a prevailing chronic joint affliction, affecting millions of individuals globally, particularly those aged 65 or older. We propose the development of an innovative AI-powered web application, tailored to facilitate the monitoring and analysis of knee joint space, and by extension, the progression of knee OA. This web application will serve as a beacon of hope for aging individuals suffering from the burden of knee OA. By building, training, and validating deep learning computer vision algorithm, we aim to empower patients, their caregivers, and healthcare providers with an intuitive and cost-effective solution. Our overarching goal is thus to provide a platform that allows for the quantitative and longitudinal assessment of knee joint space, thereby enhancing our understanding of the degeneration process in the aging knee. Beyond the technical intricacies, our mission is deeply rooted in delivering a solution that is accessible to those who need it the most. This technology will bridge geographical distances, transcending traditional healthcare limitations and opening new avenues for remote patient care. As we delve into the specific aims of this project, it is vital to underscore the potential impact it holds for individuals afflicted by knee OA, the individuals who care for them, and the healthcare professionals committed to their well-being. The specific aims are: (1) To develop an AI-powered web application to quantitatively assess and analyze knee joint space using only plain radiographs.Osteoarthritis (OA) stands as a prevailing chronic joint affliction, affecting millions of individuals globally, particularly those aged 65 or older. We propose the development of an innovative AI-powered web application, tailored to facilitate the monitoring and analysis of knee joint space, and by extension, the progression of knee OA. This web application will serve as a beacon of hope for aging individuals suffering from the burden of knee OA. By building, training, and validating deep learning computer vision algorithm, we aim to empower patients, their caregivers, and healthcare providers with an intuitive and cost-effective solution. Our overarching goal is thus to provide a platform that allows for the quantitative and longitudinal assessment of knee joint space, thereby enhancing our understanding of the degeneration process in the aging knee. Beyond the technical intricacies, our mission is deeply rooted in delivering a solution that is accessible to those who need it the most. This technology will bridge geographical distances, transcending traditional healthcare limitations and opening new avenues for remote patient care. As we delve into the specific aims of this project, it is vital to underscore the potential impact it holds for individuals afflicted by knee OA, the individuals who care for them, and the healthcare professionals committed to their well-being. The specific aims are: (1) To develop an AI-powered web application to quantitatively assess and analyze knee joint space using only plain radiographs. (2) To establish a prospective adult cohort with knee OA to clinically validate the AI-powered web application.

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An Accessible Machine Learning-Based ADRD Screening Tool for Families and Caregivers

A machine learning-enabled speech-based screening tool for AD/ADRD caregivers
Awardee Organization(s): University of Southern California
Principal Investigator(s): Maja Matarić, PhD
Official Project Title: An Accessible Machine Learning-Based ADRD Screening Tool for Families and Caregivers
AITC Partner: PennAITech
Website(s): www.robotics.usc.edu/~maja

The goal of this project is to develop an app-based screening system capable of detecting early signs of Alzheimer’s Disease (AD) using data captured during sessions of standard clinical AD diagnostics. Approximately 50 million people worldwide are diagnosed with dementia. As of 2021, an estimated 6.2 million Americans, one in nine people 65 and older, are living with AD.The majority of affected people do not obtain early screening toward a timely dementia diagnosis. Consequently, there is a large and rapidly growing need for lowcost, non-invasive, and accessible tools for dementia screening toward alerting families and caregivers and encouraging them to pursue medical evaluation. The proposed app is intended for family members and caregivers and will be designed to be easy to use and encourage regular screening. The goal is for the proposed app to enable convenient early flagging of AD for the general public.

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Conversational Care Technologies

The PI’s research team will use a human-centered approach to design, build, and evaluate conversational care technologies that scaffold meaningful care discussions between older adults and their informal caregivers
Awardee Organization(s): University of Michigan
Principal Investigator(s): Robin Brewer, PhD
Official Project Title: Conversational Care Technologies
AITC Partner: PennAITech
Website(s): www.umich.edu, www.si.umich.edu

This project focuses on designing and developing conversational care technologies for older adults and their caregivers. In prior work, we surveyed informal caregivers and older adult care receivers to understand their care routines. Survey findings showed how nearly 20% of care partners used voice assistants in their homes, signaling an opportunity to extend research on older adults’ conversational technology use to include care partners. Next, we conducted a diary study and interviews with caregivers and care receivers to investigate gaps in care interactions and conversations. We found that care receivers experienced more communication frustrations than caregivers and that older adult caregivers wanted more opportunities to influence their care routines.
In this project, we will use these findings to develop in-home conversational technologies that use prompts to structure care conversations between older adults and their caregivers.
We contribute a nuanced dyadic perspective to care relationships as most care research focuses solely on caregiver perspectives. We also extend conversational technology research beyond information seeking to include more social uses by developing conversational technology applications with mainstream voice technologies (e.g., Amazon Alexa) to support improved care relationships, social and emotional well-being, and quality of life.

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Designing Usable Technologies for Older Adults via Data-Driven Whole-Person User Personas

Using machine learning to create data-driven user personas for the design of usable technologies for older adults
Awardee Organization(s): University of Minnesota

Principal Investigator(s): Robin Austin, PhD, DNP, DC, RN-BC
Official Project Title: Designing Usable Technologies for Older Adults via Data-Driven Whole-Person User Personas
AITC Partner: PennAITech
Website(s): www.nursing.umn.edu

The long-term goal of this research led by Dr. Robin Austin at the University of Minnesota and her team is to improve health outcomes by combining whole-person patient-generated health data with EHR data, to inform clinical conversations, predict patient trajectories, and identify appropriate interventions. This research, Designing Usable Technologies for Older Adults via Data-Driven Whole-Person User Personas, will create a set of data-driven user personas based on data from 6 studies where 783 adults 65+ years old independently completed a comprehensive health assessment using the MyStrengths+MyHealth (MSMH) mobile app developed by Dr. Robin’s team. MSMH assesses 42 strength/problem areas (e.g., Income, Spirituality, Nutrition) divided into four categories (e.g., My Living, My Mind and Networks, My Body, My Self- Care). Individuals can specify any of 335 challenges (e.g., Hard to concentrate) and any of 4 needs related to each strength/problem area (e.g., Check-ins, Hands-on Care, Info/Guidance, Care Coordination). We will use machine learning approaches, clustering analysis and association rule learning, which are frequently used to develop user personas. These whole-person user personas will account for a 360 degree view of the person, meaning the environments in which individuals live, their psychosocial and physical health needs, and their strengths. This research will inform person-centered technology design and develop a better understanding of the types of older adults who may use AI-based technologies.

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Detecting Respiratory Distress in Patients with Advanced AD/ADRD Using Radio Sensors

AI-enabled near-field coherent sensing (NCS) radio sensors to detect respiratory distress for advanced AD/ADRD patients who are unable to self-report
Awardee Organization(s): Weill Cornell Medicine
Principal Investigator(s): Veerawat Phongtankuel, MD, MS
Official Project Title: Detecting Respiratory Distress in Patients with Advanced ADRD Using Radio Sensors
AITC Partner: PennAITech
Website(s): www.weill.cornell.edu

This project focuses on designing and developing conversational care technologies for older adults and their caregivers. In prior work, we surveyed informal caregivers and older adult care receivers to understand their care routines. Survey findings showed how nearly 20% of care partners used voice assistants in their homes, signaling an opportunity to extend research on older adults’ conversational technology use to include care partners. Next, we conducted a diary study and interviews with caregivers and care receivers to investigate gaps in care interactions and conversations. We found that care receivers experienced more communication frustrations than caregivers and that older adult caregivers wanted more opportunities to influence their care routines.
In this project, we will use these findings to develop in-home conversational technologies that use prompts to structure care conversations between older adults and their caregivers. We contribute a nuanced dyadic perspective to care relationships as most care research focuses solely on caregiver perspectives. We also extend conversational technology research beyond information seeking to include more social uses by developing conversational technology applications with mainstream voice technologies (e.g., Amazon Alexa) to support improved care relationships, social and emotional well-being, and quality of life.

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Determinants of Access to and Outcomes Following Specialized Palliative Care for Patients with ADRD

Awardee Organization(s): Palliative and Advanced Illness Research (PAIR) Center
Principal Investigator(s): Emily Moin, MD, MBE
Official Project Title: Determinants of Access to and Outcomes Following Specialized Palliative Care for Patients with ADRD
AITC Partner: PennAITech
Website(s): https://pair.upenn.edu/

As a supplement to the PennAITech program, we will link electronic health record data from all patients at the University of Pennsylvania Health System (Penn Medicine) with inpatient encounters from 2017-2023 to claims data from the Centers for Medicare and Medicaid Services (CMS) from 2018-2024. The central goal of creating these linkages is to identify determinants of access to and outcomes following specialist palliative care (SPC) for patients with ADRD and other serious illnesses. Engaging SPC clinicians in the longitudinal management of patients with ADRD and other serious illnesses is a key priority, yet patients with ADRD less commonly receive SPC than do patients with cancer and other illnesses, and more commonly experience hospitalizations and inadequate symptom control. To surmount these inequities in care delivery requires filling key knowledge gaps related to the extents to which patients with ADRD experience novel and more holistic patient- centered outcomes than have commonly been measured, and whether patients at risk for poor outcomes can be reliably identified so as to target SPC resources toward them.
We will achieve this central goal and address these knowledge gaps through completion of three specific aims. First, we will quantify differences in SPC consultation among Medicare and Medicaid beneficiaries with vs. without AD/ADRD admitted to Penn Medicine hospitals. We will first assess SPC access using the gold-standard approach we have pioneered of measuring signed SPC notes in the electronic health record (EHR), and second using the proportions with Z51.5 billing codes (“encounter for palliative care”) in CMS data. While this claims-based approach is commonly used due to its efficiency, there are many reasons to believe it may not possess favorable operating characteristics, thereby yielding biased conclusions when used as a measure of SPC receipt. Comparing its sensitivity, specificity, calibration, and other measures to our gold standard will elucidate this approach’s utility overall and specifically among patients with ADRD.
Second, we measure changes in calculating a key patient-centered outcome – hospital-free days (HFDs), or days alive and living outside a hospital through 6 months of follow-up – using only EHR data vs. supplementing with CMS data among patients with ADRD and other serious illnesses. We hypothesize that adding CMS data to EHR data will produce more robust and accurate quantification of this critical outcome relative to either method alone. Third, we will build an Artificial Intelligence (AI) model to predict which patients with (1) ADRD and (2) all serious illnesses are at risk for low numbers of HFDs, thereby guiding the allocation of SPC services in practice enabling prognostic enrichment of patients with ADRD in future trials of palliative care interventions using this endpoint.

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Feasibility of Digital Monitoring to Detect Autonomic Markers of Empathy Loss in bvFTD

Wearable sensors capturing digital autonomic biomarkers to detect empathy loss for frontotemporal dementia (bvFTD)
Awardee Organization(s): University of Pennsylvania Frontotemporal Degeneration Center
Principal Investigator(s): Emma Rhodes, PhD
Official Project Title: Feasibility of Digital Monitoring to Detect Autonomic Markers of Empathy Loss in bvFTD
AITC Partner: PennAITech
Website(s): www.med.upenn.edu/ftd
Loss of empathy is a core symptom of behavioral variant frontotemporal dementia (bvFTD) that negatively impacts daily functioning and is highly distressing to families and caregivers. Scientific research has struggled to understand the specific causes of empathy loss in bvFTD. A relatively unexplored but promising avenue of scientific inquiry is the role of autonomic nervous system (ANS) arousal in empathy loss in bvFTD. The ANS is comprised of two complementary subsystems, the sympathetic and parasympathetic nervous systems, which operate together to regulate an individual’s level of physiologic arousal in response to emotional cues from the environment. Patients with bvFTD show abnormalities in autonomic arousal that are linked to symptoms of social dysfunction, including loss of empathy, but this line of research has been hindered by reliance on traditional methods of measuring autonomic arousal, namely hard-wired EKG and skin conductance sensors, which restrict the movement of the patient and are sensitive to motion effects. Recent advances in wearable smartwatch technology allow for precise, unobtrusive measurement of autonomic arousal with built-in motion sensors that more accurately capture key arousal variables, such as respiratory sinus arrythmia and skin conductance. Use of smartwatch technology will advance our understanding of physiologic mechanisms of empathy loss in bvFTD and other neuropsychiatric symptoms in ADRD and identify potential treatment targets. The overarching goal of this project is to test the feasibility of using a smartwatch to capture abnormalities in autonomic arousal in bvFTD and validate digital markers of autonomic abnormalities against behavioral measures of empathy loss.
In this project, we will use these findings to develop in-home conversational technologies that use prompts to structure care conversations between older adults and their caregivers.
We contribute a nuanced dyadic perspective to care relationships as most care research focuses solely on caregiver perspectives. We also extend conversational technology research beyond information seeking to include more social uses by developing conversational technology applications with mainstream voice technologies (e.g., Amazon Alexa) to support improved care relationships, social and emotional well-being, and quality of life.

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Intelligent decision-making tool to connect individuals with AD/ADRD and their caregivers to health app technologies

Awardee Organization(s): University of Pittsburgh
Principal Investigator(s): Julie Faieta, PhD, MOT OTR/L
Official Project Title: Health App Review Tool: Connecting those Affected by Alzheimer’s to Needed Technology Support
AITC Partner: PennAITech
Website(s): https://www.shrs.pitt.edu/

The goal of this project is to connect those affected by Alzheimer’s disease and related dementias (ADRD) with effective apps using an intelligent decision-making aid, the Health App Review Tool (HART). The HART is comprised of a User Assessment and App Assessment, that together characterize the features of health apps relative to the needs, abilities, and preferences of individuals with ADRD and their informal caregivers. The HART assesses the goodness of match between user and app variables in order to guide app selection.
The first phase of this pilot project will be used to develop a web-base and app interface to house the HART. The dedicated interface is necessary in preparation for real-world and wide-spread use of the HART. There will be a user interface displaying the HART assessment questions, a back end that completes the scoring process, and a results display. In addition, we will establish a cloud-based library of app scores that can be downloaded and compared to new HART users in the future. The second phase of the project will be a usability study to gather feedback and insight on the HART interfaces for those impacted by ADRD.
The Health App Review Tool (HART) is expected facilitate clinicians, caregivers, and community organizations to select the best apps to meet the unique needs of individuals with ADRD and their caregivers. Improving access to person centered, easy to use technology guidance is intended to increase the impact and equity of app-mediated care.

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