Using Wearable Sensors to Measure Goal Achievement in Older Veterans with Dementia

Jennifer Freytag, Ram Kinker Mishra, Richard L Street Jr, Angela Catic, Lilian Dindo, Lea Kiefer, Bijan Najafi, Aanand D Naik, Jennifer Freytag, Ram Kinker Mishra, Richard L Street Jr, Angela Catic, Lilian Dindo, Lea Kiefer, Bijan Najafi, Aanand D Naik

Abstract

Aligning treatment with patients' self-determined goals and health priorities is challenging in dementia care. Wearable-based remote health monitoring may facilitate determining the active participation of individuals with dementia towards achieving the determined goals. The present study aimed to demonstrate the feasibility of using wearables to assess healthcare goals set by older adults with cognitive impairment. We present four specific cases that assess (1) the feasibility of using wearables to monitor healthcare goals, (2) differences in function after goal-setting visits, and (3) goal achievement. Older veterans (n = 17) with cognitive impairment completed self-report assessments of mobility, then had an audio-recorded encounter with a geriatrician and wore a pendant sensor for 48 h. Follow-up was conducted at 4-6 months. Data obtained by wearables augments self-reported data and assessed function over time. Four patient cases illustrate the utility of combining sensors, self-report, notes from electronic health records, and visit transcripts at baseline and follow-up to assess goal achievement. Using data from multiple sources, we showed that the use of wearable devices could support clinical communication, mainly when patients, clinicians, and caregivers work to align care with the patient's priorities.

Keywords: Alzheimer’s disease; aging; cognitive impairment; dementia; digital health; goal setting; patient goals; remote patient monitoring; telemedicine; wearable.

Conflict of interest statement

R.K.M. is currently employed with BioSensics LLC, the manufacturer of the wearable sensors used in this study. R.K.M. was employed by Baylor College of Medicine and not associated with BioSensics LLC during the recruitment, data collection and analysis portions of this study. B.N., Co-Author, is serving as a consultant for BioSensics LLC.

Figures

Figure 1
Figure 1
Intervention Design: Consort chart for the study.
Figure 2
Figure 2
Patient Priorities Care program to determine patient-centric health priorities and setting relevant goals. Wearable sensors were used to determine patient participation in achieving the goals and facilitate the goal-setting process.
Figure 3
Figure 3
PAMSysTM pendant.
Figure 4
Figure 4
Change in activity timelines from baseline to follow-up.

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