Administrative Supplement: Life-Space and Activity Digital Markers for Detection of Cognitive Decline in Community-Dwelling Older Adults: The RAMS Study

Virginia Commonwealth University, Richmond VA

Investigators

Abstract

Project Summary - for Administrative Supplement to the RAMS Study (R01AG082251; MPIs: Chung and Sargent) This request for an administrative supplement is in response to PA-20-272. Summary of Parent Study: The parent study (R01AG082251), or the “Life-space and Activity Digital Markers for Detection of Cognitive Decline in Community-Dwelling Older Adults: The RAMS Study,” is a study that aims to develop sensitive, practical, and ecologically acceptable life-space mobility (LSM) digital indicators that could be used as clinically relevant markers of subsequent cognitive decline among community-dwelling older adults. Markers of functional decline begin years before clinical symptoms of Alzheimer’s disease and related dementias (ADRD). It is essential to capture these functional changes as early as possible to intervene before symptoms arise to prevent further deterioration. Resources to assess cognitive changes and detect the progression to mild cognitive impairment (MCI) and ADRD are limited among older adults with health disparities. The digital technology-based assessment of cognitively complex activities, such as LSM, has the potential to identify those at risk for cognitive decline. Participants are classified as cognitively normal (CN; n=157) or MCI (n=157) based on a neuropsychological battery at baseline and will be prospectively followed up for 3 years to collect 7-day RAMS data and neuropsychological evaluations every 6 months. The specific aims are to (1) Compare baseline and longitudinal trajectories of RAMS measures between CN and MCI groups and determine the impact of social health factors on RAMS indicators and cognitive function; (2) Determine RAMS indicators that classify CN and MCI groups at baseline and evaluate the ability of RAMS indicators to predict the subsequent onset of MCI and dementia over a 3-year period; and (3) Evaluate older adults’ attitudes towards digital health technology for monitoring risks of cognitive decline. Summary of Administrative Supplement: The request for the administrative supplement funding supports a targeted opportunity to include baseline ADRD biomarkers in the parent study. This funding will allow our team to compare the study RAMS digital measures with established ADRD markers. Adding the ADRD biomarkers will strengthen the study prediction model, allow for deep phenotyping, and validate the RAMS digital prediction model with other ADRD prediction models. The findings from the baseline ADRD biomarkers will advance the scientific knowledge and accelerate the translation of clinically meaningful digital measures into clinical practice to support early identification and prevention of the progression of MCI to ADRD. We had considered incorporating ADRD biomarker measures in the parent grant (R01AG08225) but did not have an established working relationship with the University of Kansas (KU) Alzheimer’s Disease Research Center (ADRC) Biomarker Core until after the grant was submitted. The KU ADRC collaboration has guided the methods and provided the materials to conduct the biomarker analysis proposed in this administrative supplement. Therefore, the administrative supplement provides our team with a targeted opportunity to include ADRD biomarkers in the parent study that were not previously available.