A Practical Platform for In-Home Remote Monitoring of Cognitive Frailty

Cognitive frailty, characterized by the coexistence of physical frailty and cognitive impairment, is a robust indicator of cognitive decline. Recognizing its significance, the International Association of Gerontology and Geriatrics and the International Academy on Nutrition and Aging have advocated for the use of cognitive frailty assessment as a means of monitoring the progression of mild cognitive impairment towards debilitating conditions like dementia, Alzheimer's disease, and loss of independence. Despite the clear need, a practical and remotely accessible tool for measuring cognitive frailty is currently lacking, especially within the context of telehealth visits. With telehealth video-conferencing becoming increasingly popular, accepted by healthcare payers, and preferred by older adults who may face difficulties traveling to a clinic, there is a pressing need for a software-based solution for remote cognitive frailty assessment that can be easily integrated into existing telehealth systems. This study proposes designing and validating a video-based solution to remotely monitor cognitive-frailty in older adults.

Inclusion Criteria:50 years or olderAmbulatoryAble and willing to provide consentMay have a diagnosis of mild dementia or pre-dementia or mild cognitive impairment (MCI), or MoCA score of 26 or lower.Exclusion Criteria:Major bilateral upper-limb disorderMajor hearing/visual impairmentHistory of stroke in the last 90 daysReceiving hospice careImmobility or major mobility disorder: We will exclude those who were bedbound or unable to stand or ambulate with or without walking assistanceinability to use telemedicine (e.g. no internet at home, severe visual or hearing problem, lack of caregiver support, etc)inability or unwillingness to participate in bi-monthly tele-medicine assessments or in-clinic visit (e.g., living farther than 30 mills from the clinic, unavailability of caregivers).significant cognitive impairment (MoCA score<16)severe dementiasevere apathysevere depressionin hospice care or palliative carehistory of drug or alcohol abuse over the last six monthsunable to communicate in English or Spanish