Digital Biomarkers for Monitoring Intrinsic Capacity for Healthy Ageing (BioMIC)
Symposium B3
DOI:
https://doi.org/10.14288/hfjc.v14i3.476Keywords:
Frailty, Intrinsic Capacity, Physical Activity, Accelerometers, Healthy AgeingAbstract
Purpose: This symposium will report on the development of digital biomarkers data that will contribute to a panel of measures for proactively assessing different aspects of intrinsic capacity, a critical component of healthy ageing.
Description:
Chair: Melvyn Hillsdon. Introduction to symposium
Presenter 1: Veerle Knoop, PhD. Intrinsic capacity - a model of healthy ageing.
Presenter 2: Melvyn Hillsdon. The potential of remote monitoring of digital biomarkers of intrinsic capacity.
Presenter 3: Brad Metcalf. The clinical validity of digital biomarkers of stepping.
Presenter 4: Joss Langford. Developing digital biomarkers for public health.
The World Health Organisation (WHO) has called for a move away from a disease management model of ageing and frailty that involves counting deficits and providing expensive medical intervention, to a more positive model of healthy ageing that focuses on preserving functional ability and preventing loss of capacity. They describe a pre-symptomatic phase of pre-frailty signaled by a decline in intrinsic capacity (IC). Intrinsic capacity is the combination of the individual’s physical and mental, including psychological, capacities. Capacities tend to peak in early adulthood and fade with ageing, increasing the gap between what the person desires to do and what in reality they actually do. Early detection of deterioration and interventions that preserve or increase IC, would allow older persons to (1) do what they have reason to value, and (2) make them again active and functional in the society where they live. Several challenges must be addressed before IC can be an integral part of a healthcare system designed to promote health ageing. These include developing standardised, valid, objective, community-level tools for assessing IC and determining how to monitor IC in mid-life. The ubiquity and rapid development of wearable devices could be used as early indicators of declining IC, but algorithms are needed to translate metadata from these devices, to meaningful metrics for use by clinicians and the public to understand how to enhance IC. Wearable movement detection devices such as accelerometers provide a tool with which to detect, monitor and assess specific parameters of IC remotely in the community. Whilst accelerometers alone cannot capture all the proposed domains of IC, they are very well suited to understanding parameters of locomotion and mobility. This symposium will report on the development, analytic and clinical validity of several early, pre-symptomatic biomarkers of a compromised intrinsic capacity derived from a wrist worn accelerometer.
Results: The symposium will report on the context of use of a panel of digital biomarkers of intrinsic capacity, and tests of fit-for-purpose. Clinical validity will be assessed by examining the associations between digital biomarkers and objective measures of physical function and prevalent disease in a sample of 768, sedentary, community-dwelling older people aged 65 year and older. Cross-sectional analysis of the association between biomarkers and the Short Physical Performance Battery test will be reported.
Conclusions: The development of a panel of digital biomarkers, when combined with other routine public health data, could provide insights about the unmet demand of people with a loss of capacity in the community. This will enable better modelling of the trajectory of how frailty in the community is associated with visit rates to primary and secondary care.
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Copyright (c) 2021 Veerle Knoop, Melvyn Hillsdon, Brad Metcalf, Joss Langford
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