Nicole Sharma

Pervasive Computing Technologies to Continuously Assess Alzheimer’s Disease Progression and Intervention Efficacy

Traditionally, assessment of functional and cognitive status of individuals with dementia occurs in brief clinic visits during which time clinicians extract a snapshot of recent changes in individuals’ health. Conventionally, this is done using various clinical assessment tools applied at the point of care and relies on patients’ and caregivers’ ability to accurately recall daily activity and trends in personal health. These practices suffer from the infrequency and generally short durations of visits. Since 2004, researchers at the Oregon Center for Aging and Technology (ORCATECH) at the Oregon Health and Science University have been working on developing technologies to transform this model. ORCATECH researchers have developed a system of continuous in-home monitoring using pervasive computing technologies that make it possible to more accurately track activities and behaviors and measure relevant intra-individual changes. We have installed a system of strategically placed sensors in over 480 homes and have been collecting data for up to 8 years. Using this continuous in-home monitoring system, ORCATECH researchers have collected data on multiple behaviors such as gait and mobility, sleep and activity patterns, medication adherence, and computer use. Patterns of intra-individual variation detected in each of these areas are used to predict outcomes such as low mood, loneliness, and cognitive function. These methods have the potential to improve the quality of patient health data and in turn patient care especially related to cognitive decline. Furthermore, the continuous real-world nature of the data may improve the efficiency and ecological validity of clinical intervention studies.

ECOLOGICALLY VALID ASSESSMENT OF LIFE ACTIVITIES: UNOBTRUSIVE CONTINUOUS MONITORING WITH SENSORS

not available. PL-05-02 NEXUS OFALZHEIMER’S AND CANCER Jane Ann Driver, Brigham and Women’s Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Contact e-mail: JDRIVER@ partners.org Abstract not available.not available. THURSDAY, JULY 28, 2016 ORAL SESSIONS O5-01 NEUROIMAGING: NEUROIMAGING CHANGES ASSOCIATED WITH APOE4 AND OTHER GENETIC LOCI O5-01-01 APOE E4 ALLELE EFFECT ON VASCULAR REACTIVITY MEASURED BY BREATH-HOLD ARTERIAL SPIN LABELING IN NORMAL AND MEMORY-IMPAIRED ADULTS Megan E. Johnston, Laura D. Baker, Suzanne Craft, Christopher T. Whitlow, Youngkyoo Jung, Wake Forest University Health Sciences, Winston Salem, NC, USA; 2 Wake Forest School of Medicine, Winston-Salem, NC, USA. Contact e-mail: megjohns@ wakehealth.edu Figure 1. Selection of slices from representative baseline and breath hold CBF maps Figure 2. Plot of Ab42 vs percent change in averaged GMCBFwith breathhold paradigm in APOE ε4 carriers adjusted for sex; adjusted R 1⁄4 0.224, P1⁄40.025 Podium Presentations: Thursday, July 28, 2016 P374

Things Are Changing so Fast: Integrative Technology for Preserving Cognitive Health and Community History

Background and Objectives Multimodal interventions are increasingly targeting multiple cognitive decline risk factors. However, technology remains mostly adjunctive, largely prioritizes age relevancy over cultural relevancy, and often targets individual health without lasting, community-wide deliverables. Meanwhile, African Americans remain overburdened by cognitive risk factors yet underrepresented in cognitive health and technology studies. The Sharing History through Active Reminiscence and Photo-imagery (SHARP) program increases physical, social, and cognitive activity within a culturally meaningful context that produces community deliverables-an oral history archive and cognitive health education. Design and Methods The SHARP application was tested with 19 African Americans ≥55 years, aiming for an easy, integrative, and culturally meaningful experience. The application guided triads in walks 3 times weekly for 6 months in Portland, Oregons historically Black neighborhoods; local historical images prompted recorded conversational reminiscence. Focus groups evaluated factors influencing technology acceptance-attitudes about technology, usefulness, usability, and relevance to integrating program goals. Thematic analysis guided qualitative interpretation. Results Technology acceptance was influenced by group learning, paper-copy replicas for reluctant users, ease of navigation, usefulness for integrating and engaging in health behaviors, relevance to integrating individual benefit and the community priority of preserving history amidst gentrification, and flexibility in how the community uses deliverables. Perceived community benefits sustained acceptance despite intermittent technology failure. Discussion and Implications We offer applicable considerations for brain health technology design, implementation, and deliverables that integrate modalities, age, and cultural relevance, and individual and community benefit for more meaningful, and thus more motivated community engagement.

COMPARING SLEEP AND ACTIVITY OUTCOMES IN INDIVIDUALS WITH ALZHEIMER’S DISEASE AND MILD COGNITIVE IMPAIRMENT USING ACTIGRAPHY

accuracies in distinguishing between different diagnostic groups were as follows: 1) the combination [Ab1-42+p-tau+NFL] differentiated ADD patients from HC with an AUROC of 0.86 (95% confidence interval [CI], 0.83-0.89); 2) total tau and [Ab1-42+ptau+YKL-40] combination discriminated ADD from FTD patients with an AUROC of 0.82 (95% CI, 0.78-0.86) and 0.81 (95% CI, 0.77-0.85), respectively; 3) total tau and [p-tau+YKL-40] combination distinguished FTD patients from HC with an AUROC of 0.78 (95% CI, 0.73-0.83) and 0.73 (95% CI, 0.67-0.79), respectively. Conclusions:Our data indicate that none of the multivariate combinations performed superior to the gold-standard core, feasible biomarkers in the classification of HC from MCI, HC from ADD, HC from FTD, MCI from ADD, and ADD from FTD patients. Future independent validation of our findings in larger multicenter cohorts is warranted to confirm and expand on our data. Particularly, longitudinal analyses are needed in asymptomatic preclinical at risk for AD individuals to investigatewhether components of the biomarker panel valuably predict disease progression and conversion to clinical milestones, including prodromal stage and dementia.

THE COLLABORATIVE AGING RESEARCH USING TECHNOLOGY (CART) INITIATIVE: BUILDING SCALABLE, ECOLOGICALLY VALID INFORMATION COMMUNICATION TECHNOLOGY RESEARCH CAPACITY

who are struggling on exercises or protocol adherence, such that online trainers can be “called up” during training to instruct, mentor and motivate. Conclusions:Overall, next generation brain training focuses more on the nature of delivery, supervision and wider training context rather than exercise content alone. We aim to socialize the online brain training experience, connecting participants with likeminded peers, expert trainers and their own social network for long term engagement and sustained cognitive benefit.

EVALUATE-AD (ECOLOGICALLY VALID, AMBIENT, LONGITUDINAL AND UNBIASED ASSESSMENT OF TREATMENT EFFICACY IN ALZHEIMER’S DISEASE): A PRAGMATIC PROOF-OF-CONCEPT CLINICAL TRIAL

accommodated older adults who had a variety of psychiatric conditions such as dementia, schizophrenia and bipolar disorder, were involved in this exploratory pilot study. Both Apple iPad and Samsung tablets were used. Staff training methods included written instructions, practical demonstrations and group workshops. These workshops focused on improving knowledge and confidence in using tablet devices with residents. A list of apps were provided depending on the residents’ preferences, and included games, puzzles and relaxation. Following completion of the study, 80% of staff were confident in using tablet devices with residents and 24% used these more than weekly. The majority of them (85.7%) reported that the residents enjoyed using the devices. Conclusions: Tablet devices and apps can successfully be used to engage residents but it is essential that staff are involved in the implementation process. Further research involving larger sample sizes are recommended.

Weekly observations of online survey metadata obtained through home computer use allow for detection of changes in everyday cognition before transition to mild cognitive impairment

Subtle changes in instrumental activities of daily living often accompany the onset of mild cognitive impairment (MCI) but are difficult to measure using conventional tests.

PATTERNS OF HOME COMPUTER USE DIFFER OVER TIME BETWEEN OLDER ADULTS DESTINED TO DEVELOP MILD COGNITIVE IMPAIRMENT AND THOSE WHO REMAIN COGNITIVELY INTACT

in the total severity score of neuropsychiatric and depressive symptoms assessed through the Neuropsychiatric Inventory-Questionnarie (NPI-Q) and the Geriatric Depression Scale (GDS), using repeated measures ANOVA with the within-subject NPI-Q and GDS scores as dependent variables, and Group (the four groups) and Evaluation (baseline and follow-up) as factors. Results: We found significant effects for Group and interaction Group*Evaluation in the neuropsychiatric symptoms (NPI-Q). The group mdaMCI showed higher neuropsychiatric symptoms than the other groups at baseline and an increase at the follow-up. In depressive symptoms (GDS) only significant main effects for Group and Evaluation were found. The mda-MCI and mdna-MCI groups displayed more depressive symptoms than the Healthy Controls. For all groups there was a slight increase at the follow-up. Conclusions: Neuropsychiatric and depressive symptoms are more common in patients with mda-MCI subtype, and in these patients increase significantly at relatively short follow-up evaluations. Further longitudinal research is necessary to determine the trajectory of that change and the predictive role of these symptoms on the conversion to Alzheimer Disease. P3-215 PATTERNS OF HOME COMPUTER USE DIFFER OVER TIME BETWEEN OLDER ADULTS DESTINED TO DEVELOP MILD COGNITIVE IMPAIRMENTAND THOSE WHO REMAIN COGNITIVELY INTACT Adriana Seelye, Nora Mattek, Nicole Sharma, Phelps Witter, Christy Dunn, Thomas Riley, Johanna Austin, Hiroko H. Dodge, Katherine Wild, Jeff A. Kaye, Oregon Center for Aging & Technology (ORCATECH), Portland, OR, USA; 2 NIA-Layton Aging & Alzheimer’s Disease Center, Portland, OR, USA; 3 Oregon Health & Science University, Portland, OR, USA; 4 Minneapolis VA Health Care System, Minneapolis, MN, USA; University of Michigan, Ann Arbor, MI, USA. Contact e-mail: seelyea@ohsu.edu