Skip to main content
SpringerLink
Log in

Intrinsic Capacitiy Monitoring by Digital Biomarkers in Integrated Care For Older People (ICOPE)

  • Special Article
  • Published:
The Journal of Frailty & Aging Aims and scope Submit manuscript

Abstract

The WHO action plan on aging expects to change current clinical practices by promoting a more personalized model of medicine. To widely promote this initiative and achieve this goal, healthcare professionals need innovative monitoring tools. Use of conventional biomarkers (clinical, biological or imaging) provides a health status assessment at a given time once a capacity has declined. As a complement, continuous monitoring thanks to digital biomarkers makes it possible to remotely collect and analyze real life, ecologically valid, and continuous health related data. A seamless assessment of the patient’s health status potentially enables early diagnosis of IC decline (e.g. sub-clinical or transient events not detectable by episodic evaluations) and investigation of its probable causes. This narrative review aims to develop the concept of digital biomarkers and its implementation in IC monitoring.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Cesari M, Araujo de Carvalho I, Amuthavalli Thiyagarajan J, Cooper C, Martin FC, Reginster JY, et al. Evidence for the Domains Supporting the Construct of Intrinsic Capacity. J Gerontol A Biol Sci Med Sci. 2018;73:1653–1660. doi: https://doi.org/10.1093/gerona/gly011.

    Article  PubMed  Google Scholar 

  2. de Kerimel J, Tavassoli N, Lafont C, Soto M, Pedra M, Nourhashemi F, et al. How to Manage Frail Older Adults in the Community? Proposal of a Health Promotion Program Experienced in a City of 16,638 Inhabitants in France. J Frailty Aging. 2018;7:120–126. https://doi.org/10.14283/jfa.2017.47.

    PubMed  CAS  Google Scholar 

  3. Piau A, Sourdet S, Toulza O, Bernon C, Tavassoli N, Nourhashemi F. Frailty Management in Community-Dwelling Older Adults: Initial Results of a Trained Nurses Program. J Am Med Dir Assoc. 2019;20:642–643. doi: https://doi.org/10.1016/j.jamda.2018.11.011.

    Article  PubMed  Google Scholar 

  4. Insel T. Digital phenotyping: technology for a new science of behavior. JAMA 2017;318:1215–6

    Article  PubMed  Google Scholar 

  5. Seelye A, Mattek N, Sharma N, Riley T, Austin J, Wild K, et al. 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. Alzheimers Dement. 2018;14:187–194. doi: https://doi.org/10.1016/j.jalz.2017.07.756.

    Article  PubMed  Google Scholar 

  6. FDA-NIH. Biomarker Working Group. BEST (Biomarkers, EndpointS, and other Tools) Resource. US: Silver Spring (MD), Food and Drug Administration, 2016. PMID:27010052

    Google Scholar 

  7. Wild KV, Mattek N, Austin D, Kaye JA. “Are You Sure?”: Lapses in Self-Reported Activities Among Healthy Older Adults Reporting Online. J Appl Gerontol. 2016;35:627–41. doi: https://doi.org/10.1177/0733464815570667.

    Article  PubMed  Google Scholar 

  8. Kramer F, Sabbah HN, Januzzi JJ, Zannad F, Peter van Tintelen J, Schelbert EB, et al. Redefining the role of biomarkers in heart failure trials: expert consensus document. Heart Fail Rev. 2017;22:263–277. doi: https://doi.org/10.1007/s10741-017-9608-5. PMID:28332132

    Article  PubMed  Google Scholar 

  9. Gold M, Amatniek J, Carrillo MC, Cedarbaum JM, Hendrix JA, Miller BB, et al. Digital technologies as biomarkers, clinical outcomes assessment, and recruitment tools in Alzheimer’s disease clinical trials. Alzheimers Dement (N Y). 2018;4:234–242. doi: https://doi.org/10.1016/j.trci.2018.04.003.

    Article  Google Scholar 

  10. Faurholt-Jepsen M, Vinberg M, Frost M, Christensen EM, Bardram JE, Kessing LV. Smartphone data as an electronic biomarker of illness activity in bipolar disorder. Bipolar Disord 2015;17:715–728.

    Article  PubMed  Google Scholar 

  11. Saeb S, Zhang M, Karr CJ, Schueller SM, Corden ME, Kording KP, et al. Mobile phone sensor correlates of depressive symptom severity in daily-life behavior: an exploratory study. J Med Internet Res 2015;17:e175.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Arnerić SP, Cedarbaum JM, Khozin S, Papapetropoulos S, Hill DL, Ropacki M, et al. Biometrie monitoring devices for assessing end points in clinical trials: developing an ecosystem. Nat Rev Drug Discov. 2017;16:736. doi: https://doi.org/10.1038/nrd.2017.153.

    Article  CAS  PubMed  Google Scholar 

  13. Kaye J. Home-based technologies: a new paradigm for conducting dementia prevention trials. Alzheimers Dement 2008;4(1 Suppl 1):S60–6.

    PubMed  Google Scholar 

  14. Kaye J, Mattek N, Dodge HH, Campbell I, Hayes T, Austin D, et al. Unobtrusive measurement of daily computer use to detect mild cognitive impairment. Alzheimers Dement. 2014;10:10–7. doi: https://doi.org/10.1016/j.jalz.2013.01.011.

    Article  PubMed  Google Scholar 

  15. Dodge HH, Mattek NC, Austin D, Hayes TL, Kaye JA. In-home walking speeds and variability trajectories associated with mild cognitive impairment. Neurology. 2012;78:1946–52. doi: https://doi.org/10.1212/WNL.0b013e318259elde.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Leach JM, Mancini M, Kaye JA, Hayes TL, Horak FB. Day-to-Day Variability of Postural Sway and Its Association With Cognitive Function in Older Adults: A Pilot Study. Front Aging Neurosci. 2018;10:126. doi: https://doi.org/10.3389/fnagi.2018.00126.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Austin J, Klein K, Mattek N, Kaye J. Variability in medication taking is associated with cognitive performance in nondemented older adults. Alzheimers Dement (Amst). 2017;6:210–213. doi: https://doi.org/10.1016/j.dadm.2017.02.003.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Hayes TL, Abendroth F, Adami A, Pavel M, Zitzeiberger TA, Kaye JA. Unobtrusive assessment of activity patterns associated with mild cognitive impairment. Alzheimers Dement, 2008;4:395–405. doi: https://doi.org/10.1016/j.jalz.2008.07.004.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Piau A, Mattek M, Duncan C, Sharma N, Riley T, Kaye J. The five W’s of falls — weekly online health survey of community-dwelling older adults: analysis of four years prospective follow-up. J Gerontol A Biol Sci Med Sci. 2019. doi: https://doi.org/10.1093/gerona/glz114.

  20. Kaye JA, Maxwell SA, Mattek N, Hayes TL, Dodge H, Pavel M, et al. Intelligent systems for assessing aging changes: home-based, unobtrusive, and continuous assessment of aging. J Gerontol B Psychol Sci Soc Sci 2011;66B:i180–90.

    Article  PubMed Central  Google Scholar 

  21. Piau A, Wild K, Mattek N, Kaye J. Current State of Digital Biomarker Technologies for Real-Life, Home-Based Monitoring of Cognitive Function for Mild Cognitive Impairment to Mild Alzheimer Disease and Implications for Clinical Care: Systematic Review. J Med Internet Res. 2019;21:e12785. doi: https://doi.org/10.2196/12785.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Seelye A, Mattek N, Sharma N, Witter P, Brenner A, Wild K, et al. Passive Assessment of Routine Driving with Unobtrusive Sensors: A New Approach for Identifying and Monitoring Functional Level in Normal Aging and Mild Cognitive Impairment. J Alzheimers Dis 2017;59:1427–1437. PMID:28731434.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Westerberg CE, Lundgren EM, Florczak SM, Mesulam MM, Weintraub S, Zee PC, et al. Sleep influences the severity of memory disruption in amnestic mild cognitive impairment: results from sleep self-assessment and continuous activity monitoring. Alzheimer Dis Assoc Disord 2010;24:325–33. PMID:20592579.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Piau A, Wild K. Performance of eHealth devices for frailty evaluation in real life settings is far from being demonstrated. Gerontology. 2019;65:309–310. doi: https://doi.org/10.1159/000495208.

    Article  PubMed  Google Scholar 

  25. Vellas B, Scrase D, Rosenberg GA, Andrieu S, Araujo de Carvalho I, Middleton LT. Editorial: WHO Guidelines on Community-Level Interventions to Manage Declines in Intrinsic Capacity: The Road for Preventing Cognitive Declines in Older Age?. J Prev Alzheimers Dis. 2018;5:165–167.

    PubMed  CAS  Google Scholar 

  26. De Souto Barreto P, Guyonnet S, Ader GI, Andrieu S, Casteilla L, Davezac N, et al. The INSPIRE research initiative: A program for geroscience and healthy aging research going from animal models to humans and the healthcare system. J Frailty Aging 2020. doi: https://doi.org/10.14283/jfa.2020.18.

  27. Beard JR. Linking Geroscience and Integrated Care to Reinforce Prevention. J Prev Alz Dis 2020;2:68–69.

    Google Scholar 

  28. Takeda C, Guyonnet S, Sumi Y, Vellas B, Araujo de Carvalho I. Integrated Care for Older People and the Implementation in the INSPIRE Care Cohort. J Prev Alzheimers Dis. 2020;7:70–74.

    PubMed  CAS  Google Scholar 

  29. Dent E, Morley JE, Cruz-Jentoft AJ, Woodhouse L, Rodríguez-Mañas L, Fried LP, et al. Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management. J Nutr Health Aging. 2019;23:771–787. doi: https://doi.org/10.1007/s12603-019-1273-z.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Guralnik J, Bandeen-Roche K, Bhasin SAR, Eremenco S, Landi F, Muscedere J, et al. Clinically Meaningful Change for Physical Performance: Perspectives of the ICFSR Task Force. J Frailty Aging. 2020;9:9–13. doi: https://doi.org/10.14283/jfa.2019.33.

    PubMed  PubMed Central  CAS  Google Scholar 

  31. Rodriguez-Mañas L, Araujo de Carvalho I, Bhasin S, Bischoff-Ferrari HA, Cesari M, Evans W, et al. ICFSR Task Force Perspective on Biomarkers for Sarcopenia and Frailty. J Frailty Aging. 2020;9:4–8. doi: https://doi.org/10.14283/jfa.2019.32.

    PubMed  Google Scholar 

  32. Morley JE. Editorial: The Future of Geriatrics. J Nutr Health Aging. 2020;24:1–2. doi: https://doi.org/10.1007/s12603-019-1308-5.

    Article  CAS  PubMed  Google Scholar 

  33. Marengoni A. Letter to the editor: Reply to: The Future of Geriatrics. J Nutr Health Aging. 2020;24:242. doi: https://doi.org/10.1007/s12603-020-1321-8.

    Article  CAS  PubMed  Google Scholar 

  34. Muscedere J. Editorial: The Need to Implement Frailty in the International Classification of Disease (ICD). J Frailty Aging. 2020;9:2–3. doi: https://doi.org/10.14283/jfa.2020.2.

    PubMed  CAS  Google Scholar 

  35. Kaye J, Reynolds C, Bowman M, Sharma N, Riley T, Golonka O, et al. Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data. J Vis Exp. 2018;(137). doi: https://doi.org/10.3791/56942.

  36. Guerville F, De Souto Barreto P, Ader I, Andrieu S, Casteilla L, Dray C, et al. Revisiting the Hallmarks of Aging to Identify Markers of Biological Age. J Prev Alzheimers Dis. 2020;7:56–64.

    PubMed  CAS  Google Scholar 

  37. Mahoney DF, Purtilo RB, Webbe FM, Alwan M, Bharucha AJ, Adlam TD, Working Group on Technology of the Alzheimer’s Association. In-home monitoring of persons with dementia: Ethical guidelines for technology research and development. Alzheimers Dement 2007 Jul;3(3):217–226. doi: https://doi.org/10.1016/j.jalz.2007.04.388.

    Article  PubMed  Google Scholar 

  38. Reiners F, Sturm J, Bouw LJW, Wouters EJM. Sociodemographic Factors Influencing the Use of eHealth in People with Chronic Diseases. Int J Environ Res Public Health. 2019; 16. pii: E645. doi: https://doi.org/10.3390/ijerph16040645.

  39. Kamis K, Janevic MR, Marinec N, Jantz R, Valverde H, Piette JD. A study of mobile phone use among patients with noncommunicable diseases in La Paz, Bolivia: implications for mHealth research and development. Global Health. 2015;11:30. doi: https://doi.org/10.1186/s12992-015-0115-y.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Maurizi N, Faragli A, Imberti J, Briante N, Targetti M, Baldini K, et al. Cardiovascular screening in low-income settings using a novel 4-lead smartphone-based electrocardiograph (D-Heart®). Int J Cardiol. 2017;236:249–252. doi: https://doi.org/10.1016/j.ijcard.2017.02.027.

    Article  PubMed  Google Scholar 

  41. Piau A, Mattek M, Crissey R, Beattie Z, Dodge H, Kaye J. When will my patient fall? Sensor-based in-home walking speed identifies future falls in older adults. J Gerontol A Biol Sci Med Sci. 2020;75:968–973. doi: https://doi.org/10.1093/gerona/glzl28.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank all the health professionals participating in the INSPIRE ICOPE CARE Program. We would also like to thank Zachary Beattie and Judith Kornfeld (OHSU, OR, Portland) for their careful rereading of the first drafts of the article.

Funding

The Inspire Program was supported by grants from the Region Occitanie/Pyrénées-Méditerranée (Reference number: 1901175), the European Regional Development Fund (ERDF) (Project number: MP0022856), and the Inspire Chairs of Excellence funded by: Alzheimer Prevention in Occitania and Catalonia (APOC), EDENIS, KORIAN, Pfizer, Pierre-Fabre, Fondation Avenir Cogfrail Grant.

Author information

Authors and Affiliations

  1. Gerontopole, Toulouse University Hospital, 31059, Toulouse, France

    Antoine Piau, Z. Steinmeyer, B. Vellas & F. Nourhashemi

  2. UPS/INSERM, UMR1027, F-31073, Toulouse, France

    Antoine Piau, B. Vellas & F. Nourhashemi

  3. Department of Clinical Sciences and Community Health, University of Milan, 20122, Milan, Italy

    M. Cesari

  4. Oregon Center for Aging & Technology (ORCATECH), Oregon Health & Science University, Portland, USA

    J. Kornfeld, Z. Beattie & J. Kaye

  5. La Cité de la Santé, Bâtiment Ex-Biochimie, Hôpital La Grave, Place Lange, TSA 60033, 31059, Toulouse Cedex 9, France

    Antoine Piau

Authors
  1. Antoine Piau
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Z. Steinmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Cesari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Kornfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Z. Beattie
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. Kaye
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. B. Vellas
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. F. Nourhashemi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Antoine Piau.

Ethics declarations

There were no patients included in this study, therefore we did not obtain consent and were not reviewed by an ethics committee.

Additional information

Potential Conflicts of Interest

All authors declare to have no support from any organization for the submitted work (except the French Ministry of Health which supported the study by a grant), no financial relationships with any organisations that might have an interest in the submitted work, no other relationships or activities that could appear to have influenced the submitted work.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Piau, A., Steinmeyer, Z., Cesari, M. et al. Intrinsic Capacitiy Monitoring by Digital Biomarkers in Integrated Care For Older People (ICOPE). J Frailty Aging 10, 132–138 (2021). https://doi.org/10.14283/jfa.2020.51

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.14283/jfa.2020.51

Key words

Search

Navigation