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Detecting Frailty with Passive In-Home Heat Sensors
As a geriatrician, Dr. Dae Kim regularly assesses his patients for frailty—a common state of increased vulnerability associated with aging. Frailty is distinguished by physical features such as slow walking speed, difficulty rising from a chair, and declines in activity level. Patients with frailty are less able to cope with stressors—such as medication side effects or surgery—and are more likely to experience loss of independence, falls, delirium, and death.
Yet frailty assessments are time-consuming and there aren’t nearly enough geriatricians who can assess and manage older people with frailty in our aging society. “And when geriatricians conduct frailty assessments, they don’t always do so in a consistent manner,” said Kim, who is affiliated with Harvard Medical School and the Hebrew SeniorLife Marcus Institute for Aging Research.
When patient frailty goes undetected, valuable opportunities are missed to intervene early to improve their health outcomes and quality of life.
“As a clinician, it’s important to understand a patient’s frailty level in order to individualize treatment. A frail patient is likely to see better outcomes if their doctor prescribes medication with lower toxicity levels, or avoids certain invasive surgeries,” Kim explained. Patients with frailty also may benefit more from physical therapy or exercise to slow the progression of frailty and prolong their independence.
Kim has long been interested in finding passive ways to measure those trademark characteristics of frailty in order to provide information that could empower patients—as well as patients’ relatives, home health care agencies, and assisted living or memory care facilities—and promote early intervention. After learning about the MassAITC pilot grant opportunity, Kim met with co-leader Deepak Ganesan, who connected him with Amanda Paluch—UMass Amherst assistant professor of kinesiology, whose expertise centers on using wearable technologies to promote healthy aging—and Raghav “Rags” Gupta, chief growth officer at Butlr.io, a start-up that develops in-home sensing technologies. With their common interests and complementary skills, the three are collaborating to develop a contactless in-home assessment tool for frailty using body heat-sensing technology. Such a tool would protect the privacy of older adults while avoiding any need for them to interface with the technology themselves.
The pilot study includes 60 older adults from Kim’s clinic, who have been assessed as having a range of frailty levels. Butlr affixes heat sensing devices on the ceilings of participants' homes for between two and four weeks. The participants also wear sensors (produced by a different company) on their thighs continuously for 10 days, which collect “ground truth” data on their activity, including time spent sitting and standing, walking speed, and sit-to-stand transition. Ultimately, this research will allow Butlr to develop AI algorithms for passive, heat sensor-based assessment of frailty. In addition, the researchers will conduct an acceptability survey with participants to understand how they felt about having these sensors in their homes.
With this technology, said Kim, “I think we’re really pushing the boundaries of geriatric medicine, expanding detection of this massive problem of frailty beyond the clinic and finding societal solutions."
“These types of sensing technologies are already being used to monitor movement patterns and health measures of elite athletes,” said Gupta. “It feels inevitable to us that these same technologies should be deployed to bridge care gaps for older adults.”
“I think many of us have faced emotionally charged decisions with our own loved ones in determining when more care is needed,” he added. “Having more health information available can certainly help inform those decisions."