Language Biomarkers of Brain Health. Rhoda Au, Ph.D. 2 nd International Symposium on Language Resources and Intelligence
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1 Language Biomarkers of Brain Health Rhoda Au, Ph.D. 2 nd International Symposium on Language Resources and Intelligence
2 Global Burden of Dementia
3 Can We Prevent the Tsunami Wave of Dementia?
4 So Far the Answer is No
5 Current A New Strategy Situation Preclinical Screening Test Current Screening Test Adapted by Drs. Dana Penney and Randall Davis from Fig 3 of Criteria For Preclinical Alzheimer s Disease, Alzheimer s Association report (2010), which in turn cites Jack C R, et al., Hypothetical model of dynamic biomarkers of the Alzheimer s pathological cascade, The Lancet, 9:1, Jan 2010, pp
6 The Impact Severe Dementia Dementia Threshold Normal Midlife Age/Time Later in life Alzheimer's Association. "Changing the Trajectory of Alzheimer's Disease." Washington DC (2010).
7 Leveraging Framingham
8
9 Dementia Study NINDS-ADRDA AD Diagnostic Criteria Baseline NP 1981 MMSE
10
11 Framingham Cognitive Aging Preclinical-Incident Dementia Gen NINDS-ADRDA AD Diagnostic Criteria 2016 Gen Baseline NP 1981 MMSE 1999 NP/MRI MMSE 1999 NP/MRI Mild Cognitive Impairment
12 Cognitive Impairment Detection Challenge FHS Two-Method Approach The Traditional Approach Boston Process Approach Preserve traditional measures Expand test beyond single score Focus on path to final response - Value of incorrect responses
13 Logical Memory Error Measures Traditional scores None Qualitative Scores Confabulations related Intrusions related Confabulations unrelated Intrusions unrelated
14 Framingham Cognitive Aging Today Preclinical-Incident Disease Gen NINDS-ADRDA AD Diagnostic Criteria 2016 Gen Baseline NP 1981 MMSE 1999 NP/MRI 2016 Repeat NP/MRI 1991 MMSE 1999 NP/MRI Repeat NP/MRI
15 Framingham Cognitive Aging Today Asymptomatic-Preclinical-Incident Disease Gen NINDS-ADRDA AD Diagnostic Criteria 2016 Gen Baseline NP 1981 MMSE 1999 NP/MRI 2016 Repeat NP/MRI Gen MMSE 1999 NP/MRI Repeat NP/MRI NP/MRI w/ DTI Repeat NP/MRI
16 What is Preclinical? 65+ years old Measures differentiate cognitively intact vs. clinically demented years old Measures differentiate cognitively intact vs. preclinical <45 years old Measures differentiate cognitively intact vs. cognitively intact
17
18
19 BPA on Steroids Digital Voice Not Demented: 2009 Mild Cognitive Impairment:2015
20 Digital Voice Markers Cognitive Impairment
21 FDA Digital Health Initiative The FDA has implemented the Digital Health Innovation Action Plan Promote the development and use of digital health technologies Source:
22 Digital Health Initiative Digital health technologies may act as susceptibility/risk biomarkers Sources:
23 Digital Biomarkers
24 Digital Voice Biomarkers
25 What Else?
26 Cognitive Impairment Cognitive Health
27 Sustaining brain health across life span
28 What We Need to Do Precision Brain Health Data Science/AI
29 What It Will Take Paradigmatic Shift Dimension Current Mindset New Mindset Investment Focus Research Focus Research Scope Care Focus Healthcare Delivery Data Capture Health Information Management From Finding the cure for Alzheimer s disease and related disorders Siloed, a-priori hypothesis-driven research to find treatments for Alzheimer s diseases Isolating single or small set of factors associated with disease Diagnosing and treating dementia Stove-piped 烟道式 Healthcare Institutions In clinic, sporadic time point, highly invasive, often self reported data collection Raw, unusable cognitive and related data stored in disparate sources. To Finding how to prevent brain related disorders Understanding lifelong health and experiences of sub-populations to optimize their brain health Deploying scalable, multi-factorial solutions to diverse populations with and without disease risk Monitoring and sustaining brain health Healthcare Ecosystem Continuous, passive capture of brain related data with rich demographic metadata Networked, secure, seamless, integrated, sharable, cloud based platform made widely available
30 What We Want to Do Next Build Plug and Play System
31 Where We Want to Do It Test Platform Robustness Across Diverse Study Sites
32 What We Have Learned Secure Open Source API Device Grade Level of Use Balance Criteria Defined stakeholder value proposition Scalable Flexible & Agnostic Strong data infrastructure Easy data use/sharing
33
34 Ambient Technology Sustainable Remote Monitoring
35 Where Next?
36 Sleep Eating Behavior Inferred Cognition Physical Activity Social Activity Medication
37 Sleep Eating Behavior Inferred Cognition Physical Activity Social Activity Medication
38 Sleep Eating Behavior Inferred Cognition Physical Activity Social Activity Medication
39 Sleep Eating Behavior Inferred Cognition Physical Activity Social Activity Medication
40 Sleep Eating Behavior Inferred Cognition Physical Activity Social Activity Medication
41 Sleep Eating Behavior Inferred Cognition Physical Activity Social Activity Medication
42 Sleep Eating Behavior Inferred Cognition Physical Activity Social Activity Medication
43 What Ultimate Success Will Look Like Open Science, Scalable, Integrated Research & Care Platform
44 Impact of Success
45 Think Different, Be Different
46
47 Thanks.
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