Development and Validation of a Digital Phenotype of Affective Dysregulation in Alzheimer's Disease and Alzheimer's disease-related dementias

About This Grant

PROJECT SUMMARY/ABSTRACT The objective of this K23 career development award is to prepare Dr. Alyssa De Vito, a research assistant professor and clinical neuropsychologist, for an independent research career focused on using novel technologies to improve the detection and monitoring of neuropsychiatric symptoms (NPS) in Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD). Neuropsychiatric symptoms (NPS) affect up to 85% of individuals with Alzheimer’s disease and Alzheimer’s disease-related dementias (AD/ADRD) and are associated with accelerated disease progression, increased healthcare utilization, and more caregiver burden. Affective dysregulation symptoms (i.e., depression, anxiety, and irritability) are the most common NPS and those that are the earliest to emerge in AD/ADRD. Established NPS assessments are not well-suited for disease monitoring due to their reliance on subjective, patient/caregiver insight and infrequent, in-person data collection, which fails to capture the dynamic nature of symptoms. Objective metrics of NPS are critically needed. Digital phenotyping, the continuous and real-time collection of an individual’s behavioral, psychological, and physiological states through personal devices (e.g., smartphones and smartwatches), may overcome these limitations and improve our ability to objectively detect, monitor, and identify critical windows for intervention of NPS in AD/ADRD. The proposed aims of this K23 include: 1) develop a digital phenotype of affective dysregulation symptoms, 2) determine the convergent and criterion validity of the digital phenotype, and 3) characterize temporal patterns of symptoms in those with and without cognitive impairment over the four-week monitoring period. Completion of the project aims and the proposed training plan which includes: 1) Neural mechanisms of NPS in AD/ADRD (Primary Mentor: Edward Huey, MD), 2) data reduction and multivariate longitudinal statistics (Co-Mentor: Richard Jones, ScD), 3) ecological momentary assessment/digital phenotyping research design and methodology (Co-Mentor: John Torous, MD), and 4) Digital bioethics (Co-Mentor: John Torous, MD). Brown University/Butler Hospital provides the ideal environment and research infrastructure to complete the proposed mentored research project and career development training plan outlined in this application.