52 THE SCIENTIST | the-scientist.com
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hree years ago, Eli Lilly, Apple,
and California-based health and
measurement company Evidation
Health came together to ask a new kind
of research question: Can we identify cog-
nitive impairment by analyzing the many
types of digital data people inadvertently
generate in their everyday lives?
For 12 weeks in 2018, more than 100
people with varying states of cognitive
decline—or none at all—used an iPhone,
an Apple Watch, an iPad pro with a smart
keyboard, and a Beddit sleep monitoring
device. Each of these devices contains
various sensors such as gyroscopes,
pedometers, accelerometers, heart
rate monitors, and sleep sensors. The
iPad also administered language and
motor control tests on a biweekly basis.
Throughout the study period, partici-
pants talked, slept, worked, cleaned, and
socialized as their digital biomarker data
streams flowed to a cloud-based server
viewed by researchers at the study head-
quarters at Evidation in San Mateo.
The project, which ultimately aims
to improve diagnosis of cognitive decline
and the diseases it often accompanies,
addresses a pressing need. More than 5.8
million Americans live with dementia, cost-
ing the healthcare system and patients’ fam-
ilies about $305 billion per year. One in 10
Americans over the age of 65 now suffer
from Alzheimer’s disease, deaths from which
have increased 146 percent since 2000—it’s
now the sixth leading cause of mortality in
the US. There are no drug treatments on the
market to improve the cognitive function of
people who already have dementia.
But diagnosing dementia, especially
early on, can be difficult. Typically, doc-
tors assess patients in their offices with
tests that only effectively diagnose peo-
ple who have already noticeably started
losing cognitive ability. These testsmust be administered by a health pro-
fessional, and provide just a snapshot of
the patient’s experience.
Thus, current diagnostic tools usually
cannot identify people in the early stages
of disease, nor determine whether some-
one will develop dementia years down the
road. By the time patients receive a diagno-
sis, neurons have died and brain anatomy
has changed. “The periods beforehand have
been unknown territory,” says Arlene Astell,
a dementia and technology researcher atthe University of Reading in the UK and
the University of Toronto. “We haven’t been
able to collect those sorts of data in the past.”
Carol Routledge, director of research at the
nonprofit Alzheimer’s Research UK, agrees:
“We know nothing, or very, very little, about
early-stage disease.”Humans generate terabytes of behavioral data while using their smart devices.
Crunching those numbers could help identify the very start of cognitive decline.BY RACHAEL MOELLER GORMANDigital Detection of Dementia
KEEPING TABS: Massachusetts-based digital
health company Linus Health has developed
tools for smartphones and tablets that aim to
measure cognitive function.COURTESY OF LINUS HEALTH