Remote assessment of functional ability in Alzheimer’s disease

Alzheimer's disease is the most common cause of dementia. Clinical symptoms of Alzheimer's disease are decline in thinking ability (cognitive decline), causing patients to gradually lose their ability to function independently in daily life (functional decline). Currently, only one known treatment that slows down cognitive and functional decline in Alzheimer's disease is available, but this slowing is very minimal. Possible cause for the absence of good treatments is that measurement methods used in clinical trials are often not sensitive enough to measure cognitive and functional decline, especially in early stages of the disease. Remote monitoring technologies (RMTs), for example wearables, smartphone apps or sensors in the home, can help in this regard, as they measure continuously, passively, objectively and in in the real world. The aim of this thesis was therefore to better understand how we can use RMTs to measure cognitive and functional decline in Alzheimer's disease. We showed that research with RMTs is is feasible in older adults with Alzheimer's disease. We also showed that these RMTs can distinguish between participants with and without problems of thinking ability, by remotely measuring cognition, social functioning, physical activity and movement patterns in the home. Before we can use these results in clinical trials, future research with RMTs should focus primarily on detecting Alzheimer's disease at an even earlier stage, and longitudinal research is needed to assess sensitivity to change.