Design of a neurocognitive digital health system (NDHS) for neurodegenerative diseases

ABSTRACTDigital health technology is becoming more ubiquitous in monitoring individuals' health as both device functionality and overall prevalence increase. However, as individuals age, challenges arise with using this technology particularly when it involves neurodegenerative issues (e.g., for individuals with Parkinson's disease, Alzheimer's disease, and ALS). Traditionally, neurodegenerative diseases have been assessed in clinical settings using pen-and-paper style assessments; however, digital health systems allow for the collection of far more data than we ever could achieve using traditional methods. The objective of this work is the formation and implementation of a neurocognitive digital health system designed to go beyond what pen-and-paper based solutions can do through the collection of (a) objective, (b) longitudinal, and (c) symptom-specific data, for use in (d) personalized intervention protocols. This system supports the monitoring of all neurocognitive functions (e.g., motor, memory, speech, executive function, sensory, language, behavioral and psychological function, sleep, and autonomic function), while also providing methodologies for personalized intervention protocols. The use of specifically designed tablet-based assessments and wearable devices allows for the collection of objective digital biomarkers that aid in accurate diagnosis and longitudinal monitoring, while patient reported outcomes (e.g., by the diagnosed individual and caregivers) give additional insights for use in the formation of personalized interventions. As many interventions are a one-size-fits-all concept, digital health systems should be used to provide a far more comprehensive understanding of neurodegenerative conditions, to objectively evaluate patients, and form personalized intervention protocols to create a higher quality of life for individuals diagnosed with neurodegenerative diseases.