# Development of novel digital biomarkers for proactive detection and treatment of functional decline

> **NIH NIH R43** · SMYL FITNESS RX LLC · 2022 · $299,797

## Abstract

PROJECT SUMMARY
By age sixty-five, 1 in 4 Americans will experience functional decline, a “silent killer” defined by life altering loss
of independence and limitations performing activities of daily living (ADLs). Poor health outcomes and
skyrocketing costs linked to functional decline cut across many diagnoses, leading to national expenditures
projected to exceed $1 trillion annually. Routine functional screening assessments are the gold-standard for
addressing this condition. However, due to numerous barriers, most older adults are cared for in settings
where screening is poor, inaccurate, or not conducted at all. As a result, functional decline often goes
unnoticed until obvious disability and adverse outcomes occur. Leaders in geriatrics have long recognized
obstacles addressing functional decline and have called for improved screening and treatment approaches.
Meanwhile, ownership, adoption, and usage of digital devices has climbed sharply among older adults,
particularly during the pandemic. Smyl Fitness Rx, LLC (Smyl) has identified a novel method to use these
devices to address functional decline. This Phase I SBIR proposes development of a mobile application
powered by technology that will offer a scalable solution to automate functional screening assessments,
compute novel digital biomarkers of functional decline, and deliver evidence-based fitness prescriptions with
behavior modification features to facilitate ongoing treatment and prevention. Smyl developed a framework for
the application in consultation with key opinion leaders from the American Medical Association’s (AMA’s)
Exercise Is Medicine (EIM) advisory board been and tested it with older adults. Commercialization will focus on
addressing key pain points and unmet needs identified during Smyl’s market research. Aim 1 will focus on
developing machine learning models that use computer vision technology to automate routine functional
assessments. Computer vision technology has shown to be effective for use among older adults, including
those with dementia. Aim 2 will consist of developing analytic models that use parameters from the automated
assessment to compute novel digital biomarkers of functional decline. These digital biomarkers will indicate the
presence or future risk of functional decline, ongoing severity, and response to treatment. In Aim 3 Smyl will
develop a movement quality & fitness prescription model to facilitate safe and effective exercise prescriptions
shown to address functional decline. Phase II efforts will focus on optimizing the technology for home use,
developing data-driven fitness prescriptions, and enhancing the platform for use among people living with
Alzheimer's disease and Alzheimer's disease-related Dementias (AD/ADRD). The scientific and technology
developments of this project have the potential to impact over 34 million middle and older age adults.
Implementation of the proposed innovation could reduce the loss of independence, poor health outc...

## Key facts

- **NIH application ID:** 10484214
- **Project number:** 1R43AG078069-01
- **Recipient organization:** SMYL FITNESS RX LLC
- **Principal Investigator:** Terrance Walless
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $299,797
- **Award type:** 1
- **Project period:** 2022-06-15 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10484214

## Citation

> US National Institutes of Health, RePORTER application 10484214, Development of novel digital biomarkers for proactive detection and treatment of functional decline (1R43AG078069-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10484214. Licensed CC0.

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