A new Artificial Intelligence (AI) powered technology, driven by a smartphone app, is helping doctors at Tallaght University Hospital (TUH) to diagnose early-Alzheimer's disease. It also supports identification and recovery in many other serious conditions. Entitled GaitKeeper, the technology measures walking speed which is often referred to by doctors as the ‘sixth vital sign.’

GaitKeeper can also indicate if someone could be living with early symptoms of Alzheimer’s disease or other disorders that affect the brain. This is important as new drugs that are currently coming on stream will for the first time offer treatments to those in the early stages of the disease.

The new software has been developed by Dublin City University principal investigator Dr Aidan Boran, working in conjunction with consultants, physiotherapists and patients at TUH. Dr Boran explains that “how we walk is reflective of how well we are, and changes in how we walk can indicate we are becoming unwell. GaitKeeper uses AI computer algorithms to analyse a person’s walk. It achieves this by using a single video recorded on a mobile phone, making it very portable, and very easy to use. Working with the AI, our augmented-reality app ensures the solution is very consistent and standardised in all settings.”

Professor Seán Kennelly, Consultant Geriatrician and Director of the Institute of Memory and Cognition at TUH, was the lead clinician investigator in the project. He explains that “up until now gait analysis in clinical settings has been very limited, not because it is not important, but mainly to the expense, inaccuracies, high level of training required and the space that equipment takes up.

“This new technology changes all of that. Using AI and Augmented Reality (AR), the GaitKeeper app captures over 20 points on a person’s body, 60 times per second as they walk, using a phone. The app represents a significant breakthrough and means gait assessments can be conducted by anyone, anywhere, at any time. Gone is the need for specialised equipment like sensors, mats, or special clothing. The assessments can be done in nursing homes, GP practices, outpatient clinics, on hospital wards, and even in someone’s own home.”

For patients with chronic diseases such as Parkinson's disease, multiple sclerosis, or arthritis, walking speed serves as an indicator of disease progression and response to treatment.  Doctors at TUH believe that including walking speed assessments in regular clinical practice can significantly enhance patient care by providing a clear and objective measure of an individual's functional abilities and overall health status.

GaitKeeper collects longitudinal data on walking speed, support base, swing and symmetry measures. It is already being used in TUH to gauge frailty status – identifying increased risks of adverse events such as falls, prolonged hospital stays and overall functional decline.

Those involved in the creation of this new technology believe that developing accessible technology that measures subtle changes in gait performance easily and accurately will enhance the detection of declining health and the timely delivery of care to older people. Critically, it is hoped this will mean the necessary medical interventions occur ahead of significant falls or other illnesses, when treatments are more costly, take more time, and often have poorer results for the patient.

Frailty is a significant concern for healthcare systems all over the world, particularly those with an ageing population. Studies have demonstrated that slower walking speeds in older adults are predictive of adverse outcomes like falls, hospitalisation, and even mortality. However regular monitoring of walking speed can guide interventions aimed at preventing mobility loss and maintaining independence in older adults.

Dr Paul McElwaine, Director of the Falls Unit in TUH, explains that they will use GaitKeeper in the TUH Hospital Falls service, to estimate a person’s risk of falling, and thereby direct them towards interventions to prevent that fall  from happening.

Dr McElwaine outlines how ”international guidelines have always recommended the importance of gait speed as an important indicator of someone’s risk of falling, but for lots of reasons this has been significantly challenging to implement in clinical settings. GaitKeeper addresses all these issues and is a real breakthrough in allowing for easy and accurate measurement of gait speed in falls clinic and acute care settings, so that we can focus resources on those most in need to prevent future falls”.

The development of GaitKeeper was significantly funded by Enterprise Ireland through their Commercialisation Fund Programme, and supported by the Insight Centre for Data Analytics, DCU Invent and Innovate Health at TUH.