Finding indicators of a predisposition to Alzheimer’s disease. Identifying cardiovascular and diabetic risk factors. These could be possible through the proliferation of genetic screening of senior living residents.
Insight Living President Bryan Ziebart sees a future in which senior living residents can receive better care through hyper-personalized genetic testing assessments, something the Salem, Oregon-based senior living provider will roll out later this year.
“We believe that the data we can capture at the communities should lead to better outcomes for residents, better engagement with families, and better overall internal operating efficiency,” he told Memory Care Business.
While genetic screening is not novel to senior living, but the idea has yet to take hold widely across the industry.
Ziebart sees the opportunity to improve care plans for residents and an opportunity for older adults today to contribute to medical breakthroughs down the road for future generations.
Starting small through a pilot program
Insight Living will start with a cohort of 10 senior living residents across its portfolio in a “really controlled pilot” genetic assessment program.
Residents will take a cheek swab that will be sent for analysis with Insight Living’s partner, Gainesville, Florida-based Applied Ingenuity Diagnostics, to conduct testing of the samples.
In conjunction with Applied Ingenuity Diagnostics, Insight Living will conduct the initial pilot and work on “creating a scalable approach” for future rollout of genetic assessments.
The new genetic assessment program targets genetic indicators in the early detection and prevention of age-related conditions, including cardiovascular disease, diabetes, neurological disorders, and identifying the APOE gene linked to the proliferation of Alzheimer’s disease.
Once a test is completed and an assessment is sent to Insight Living care staff, Ziebart said future adjustments could be made to tailor care and lifestyle programming to a resident’s unique health needs.
In order to get to this point, Ziebart said the effort was two years in the making and required thinking differently about what a senior living operator’s care model looks like.
“We can also then look at all of their behavioral, dietary, sleep, and quality history for the last many months, and we’re really building a story for each of our residents,” he said.
Data from the genetic assessments are anonymized to protect residents’ identities and will be, with their consent, used in aiding ongoing research through the National Institute of Aging (NIA).
Insight Living has also partnered with Stanford University’s Clinical Excellence Research Center and the Johns Hopkins Artificial Intelligence and Technology Collaboratory for Aging Research to provide this anonymized data to aid in aging research.
“It’ll be one of the most rich data sets that can really paint this holistic story leading up to those moments of a diagnosis,” Ziebart said. “We intend to scale this sampling as broadly as possible to increase the breadth and depth of the data.”
Scaling dependent on multiple factors
A 2018 study by the University of Michigan found that more than 1 in 10 people have had genetic tests ordered by a doctor or ordered by individuals directly.
Scaling the genetic assessment tool depends on whether senior living residents actually want to know if they could be at risk of such serious health problems, Ziebart said candidly.
“It’s an interesting philosophical question,” Ziebart said. “Do you want to know if you have comorbidities and health issues and that you have an 89% chance of an Alzheimer’s diagnosis within six months?”
Tests are free of charge for residents participating in the test program, and residents are educated on how their health data is protected before being used to aid in ongoing aging research, Ziebart said.
“There’s an economic case for us to say that when you live at an Insight community and you get this free test that will tell you if you’re more likely to have a diagnosis of a cognitive issue, we’re watching for those things proactively, and we have custom programming around that,” Ziebart said.
The genetic testing tool could allow for changes to care delivery and health assessments for Insight Living residents, offering greater personalization to each resident.
“The goal is to create more awareness of pre-diagnosis,” Ziebart said. “We’re paying attention at a much more micro level.”
It would also allow for earlier interventions of cognitive assessments and cognitive learning tools for those diagnosed with Alzheimer’s disease or other forms of dementia.
As part of the assessment tool, Ziebart said the company has created a family portal for all families of participating residents to follow along in a loved one’s journey following an assessment.
Where Ziebart sees promise for senior living operators following a genetic assessment is in adjusting brain health programming based on the results of an individual assessment.
“We have aims there, I think just a more proactive role,” Ziebart said. “For operators, there’s a way to monetize that because it comes at the cost of additional time in creating brain health programming.”
Brain health informs value-based care efforts
Senior living operators in recent years have pivoted to value-based care growth strategies to be compensated for the positive health outcomes organizations create.
In the future, Ziebart said he envisions a world where there is “incentive” to focus on brain health, as there’s a “high correlation between accelerated cognitive decline and fall risk.”
From a cost perspective, resident falls are one of the most costly incidents operators face in maintaining resident safety, and they also frequently lead to hospitalizations; reducing hospitalizations and hospital readmissions are key goals of almost all value-based care models.
Going forward, Insight recently launched the Integrated Senior Foundation, a nonprofit aimed at driving innovation and aging technology proliferation. The nonprofit is acquiring senior living communities, and excess profits from the sales will go back into brain health research, Ziebart said.
“How can we continue to increase the breadth of the data we’re capturing and the depth by adding more residents and participants into this, and then, how can we continue to find groups trying to innovate?” Ziebart said.
