Project Abstract
In this Fast-Track SBIR project, ASTER Labs will address an urgent, immediate, need for accessible and
accurate contact tracing to aid management of infectious disease outbreaks in long-term care facilities of
patients with Alzheimer’s disease and related dementias. An estimated 5.8 million Americans in 2020 live with
Alzheimer’s dementia and nearly half of nursing home and other long-term care residents have been
diagnosed with a form of dementia. Challenges in infectious disease management in these care settings are
increased by frequent interactions between patients, caregivers, staff, and visitors, as well as higher risk from
contagion due to age and underlying health conditions. The COVID-19 pandemic has only exacerbated the
issue due to the susceptibility of the elderly to the virus. Contact tracing to identify, test, and isolate those who
may have been exposed to an infected person has traditionally been a manual, labor-intensive process. Many
care facilities lack the financial, human, and logistical resources to track sufficient detail to retrace movements.
For dementia patients in particular, limited recall of recent events and interactions, inability to respond to
tracing questions, and potential distrust of tracers risk inaccurate data. Investment in human resources to
perform contact tracing is costly, and ad hoc tracing can limit effective outcomes. Existing methods to
automate contact tracing have largely been smartphone software applications, widely criticized for lack of
privacy protection, and in long-term care settings, guarantees on mobile phone use are limited. The few
available solutions for care facilities rely on non-discreet wearable devices that, due to unfamiliarity, may be
unacceptable to dementia patients, and often require large infrastructure additions with limitations on range.
Therefore, there exists a significant unmet need to support care facilities by providing an unobtrusive, on-
demand, accurate, and automated contact tracing solution that works both indoors and outdoors with little to no
infrastructure requirements, and that addresses the special needs of dementia patients. ASTER Labs’
proposed Activtrace system leverages intelligent processing of WiFi, GPS, cellular, and inertial sensor data
from a small hardware suite concealed in a shoe insole, unnoticeable to the wearer, that achieves high-
precision location and duration of close-contact encounters in complex indoor and outdoor environments. In
Phase I, the prototype system will be assembled, and feasibility will be demonstrated by determining the
positional and temporal accuracy of the device in timed motion experiments, and through a focus group study
with contact tracers and caregivers in senior care settings. Phase I testing will provide the success criteria for
the start of the Phase II program. In Phase II, the pre-production insoles and comprehensive software
application will be assembled, and the integrated system evaluated in a study with research actors wearing the
insoles, along with confederate targets. Comparisons of results done manually by trained contact tracers and
the automated Activtrace solution in multiple planned scenarios will establish the system’s efficacy.
