Publication: Validation of commercial sleep-tracking wearables and nearables in healthy young and older adults

Authors: M.E. Searles, A. Licata, M. Cucinotta, K. Kainec, and R.M.C. Spencer Abstract Study objectives: Changes in sleep with aging are associated with risk for Alzheimer’s and other neurological diseases, risk of accidents, and can be a predictor of health decline. For this reason, continuous sleep monitoring is of great interest for researchers, clinicians, and family members. The objective of this study was to assess the validity of consumer sleep-tracking devices in older relative to young adults. Methods: Analyses were based on one night of sleep assessed in young (19-24 years; n=13) and older adults (56-80 years; n=19). Participants wore sleep-tracking wearables (Fitbit Sense 2, Oura Ring) and nearables (Withings Sleep Mat, Sleep Score Max) were positioned nearby. Sleep measures were compared to polysomnography. Results: Results suggest that devices may be less accurate in older…

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Publication: AI-Driven Sleep Staging Using Instantaneous Heart Rate and Accelerometry: Insights from an Apple Watch Study

Authors: Tzu-An Song, Yubo Zhang, Ziyuan Zhou, Luke Hou, Masoud Malekzadeh, Aida Behzad, Joyita Dutta Abstract Polysomnography, the gold standard for sleep evaluations, involves complex setup and data acquisition protocols and requires manual scoring of sleep data. Smartwatches and other multi-sensor consumer wearable devices with automated sleep staging capabilities offer a promising and scalable alternative for routine and long-term sleep evaluations in individuals. We conducted a multi-night study using a smartwatch for sleep assessment and created an AI-driven automated sleep staging framework based on instantaneous heart rate (IHR) and accelerometry data using sleep stage labels based on electroencephalography (EEG) as the reference. 47 healthy adults were recruited to record their sleep for up to seven consecutive nights using an Apple Watch Series 6 and a Dreem 2 Headband. Our sleep staging framework relies on a…

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Publication: Developing an Equitable Machine Learning-Based Music Intervention for Older Adults At Risk for Alzheimer Disease: Protocol for Algorithm Development and Validation

Authors: Chelsea S Brown, Luna Dziewietin, Virginia Partridge, Jennifer Rae Myers Abstract Background: Given the high prevalence and cost of Alzheimer disease (AD), it is crucial to develop equitable interventions to address lifestyle factors associated with AD incidence (eg, depression). While lifestyle interventions show promise for reducing cognitive decline, culturally sensitive interventions are needed to ensure acceptability and engagement. Given the increased risk for AD and health care barriers among rural-residing older adults, tailoring interventions to align with rural culture and distinct needs is important to improve accessibility and adherence. Objective: This protocol aims to develop an intelligent recommendation system capable of identifying the optimal therapeutic music components to elicit engagement and resonate with diverse rural-residing older adults at risk for AD. Aim 1 is to develop culturally inclusive user personas for rural-residing older adults to understand…

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Publication: Passive Measures of Physical Activity and Cadence as Early Indicators of Cognitive Impairment: Observational Study

Authors: Huitong Ding, Stefaniya Brown, David R Paquette, Taylor A Orwig, Nicole Spartano, Honghuang Lin Abstract Background: Emerging research shows regular physical activity reduces cognitive decline risk, but most studies rely on self-reported measures, which are limited by recall bias, subjectivity, and a lack of continuous monitoring capability. Objective: This study aimed to explore passive physical activity measures as early indicators of cognitive impairment by examining their association with cognitive impairment incidence and neuropsychological (NP) test performance. Methods: We included participants from the Framingham Heart Study (FHS), a community-based cohort with longitudinal cognitive impairment surveillance. Participants wore an Actical accelerometer for at least 3 days, excluding bathing. Thirty physical activity measures were grouped into intensity-specific durations, step and cadence summaries, and peak cadence. Cox proportional hazard models were applied to assess their associations with incident…

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Publication: Reinforcement Learning on Dyads to Enhance Medication Adherence

Authors: Ziping Xu, Hinal Jajal, Sung Won Choi, Inbal Nahum-Shani, Guy Shani, Alexandra M. Psihogios, Pei-Yao Hung, Susan A. Murphy Abstract Medication adherence is critical for the recovery of adolescents and young adults (AYAs) who have undergone hematopoietic cell transplantation. However, maintaining adherence is challenging for AYAs after hospital discharge, who experience both individual (e.g. physical and emotional symptoms) and interpersonal barriers (e.g., relational difficulties with their care partner, who is often involved in medication management). To optimize the effectiveness of a three-component digital intervention targeting both members of the dyad as well as their relationship, we propose a novel Multi-Agent Reinforcement Learning (MARL) approach to personalize the delivery of interventions. By incorporating the domain knowledge, the MARL framework, where each agent is responsible for the delivery of one intervention component, allows for faster learning…

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Publication: Proceedings from SOUPS ’25 – Can You Walk Me Through It? Explainable SMS Phishing Detection using LLM-based Agents

Authors: Yizhu Wang, Haoyu Zhai, Chenkai Wang, Qingying Hao, Nick A Cohen, Roopa Foulger, Jonathan A Handler, and Gang Wang. Abstract SMS phishing poses a significant threat to users, especially older adults. Existing defenses mainly focus on phishing detection, but often cannot explain why the SMS is malicious to lay users. In this paper, we use large language models (LLMs) to detect SMS phishing while generating evidence-based explanations. The key challenge is that SMS is short, lacking the necessary context for security reasoning. We develop a prototype called SmishX which gathers external contexts (e.g., domain and brand information, URL redirection, and web screenshots) to augment the chain-of-thought (CoT) reasoning of LLMs. Then, the reasoning process is converted into a short explanation message to help users with their decision-making. Evaluation using real-world SMS datasets shows SmishX can achieve…

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Publication: Causal Directed Acyclic Graph-informed Reward Design

Authors: Luton Zou, Ziping Xu, Daiqi Gao, Susan Murphy Abstract It is well known that in reinforcement learning (RL) different reward functions may lead to the same optimal policy, while some reward functions can be substantially easier to learn. In this paper, we propose a framework for reward design by constructing surrogate rewards with mediators informed by causal directed acyclic graphs (DAGs), which are often available in real-world applications through domain knowledge. We show that under the surrogacy assumption, the proposed reward is unbiased and has lower variance than the primary reward. Specifically, we use an online reward design agent that adaptively learns the target surrogate reward in an unknown environment. Feeding the surrogate rewards to standard online learning oracles, we show that the regret bound can be improved. Our framework provides a theoretical improvement…

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