High Tech and High Touch Take Focus on Alzheimer’s Prevention, Diagnosis

      Graphical abstract

      Every three seconds, an individual somewhere in the world develops dementia. By 2030, the illness is expected to affect 75 million people (Alzheimer’s Disease International, So it shouldn’t surprise anyone that digital health companies are prioritizing high-tech care and services for these patients. However, these innovations seem to be taking a new focus.

      Early Diagnosis Takes Center Stage

      Early in 2019, Synergus RWE, a European company specializing in providing market access for digital solutions and medical devices, conducted an exploratory internal project analyzing current digital health solutions for Alzheimer’s disease (AD) and other dementias. The findings revealed that companies are targeting person-centered efforts related to prevention, diagnosis, and patient care. In 59 companies, the study identified several categories of technological focus including:
      • Diagnostics based on eye movements tracking
      • Speech recognition
      • Analysis of brain images
      • Biomarkers
      • Training for caregivers
      • Communication with relatives
      The study suggests that there will be more technology focusing on prevention, early recognition, and ways to keep people safe as the disease progresses. For instance, some research on finding digital biomarkers has harnessed advances in mobile and wearable technologies that could help diagnose the disease even before symptoms appear. One company, Mindstrong, has shown that continuous data from seven days of passive smartphone interactions can predict performance on memory, language, dexterity, and executive function assessments.
      Elsewhere, there has been a study using a smartphone app, a game called “Sea Hero Quest,” to monitor how people between the ages of 50 and 75 navigate a virtual world. The game involves players using their thumbs to move a boat through a series of mazes.
      Expect to see more research on the use of virtual reality for early diagnosis of AD. There already has been some use of virtual reality to test the navigational skills of individuals in an effort to identify patients who are at greatest risk of dementia. Mattias Kyhlstedt, CEO of Synergus RWE, said, “While working on the project, it became apparent that this is an area where digital health may disrupt the way we see health care in the future. Rather than being centered about the doctor/health care system it will hopefully be centered about the empowered patient.”

      From Nana to Now

      Of course, technology focused on ways to support older people and promote brain health isn’t new. Caring for the Ages first published about “Nana” technology back in 2006. This was defined at the time as “technology designed, intended, or that can otherwise be used, to improve quality of life for seniors.” The five top categories for products and services at the time were health, safety, cognition, lifestyle, and whole-house/whole-facility.
      Here is some of the technology that is getting attention now and, in some cases, achieving results:
      • Wearable sensors for people with mild AD which are designed to assess walking are a cost-effective means to detect early AD and monitor its progress.
      • Because changes in speech patterns could be an early sign of AD, expect to see chatbots and digital assistants such as Alexa and Siri used to help diagnose various types of dementia. Elsewhere, researchers are looking at ways to analyze written language using smartphone technologies to identify abnormalities in sentence structure and content that could be early signs of AD.
      • Consumer digital devices that provide electrocardiograms are being considered for detecting unusual cardiac activity that could be a sign of AD.
      • Smart shoes developed by GTX Corp help patients find their way home and get oriented while walking in public.
      • Buddi, a smart wearable, has been developed to alert a caregiver if the wearer travels outside of a set zone.
      • To detect the loss of fine motor control associated with dementia, a finger-tapping speed test has been incorporated into smartphone apps.
      • Abnormal sleep patterns have been detected in AD patients, and smartphone microphones partnered with sleep-monitoring apps or wearables such as rings and watches can be used to monitor sleep patterns. Devices developed originally to detect sleep apnea can also be used to track changes in sleep patterns.
      Technology doesn’t have to be complex to help patients with AD and other dementias. Sometimes even simple tools — such as recorded messages to remind patients to take their medications — can be effective in helping to keep people safe and enable them to retain some independence longer.
      Both simple and complex solutions require study, however — and practitioners can be an important part of this process. That is one impetus for AMDA — The Society for Post-Acute and Long-Term Care Medicine’s Shark Tank program, a unique opportunity for innovators to share their ideas with a broad audience in the post-acute and long-term care community.
      “Our members on the front lines need to be innovative and promote innovation,” said the Society’s president, Arif Nazir, MD, FACP, AGSF, CMD. “It’s exciting for us to help influence companies and individuals with cutting-edge ideas at a critical decision point in the development of their products.”
      Senior contributing writer Joanne Kaldy is a freelance writer in Harrisburg, PA, and a communications consultant for the Society and other organizations.