Caregivers for those with neurocognitive disorders (Alzheimer’s disease, dementias and other related progressive diseases) have unique, long-term stressors that lead to increased risk for distress, depression, and negative health outcomes. Conventional approaches through support groups and community based programs are helpful but not adequate, especially for those living in rural areas at a distance from care. This study of 74 women caregivers with mild to moderate depression tested two approaches: a 14-week behavioral intervention using video instructional materials (DVD/VHS), in-person telephone coaching in behavioral management and reinforcing workbook materials, with pleasant events scheduling and relaxation, versus a basic education guide and limited telephone support. The first approach was a statistical improvement over the second, easing caregiver depression and helping in their managing patient behavior. Results were maintained six months after the program ended. “Distance-based interventions (e.g., telephone, video, Internet, and bibliotherapy) hold promise for family carers, especially those living in rural or metropolitan areas with limited transportation.” Now if we could add in some tablet based interactive support? A telehealth behavioral coaching intervention for neurocognitive disorder family carers (International Journal of Geriatric Psychiatry) Hat tip to Mike Clark via Twitter
This year, on the 10th Anniversary of Telehealth and Telecare Aware, we have invited industry leaders nominated by our readers to reflect on the past ten years and, if they wish, to speculate about the next ten. Here is the first article, with a UK focus, by Dr Kevin Doughty.
Many of us are frustrated at how little progress there has been in the deployment and acceptability of telecare during the past decade. Yet, despite warnings that an ageing population was about to bankrupt the NHS (and health insurance schemes elsewhere in the world), and that access to social care for older people was being withdrawn at such a rate that it could only be afforded by the wealthiest in society, our health and social care systems have just about survived.
But this can’t go on, and in England over the past 12 months: (more…)
With a personal connection. This study, just released in The Lancet, has created headlines because it contradicts previous research and conventional wisdom that the obese are at the highest risk for dementia. Of nearly 2 million aged 40+ (median age 55), developed from the UK Clinical Practice Research Datalink (CPRD) over 15 years and screened for body mass index (BMI), the highest risk–34 percent– was found among those with a BMI lower than 20, which would include low-normal and underweight, versus those in a normal weight range with BMI 20-25 percent. The very obese, with BMI over 40, had a 29 percent reduced risk versus the normal range. This leads of course to why this is, for others to study. So it looks like you should eat right and exercise, but you don’t have to be a social X-ray. Also The Telegraph, The Guardian. Cheers to one of the researchers, statistician Michelle E Johnson, MSc, of OXON Epidemiology, London–the daughter of TTA founder and EIC Emeritus Steve Hards.
10 April, Microsoft HQ, NYC
The Entrepreneurship Lab NYC (ELabNYC) presented its second annual class of companies to nearly 200 life science funders, foundations, pharmaceutical companies, healthcare organizations, universities and the occasional Editor. Of the cohort of 19 companies finishing the three-month program, 56% are now funded and 25% had first customer revenue by the end of the program. Each company pitched for five minutes on its concept, its current state of advancement (including pilots/customers), its team and a funding timeline. This Editor will concentrate on the five companies with a digital health component; she was intrigued by their diversity and focus on difficult problems of compliance and diagnosis, especially dementia and concussion. (more…)
They say if you open enough oysters you’ll find a pearl, which was certainly true of the Wearable Technology Show 2014 held in Olympia on March 18-19. Perhaps I should have paid up to be a delegate, because to me the exhibition was fairly underwhelming with little to excite. Clearly some of the exhibitors felt that way too, as at least a couple of booths had been deserted by midday on the second day. There was one star though.
Unfortunately not all the exhibitors were recorded in the “Exhibitors A-Z” in the show guide so as I had been relying on that for writing this report, I do not have a complete list. For those wondering what they missed, here are a selection (more…)
Steve Moran’s Senior Housing Forum is hosting a lively discussion on designing communities for what this Editor would term the cognitively impaired, euphemistically called ‘memory care’ here in the States, then often bluntly categorized as dementia care. This concentrates on one CEO’s journey in designing a new memory care community, The Cottages at Cedar Run (Wisconsin) and how he utilized ideas developed in the US (Eden Alternative, Green Houses — Bill Thomas’ work, TTA 30 July) as well as the Dutch Dementia Village [TA 22 Dec 12] The architect’s video still strikes this Editor as full of nice touches (the courtyard a la the Dutch, but not as spacious or a center of activity; the padded window seats) but still institutional feeling (the cottages have a nice look but need more individualization to aid resident identification; how a resident/family can personalize the cottage); all in the right direction. The comments expand upon many points, but what is really missing here is the integration of technology— (more…)
Written for the Technology Strategy Board and published by the Housing Learning & Improvement Network, the purpose of the main study is to “outline the case for a revolution in long term care all to be set in a time scale of 2012, 2020 and 2050. This includes evidence about the views of older people and their carers in the UK, lessons from abroad and the implications for industry/providers.” It is written as a ‘study of studies’ on a broadly-scoped problem; it focuses considerably on issues such as care provision, housing (including co-housing and communities) and putting the older person in more control of decisions, housing and tech design. Telehealth and telecare, while not the focus, have a hefty section (pages 32-41) but their conclusions will not be a huge surprise to our readers such as expanding inexpensive, simple assistive technologies, the need for more research and better design. The fact it is comparative is extremely helpful for those who want to see beyond borders, and there is a large section on ethical issues which is certainly unusual in studies of this type. We thank the lead author, Professor Anthea Tinker, Institute of Gerontology, Department of Social Science, Health and Medicine, King’s College London, for providing information on and the PDFs of the studies. Assisted Living Platform – The Long Term Care Revolution and A study of innovatory models to support older people with disabilities in the Netherlands
Will a market of hundreds of millions be able to access these needed technologies?
Neurotrack, a computer-based cognitive program designed to pick up changes three to six years in advance of an official diagnosis of Alzheimer’s or dementia, gained Series A funding led by Founders’ Fund (Peter Thiel) and joined by Social+Capital Partnership plus several angel investors. Developed initially at Emory University with the technology part of a five year National Institutes of Health (NIH) study, it tests subjects on preference for repeat images versus novel images; a preference for repeat images may indicate a disturbance in the hippocampus area of the brain in completely asymptomatic subjects. However, you will not find it at a doctor’s office or a pharmacy kiosk near you soon. Its initial use will be in clinical trials for pharma companies developing drugs targeting early-stage dementias. The meaning for telehealth and telecare (more…)
Significant progress on early diagnosis of Alzheimer’s is reported today by Fierce Diagnostics. The Cognoptix test involves a laser eye-scanning device and an ophthalmic ointment, according to their website, designed to spot telltale beta-amyloid proteins in the lens of the eye.
The excitement in the article is about the possibility of increasing drug sales; the ability to deploy drugs to delay progression of the disease would clearly be very important. However, whilst perhaps less commercially significant, there would be some huge benefits (more…)
26-27 June 2014, Hilton Hotel, Sydney, Australia
This annual international conference on changing the care models around dementia, possibly the only one focused solely on this topic, discusses two questions which telehealth and telecare can answer at least in part: How do we support people with dementia to live their lives well? Are we really delivering care that is personal to the person with dementia and their carer? Call for papers closes 18 October 2013 (video on submitting here) and registration for the conference opens 2 December. Organized by The Dementia Centre, HammondCare-An Independent Christian Charity and the Australian Government Department of Health and Ageing. More information.
A report in GP Online about a Medical Research Council (MRC) study published in the Lancet raises questions about what lies behind a 24% lower rate of dementia in older people in 2011 than was predicted by a previous study. Dementia rates ‘falling in UK’, research shows.
MyHomeHelper, a product for dementia clients to stay independent in their own homes, beat off competition from over 200 nominations to become one of three products selected as a finalist at this year’s Technology4Good awards. They are up against some big companies such as Barclays Bank and would appreciate votes for them on that page and, as tweets count in addition, they are also hoping for tweets about them using hashtag: #T4GMyHomeHelper.
Steinkrug, a UK based research and development company has developed an Android app for tablet-based devices that monitors users’ responses to sound and images. The technology has been designed for use in dementia research but has potential for wider applications within and beyond the healthcare sector. Whereas Google Glass looks outwards into the wearer’s environment, Steinkrug’s application tracks the user’s response to media displayed on the device. Press release: Android App For Dementia Research and Therapy.
Not telehealth or telecare directly, but relevant to many TTA readers, a new Europe-wide research findings from the King’s College London’s Cicely Saunders Institute and Project BuildCARE explores people’s preferences when it comes to decision-making at the end of life. Dr Daveson, lead author of the paper, said that when thinking about scenarios of lost capacity, for example, most people in Europe do not want to make decisions about their healthcare in advance. Some people decide not to make end of life decisions about their care before they absolutely have to because:
- They believe that they will not know what they will want to choose until they are in the situation
- It is easier not to think about it
- They think that avoiding making decisions beforehand will avoid burdening family members
However, 53% of survey respondents wanted their partner or spouse to be involved in helping them make their decision and 40% also wanted other relatives to be involved. This means that for many people these will be family decisions. Preferences for self-involvement in decision-making – new research findings from across Europe: What would you choose? KCL main site. Infographic (PDF download)