A depression treatment headset and app called Flow is being marketed in the UK and Europe by a Malmö-based company to help treat depression through brain stimulation. The user applies the headset to the forehead area and operates it through the smartphone app. The brain stimulation uses transcranial Direct Current Stimulation (tDCS) to restore brain activity in the frontal lobe to decrease depressive symptoms in as little as three weeks. tDCS has been found in randomized controlled trials to have a similar effect to anti-depressant drugs, but without the side effects. The treatment and company were formed by Daniel Mansson, a clinical psychologist, and neuroscientist Erik Rehn. The system is available for purchase for €45/monthly or outright purchase for €459. (Not available in the US)
‘Lockdown loneliness’ is a renewed concern as the pandemic won’t go away and we are both being advised to restrict our movements, physically distance, normal gathering places are closed or restricted, and in many areas, we are being asked to isolate again from family, friends, and co-workers. A study published in PLOS One from a 1,900+ sample of UK adults 18-87 years of age in March-April indicated the prevalence of self-reported loneliness was very high–27 percent. 49 to 70 percent of respondents reported feeling isolated Reported risk was higher in the younger age group, among those who are separated or divorced, or already meeting clinical criteria for depression or emotion regulation difficulty. Loneliness was measured using the Three-Item Loneliness Scale. With holidays coming up soon, this initial report does not bode well for the rest of the year.
The Guardian’s impassioned article on how common and harmful loneliness is among older adults led to some reflection by this Editor on how difficult and ‘multi-part’ an approach to help can be, even if you call it ‘The Campaign to End Loneliness’. “Studies have found loneliness can be more harmful than smoking 15 cigarettes a day, increases the risk of premature death by 30% and the chances of developing dementia by 64%. More than one million people aged over 65 are thought to be lonely – around 10-13% of older people.”–statistics from the article and AgeUK’s press release on their recent study, ‘ Promising approaches to reducing loneliness and isolation in later life’. GPs see a lot of them, and some more for an ‘event of the day’ than actual medical need. Loss of hearing, sight and mobility further isolate the older person, particularly those in rural areas where everyone and everything is at a distance requiring driving, creating dependency among those who can no longer. Even among the middle-aged, loss of hearing reduces engagement in social situations. (And the article does not include the disabled.) It closes with suggestions that councils need to budget for and organize programs to reach out to lonely adults, including carers, and that not one approach can fit all, but emphasizes more personal approaches such as groups and one-on-one support. Hat tip to Malcolm Fisk via Twitter
Is a way to fight the Loneliness Factor located in technology, even remote patient monitoring? That’s been the primary reason for some systems such as GrandCare, but even in RPM, whether hub-based or smartphone/tablet based, the reminders and active clinician monitoring part of chronic care management can and do engage. Older people are using smartphones and tablets–perhaps not as fully as a 40 year old, but they are using Skype, calendaring and social media (Facebook, LinkedIn and news/opinion sites). A big help here, according to Laurie Orlov, would be voice recognition and integration into safety/alarm technologies. This Editor also sees proactive alerting to changes in condition as a still-untapped area. There’s $279 billion of potential in ‘silvertech’ as estimated by AARP and Parks Associates–it’s a matter of getting young techies/entrepreneurs excited about it, and the Sand Hill funder crowd realizing that yes, it’s sexy too. Long Term Living