While we're waiting for Part 2 of Ted's story, let's see what technology has to offer regarding Alzheimer's Disease.
The first technology patent for dealing with Alzheimer's was filed in 1976, and it has been followed by more than 67,000 patents since then. A lot of time and attention is paid to this issue. More general research into the nature of prions (when prions malfunction it is thought to be either a cause or an effect of Alzheimer's) is also intense and ongoing. But it hasn't resulted in a cure, a vaccine or even too much in the way of effective therapies. One could come forward any moment, and I hope it does.
But existing technology can help both patients and caregivers:
"Innovative uses of high technology offer many exciting possibilities for earlier diagnosis, better care and improved quality of life for people with Alzheimer's and their family members", stated Maria Carrillo, PhD, director of Medical and Scientific Relations at the Alzheimer's Association. "We now are discovering ways to use available advanced technologies to save health care costs, ease caregiver stress, and help people with Alzheimer's live better, safer, more fulfilling lives."
"Most of the methods for diagnosis, treatment and care for Alzheimer's are based on techniques developed decades ago", stated Jeffrey Kaye, MD, chair of the Alzheimer's Association's Working Group on Technology (WGT). "We need to facilitate technology-based research and application in Alzheimer's, and bring the field up to date."
According to Dr. Kaye, who is professor of neurology and biomedical engineering at the Oregon Health and Science University (OHSU) School of Medicine in Portland, and director of the Oregon Center for Aging and Technology, a wide array of new technologies and methods for assessing and treating patients and helping families is emerging that take advantage of rapid developments in communications and monitoring technologies, such as biosensors and bodily diagnostics, activity sensors and behavioural diagnostics, displays, robotics and assistive devices.
Identifying memory and movement changes that are early signs of Alzheimer's may allow elders and their families to be pro-active about seeking diagnosis, initiating therapies and planning for the life changes that accompany the disease. Tamara Hayes, PhD, of OHSU, and colleagues focused their research on using unobtrusive technologies to monitor those changes in the home in a study called "A Novel Marker of Mild Cognitive Impairment" and funded by NIA/NIH.
Small motion sensors were used to continuously measure walking speed and overall activity in the home of seven healthy seniors and seven with mild cognitive impairment (MCI) for up to 60 consecutive weeks. The volunteers were not required to do anything except go about their daily business. Walking speed was estimated using sensors along a hall in each home.
The researchers found that the MCI participants had longer walking times than the healthy elderly group. Furthermore, the elders with MCI had more variability in their activity during the day, as compared to the healthy elders. These results are consistent with clinic-based studies of motor changes preceding dementia. However, unlike clinic-based studies in which the differences were identified using measures taken over many years, these differences were detectable in the home using unobtrusive assessment techniques after only four weeks of monitoring.
"Continuous assessment of key thinking, memory and movement skills provides an opportunity to identify early signs of impairment", Dr. Hayes stated. "This study provides the first indication of how continuous, unobtrusive monitoring may be used to assess clinically relevant motor behaviours that relate to cognitive change."
Maintaining cognitive performance is a key factor influencing elders' ability to live independently with a high quality of life. Taking advantage of growing use of computers by seniors, Holly Jimison, PhD, and colleagues from OHSU and Spry Learning Company have developed computer games that can monitor cognitive performance on a routine basis at home.
Glenn Smith, PhD, and colleagues from the Mayo Clinic-Rochester, Minnesota, observed that 30 to 40 percent of people with Alzheimer's are living alone at the time they are diagnosed. Dementia can impair a person's ability to properly take their medicine - known as "compliance" - and this issue regularly plays an important part in the decision to move patients to a residential care setting.
Dr. Smith's team investigated whether interactive video monitoring for persons with mild dementia who live alone, or who spend a significant amount of their day alone, could improve their ability to take medicine correctly and improve their mood in a study called "Telehealth Home Monitoring of Solitary Persons with Mild Dementia", funded by the Mayo Foundation, Minnesota Department of Human Services.
The researchers used two-way interactive video technology to provide virtual supervision of 12 patients with mild dementia. They contacted the participants each time they were to take their medications or have their meals. During the two-year study, more than 4000 contacts were made. Once per month, an independent evaluator went into the home to assess whether the patient had taken the appropriate amount of medication. The scientists compared their findings with 12 other participants who received no video monitoring.
In the video-monitored group, people took their medication correctly 81 percent of the time compared to 66 percent in the control group. Comparison of compliance from beginning of monitoring to the end of the programme revealed that video-monitored participants' compliance remained stable while unmonitored patients' compliance fell 12 percentage points, which is consistent with expectations for people with dementia.
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Posted by: Research Methodology | 01/05/2010 at 07:33 AM