Prime Time: A New Look At Aging

Seniors and technology roundup

Hi all,

Sorry I've been missing recently--paying job and all that.

"Japan has developed a fitness robot to help its rapidly aging population stay in shape.

Taizo is a small humanoid bot that can perform a number of calisthenics routines. It's covered with a plush white material and looks like Frosty the Snowman in a pressure suit.

Taizo, a play on "taiso" (gymnastics), has 26 joints, or degrees of freedom, and can do about 30 moves, mostly while sitting down. Its internal structure is fairly simple and resembles many of the robot kits sold in hobby stores in Japan.

The National Institute of Advanced Industrial Science and Technology (AIST), a state-run research center, and General Robotix, a spinoff company, created Taizo to help lead groups of older Japanese in rehabilitation exercises and general fitness routines."

"The developers plan to start leasing Taizo units next year, but did not say for how much. According to a Sankei News report, they plan to sell the robots for about $8,000 apiece.

That may sound exorbitant, but two key factors will help Taizo's commercialization. One is the vast number of elderly and infirm Japanese who need help with mobility and exercise. The number of centenarians in the country has doubled to more than 40,000 over the past six years, and it's expected to hit almost 1 million by 2050. Since Japan sees little to no immigration, there is a labor shortage and machines are expected to meet the demand for workers."

Elsewhere... "Rising incidents of identity theft are forcing people to be more cautious, vigilant of credit card bills and to act immediately, according to a subject expert with the Florida Office of the Attorney General.

"That is the way it is this day and age with all the technology out there," Theresa Ronnebaum told a gathering of about 25 senior citizens Tuesday at the Brannon Center.

The gathering was the first consumer education seminar on identity theft scheduled for the five Volusia County senior centers run by the Council on Aging. An anonymous grant is funding the monthly consumer education speakers and lunches for the coming year."

"Resolving identity theft can take between 500 and 1,200 hours of phone calls, letter writing and appearing before creditors.

The best way to reduce the chances of identity theft is to protect valuable documents.

Ronnebaum suggested not carrying Social Security cards, but to put them in safe storage places. She also recommended photocopying credit cards, drivers licenses and other documents carried in wallets and purses.

Other recommendations included shredding mail and other documents before throwing them out, not leaving mail in the curbside mailbox and reviewing credit histories at least once a year through one of the three bureaus -- Equifax, Experian and Trans Union. A history shows credit account and activity. It is different from a credit score that usually requires paying a fee."

And finally, "After nearly 15 years of serving senior citizens, Bill Crawford has seen - and heard - it all.

Crawford, director of case management for the Shenandoah Area Agency on Aging, loves listening to his clients reminisce about old holiday traditions and historic tales of decades past.

But then there are the less enjoyable moments on the job.

While delivering meals to homebound seniors over the last several years, Crawford has found numerous clients incapacitated by injury and unable to call for help.

For this reason, Crawford is always on the lookout for ways to equip senior citizens with the technology to help them in the event of an emergency.

Crawford's newest venture is collecting old cell phones and having them refurbished for use by seniors.

The Cell Phones for Seniors program sends old phones to Florida-based RMS Technology Inc., which reprograms them to only dial 911, and gives the Shenandoah Area Agency on Aging a small fee for the parts it collects. The funds collected by the agency go to help supplement the nonprofit organization's budget.

According to Crawford, the phones are then handed out to low-income residents throughout Page and Shenandoah counties and three other localities in northwestern Virginia.

"I have been trying to find cost-effective ways to keep people safe in their homes," Crawford said. "[Senior citizens] deserve support and they're a great population to work for. We run into people that really need the technology but can't afford it."

Crawford also has been key in starting other successful technology programs for seniors, including one that gives auto-dialers and "photo phones" to visually, cognitively and hearing impaired citizens.

The auto-dialers allow senior citizens who have fallen or been hurt to call any of three numbers preprogrammed into the device, Crawford said.

The photo phone is a landline phone that lets the user insert up to nine pictures that correspond with speed-dial buttons. The phone also blinks so hearing-impaired seniors can see when a call is coming in.

"It's obvious that a little technology can go a long way to keeping them safe," Crawford said."

When doctors share technology with patients

Doctors are not famours for being the first users of technology. In fact they have the reputation for being old-fashioned. That's often a good thing--they don't get seduced by the latest fad.

But this story is interesting. This is a list of what the medical profession has to cope with right now:

• Need to reduce healthcare system costs.

• Growing incidence of chronic diseases.

• More empowered and educated patients.

• Changing payor dynamics.

• More information available to consumers, primarily via Internet.

• Patient expectations for living a longer, more active and independent lifestyle.

• Consideration that medical errors and infections might be lower with patients cared for outside the hospital contributing to improved outcomes.

• Demographic changes.

• Greater data transparency and benchmarking among healthcare providers and technologies related to cost and outcomes.

• Advances being made in military medicine making their way back into civilian healthcare technology.

• New technological breakthroughs outside of healthcare making their way into industry.

• Technology formerly focused on acute care moving outside of the hospital.

• Changing nature of medicine and roles—Overworked clinicians pushing responsibility to patients.

• Less-expensive medical equipment available to consumers from Asian manufacturers.

• Interest among providers and payors in improving patient adherence and compliance.

• More cosmetic and elective procedures, self care.

• More options for care outside of hospitals.

• More expendable income among older Americans.

• More interest among manufacturers in anticipating patient needs due to competition.

• Growing demand for healthcare services, spending.

 

"For at least the last decade, there has been a quiet revolution under way in the healthcare field. Most Americans are well aware of the challenges facing the country’s healthcare system—escalating costs, denied tests and treatments, fragmented care, less time available for a patient-physician relationship, medical errors, inefficiencies, and other woes. However, a number of important cultural, technological, and demographic trends are increasingly putting more control into the hands of patients themselves to manage their health. This transformation has an enormous potential to change how medicine is practiced and how the healthcare system as a whole operates.

In many cases, the catalyst for this change has been new technologies that have taken advances made in the realm of professional medical products—i.e., those used by doctors, nurses, and other clinicians—and modified them for use by patients in a consumer environment. Consumers have always had access to medical devices to meet their basic needs, such as first aid kits or thermometers. But in recent years, highly advanced technologies have been increasingly rolled out to consumers themselves.

Some of the best examples of this convergence between professional and consumer devices are automated external defibrillators (AEDs), blood glucose monitors, insulin pumps, home diagnostic kits, and remote patient monitoring systems. Medical technology will follow a path similar to that of computers. Large, complex scientific instruments will ultimately become small, powerful consumer appliances for communication and entertainment. This convergence zone represents one of the greatest opportunities to manufacturers in the medical technology and consumer health markets today."

 

"Patients with chronic diseases and conditions are the top targets for most companies moving into the convergence zone between professional and consumer medical devices, and for good reason. According to the organization Partnership for Solutions, in 2000, more than 125 million Americans had chronic health conditions, such as cardiovascular disease, diabetes, asthma, and Parkinson’s disease, and the care of these patients generated direct costs of $510 billion. This number is expected to grow to 157 million people by 2020 with $1.07 trillion in direct costs. Approximately 80% of all healthcare spending will be on this population."

 

“Caring for individuals with chronic health conditions will be the public health challenge of the 21st Century,” according to Gerard Anderson, PhD, at the Johns Hopkins Bloomberg School of Public Health. Much of the increase in these costs is due to advances in medical practices and technology which often turn an acute condition into a chronic one. For example, since 1980 there has been a greater than 40% drop in mortality from coronary heart disease since, but more people are living with deleterious effects of these acute events. The same is true for patients surviving cancer, stroke, premature birth, renal failure, trauma, and other conditions.

 

 

7 areas of research to help seniors

The Center for Technology and Aging was established to advance the diffusion of technologies that help older adults lead healthier lives and maintain independence.

In July they published a paper detailing how they intend to spend some research money:

1) Medication Optimization refers to a wide variety of technologies designed to help manage medication information, dispensing, adherence, and tracking.

2) Remote Patient Monitoring (RPM) includes a wide variety of technologies designed to manage and monitor a range of health conditions. Point-of-care (e.g., home) monitoring devices, such as weight scales, glucometers, and blood pressure monitors, may stand alone to collect and report health data, or they may become part of a fully integrated health data collection, analysis, and reporting system that communicates to multiple nodes of the health system and provides alerts when health conditions decline.

3) Assistive Technologies include a wide range of devices and equipment that help individuals perform a task or prevent injury. Assistive technologies promote independence as they compensate for sensory, physical, and cognitive impairments, and promote safety for vulnerable individuals as they detect and report health hazards.

4) Remote Training and Supervision (RTS) technologies can be used to train and supervise health and long-term care workers, and offer the potential for continuing education and quality assurance. Remote training means the student does not have to be physically located where the teaching is taking place – teaching and learning can be asynchronous or synchronous in time.

5) Disease Management (DM) is a patient-centric, coordinated care process for patients with specific health conditions, particularly chronic conditions and conditions that have a significant self-care component. DM programs include data mining processes to identify high risk patients within a population, use of evidence-based medical practice guidelines to support and treat individual patients, and a coordinated, data-informed system of patient outreach, feedback, and response.

6) Cognitive Fitness and Assessment technologies include thinking games and cognitive challenge regimens. Like physical fitness, the premise of cognitive fitness is that cognitive health can be maintained or improved if individuals exercise their brain. The emphasis with older adults is to prevent or delay Alzheimer’s and related dementias. Many cognitive fitness technologies are computer or Internet based, and include an assessment and tracking component.

7) Social Networking technologies enable the creation of social networks and focus on building communities of interest that help older adults communicate, organize, and share with other older adults and with their care providers. These are already gaining traction among older adults, and could be important both for the functions just described and for peer counseling and education that would complement the Remote Training and Supervision technologies described previously.

They've chosen to dedicate their funding to the first two categories. I find this strange, as these are the two areas that are also receiving the most private sector research funding--wouldn't it make more sense to dedicate their money to research areas that are being more or less ignored? Like, umm the other five on this list?

Watch your step

Just found this:

More than 1.8 million older adults are treated annually in emergency departments for injuries from falls, 433,000 are admitted to hospitals and 16,000 die because of their injuries, according to the CDC. Every year, about a third of Americans 65 and older fall, and about a third of those who lose their footing require medical treatment.

Rocky Miller, a 60-year-old Plano resident has launched a business, Slip Doctors, that will treat floors with a chemical that he says will make them more resistant to slips, slides and falls.

After years of selling motorcycles, the 60-year-old Plano resident has launched a business, Slip Doctors, that will treat floors with a chemical that he says will make them more resistant to slips, slides and falls.

"Simply put, my partners and I sell friction," he said. "In a country where the older population will double over the next 25 years, we think that's something that will be in demand for a long time."

The Addison-based business hopes to set itself apart from competitors, Miller said, by using a high-tech robot that scoots across the floor of a home or senior-living community and identifies slick spots.

Slip Doctors joins an industry springing up from people's concern over falling. Entrepreneurs and big corporations are creating products and services to stem a problem that threatens to worsen as boomers age.

"The good news is that we can reduce the risk of falling. It doesn't have to be an inevitable part of growing old," said Lynn Beattie, vice president of injury prevention at the National Council on Aging.

Aside from promoting longer lives and greater independence, the new efforts to prevent falls may help control health care costs as the oldest boomers qualify for Medicare in about a year, she said.

More than $19 billion is spent annually on treating seniors who fall. Without better prevention, that cost is projected to escalate to $43.8 billion a year by 2020, and Medicare will pay for most of it.

The tech view of life extension

Following on from Ted's post... although I believe I would greatly enjoy sleeping between two virgins, there is a lot of work going on regarding life extension. If I were in reasonably good health, I do believe I would be pleased to keep on truckin' as long as I could.

Life expectancy has risen from 47 years of age in 1900 to just about 80 now. That's quite a feat, and there seems to be no sign of it stopping--we apparently are adding 3 years of life expectancy every decade.

The beginning work was all about removing causes of death for the young, and basic hygiene did a lot of the work in that area. The invention of antibiotics was another big help in getting us to that three score and ten. 

But now, we are focusing more on getting from 70, to 80, to 90 and on to 100. I personally think that someone born today who takes decent care of her/himself and avoids traffic accidents has a pretty good shot at reaching 100.

So what will get us there? First, each other--but after that, a lot of technology. It seems pretty clear that within the next 10 years we will be using cloned organs from our own cells for transplants. No waiting lists, no tissue rejection. How about getting a younger version of your own heart just because your current model is wearing out?

Our ability to look inside the human body and brain is improving dramatically every year. This will mean earlier and better diagnoses of diseases that currently carry us off because they are not caught in time.

We are not yet close to understanding cancer, but as Churchill might have said, we only need to understand how to kill it, and we're making progress on this front. Nanotechnology can deliver such silver bullets as are available right to a tumor cell, and nanotechnology will be heavily involved in the silver bullets themselves. But what I want to see is nanobots cleaning our bloodstreams, scouring hardened arteries, eliminating free radicals, etc. 

Traffic and the other causes of fatal accidents will continue to become less lethal, due to better communications technology and more and better safety features in the rest of the physical world.

Lots more technology that will help us. Regarding the above, I'm pretty certain that, even if I don't benefit from any or all of them, I will live to see them introduced--if I can avoid playing in traffic.

Diabetes and Alzheimers

Wow. I'm doing a bit of work for a new client on healthcare devices and stumbled across some information that really surprises me. There are similarities between Alzheimer's disease and what happens in a failing pancreas that produces diabetes.

Equally surprising, there seems to be a link between the two--people with diabetes seem to be more likely to develop Alzheimers. This story from the July 16 issue of the New York Times seems to sum up the story:

"Several new studies suggest that diabetes increases the risk of Alzheimer’s disease, adding to a store of evidence that links the disorders. The studies involve only Type 2 diabetes, the most common kind, which is usually related to obesity.

The connection raises an ominous prospect: that increases in diabetes, a major concern in the United States and worldwide, may worsen the rising toll from Alzheimer’s. The findings also add dementia to the cloud of threats that already hang over people with diabetes, including heart disease, strokes, kidney failure, blindness and amputations.

But some of the studies also hint that measures to prevent or control diabetes may lower the dementia risk, and that certain diabetes drugs should be tested to find whether they can help Alzheimer’s patients, even those without diabetes. Current treatments for Alzheimer’s can provide only a modest improvement in symptoms and cannot stop the progression of the disease."

For me, despite all the talk, money and attention devoted to cancer and to Alzheimers, diabetes has always seemed to be the 'disease of our age.' Especially Type II diabetes. Diabetes is a reflection of our lifestyle--and no, I'm not talking about lazy diet choices and watching too much TV, although they are certainly factors. What I mean is that our work has become sedentary, our transportation has become sedentary, our hobbies have become sedentary, and our diet is still based on what humans needed to maintain body weight when they consumed 4-6,000 calories a day. We now burn fractionally more calories than someone in a coma...

More from the Times article: "Alzheimer’s affects 1 in 10 people over age 65, and nearly half of people over 85. About 4.5 million Americans have it, and taking care of them costs $100 billion a year, according to the association. The number of patients is expected to grow, possibly reaching 11.3 million to 16 million by 2050, the association said.

But those projections do not include a possible increase from diabetes.

“Alzheimer’s is going to swamp the health care system,” said Dr. John C. Morris, a neurology professor at Washington University in St. Louis and an adviser to the Alzheimer’s Association.

Not everyone with diabetes gets Alzheimer’s, and not all Alzheimer’s patients are diabetic. But in the past decade, several large studies have found that compared with healthy people of the same age and sex, those with Type 2 diabetes are twice as likely to develop Alzheimer’s. The reason is not known, but researchers initially suspected that cardiovascular problems caused by diabetes might contribute to dementia by blocking blood flow to the brain or causing strokes.

More recently, though, scientists have begun to think that the diseases are connected in other ways as well. In both, destructive deposits of amyloid, a type of protein, build up: in the brain in Alzheimer’s, in the pancreas in Type 2 diabetes.

People with Type 2 often have a condition called insulin resistance, in which their cells cannot properly use insulin, the hormone needed to help glucose leave the blood and enter cells that need it. To compensate, the pancreas makes extra insulin, which can reach high levels in the blood. Too much insulin may lead to inflammation, which can contribute to damage in the brain."

The good news is, that since diet and exercise can help ward off Type II diabetes, it also can help prevent dementia.

So get on out there.

The future for assisted living

A lot of powerful groups have every incentive to make assisted living work for you, the American senior citizen.

Take hospitals. They have just spent the last decade building and refurbishing hospitals in a manner not seen since the 1950s, modernizing, refitting and refurbishing, making hospitals modern and hooked up to all kinds of new equipment. But at the end of this massive renovation and rebuilding program, there are now 88,000 fewer available beds then there were a decade ago. Hospitals want assisted living to work.

Or take politicians. The new healthcare patterns being debated or decided in Washington today depend for their success on pushing more responsibility onto the patient. Their programs will fall apart unless they can get us all to take more care of ourselves. Hopefully better, but crucially, more. Politicians don't want the taxpayer to support you in the hospital any longer than necessary--nor do they want to spend on long term care facilities. They need assisted living to work.

And then there's business. A lot of business. The U.S. and Canada spent $6 billion on home medical equipment two years ago, and it's growing by almost 9% per year. Most of it goes on wheelchairs and equipment to treat diabetes, but they cannot survive without assisted living being a good option.

So you're not alone.

Watch Aubrey deGrey talk about defeating 'aging'

Fail gracefully

In engineering there is a concept called 'failing gracefully.' It doesn't really have a precise definition, but it refers to the idea of minimising the consequences of failure. If a building collapses, graceful failure would mean it didn't knock over other buildings, and would do so slowly enough for people to escape. If an engine quits, it doesn't immediately stop what is powering it, allowing a glide to resting position.

One common view of aging is that it is a process of surrender, giving up abilities and activities that we may have practiced all our lives as our bodies are no longer able to perform or recover from them. While I'm not that big a fan of surrender as a philosophy, I am well aware that sometimes giving up is what ya gotta do.

But how many of us prepare for giving up, so that we 'fail gracefully?' If my vision is deteriorating gradually but steadily, doesn't it make sense for me to find a place to live that doesn't require my driving? If I do it well in advance, then I don't have to move at the same time I'm getting used to poorer vision. Pretty much the same is true if I know I'm going to require major surgery.

Although I generally look at modern communications technology as a 'done deal' that we should all be using unconsciously, these tools can help us plan. The internet can tell us what the likely outcome of our current conditions will be, and help us plan a strategy in advance. The tools certainly exist for us to adapt to reduced function, ranging from larger screens to call buttons to intelligent wheelchairs.

The key requirement is to abandon denial as a frame of mind and think of graceful failure as a sign of superior intelligence. And since you're reading this, we already know you have that.

Helping with assisted living

I am quite confident that governments, hospitals and non-profits will begin helping to make assisted living easier and more attractive--it's a big money saver for them, and it's what we all want. Kind of a no-brainer, actually.

Some of the things in this video may not be relevant--but some are, and the conversation about how governments need to make it possible for companies to succeed by meeting our needs is particularly interesting.