Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia

Cognitive function is an important end point of treatments in dementia clinical trials. Measuring cognitive function by standardized tests, however, is biased toward highly constrained environments (such as hospitals) in selected samples. Patient-powered real-world evidence using information and communication technology devices, including environmental and wearable sensors, may help to overcome these limitations. This position paper describes current and novel information and communication technology devices and algorithms to monitor behavior and function in people with prodromal and manifest stages of dementia continuously, and discusses clinical, technological, ethical, regulatory, and user-centered requirements for collecting real-world evidence in future randomized controlled trials. Challenges of data safety, quality, and privacy and regulatory requirements need to be addressed by future smart sensor technologies. When these requirements are satisfied, these technologies will provide access to truly user relevant outcomes and broader cohorts of participants than currently sampled in clinical trials

Information and communication technology solutions for outdoor navigation in dementia

INTRODUCTION: Information and communication technology (ICT) is potentially mature enough to empower outdoor and social activities in dementia. However, actual ICT-based devices have limited functionality and impact, mainly limited to safety. What is an ideal operational framework to enhance this field to support outdoor and social activities? METHODS: Review of literature and cross-disciplinary expert discussion. RESULTS: A situation-aware ICT requires a flexible fine-tuning by stakeholders of system usability and complexity of function, and of user safety and autonomy. It should operate by artificial intelligence/machine learning and should reflect harmonized stakeholder values, social context, and user residual cognitive functions. ICT services should be proposed at the prodromal stage of dementia and should be carefully validated within the life space of users in terms of quality of life, social activities, and costs. DISCUSSION: The operational framework has the potential to produce ICT and services with high clinical impact but requires substantial investment

Multimodal Wearable Intelligence for Dementia Care in Healthcare 4.0: A Survey

As a new revolution of Ubiquitous Computing and Internet of Things, multimodal wearable intelligence technique is rapidly becoming a new research topic in both academic and industrial fields. Owning to the rapid spread of wearable and mobile devices, this technique is evolving healthcare from traditional hub-based systems to more personalised healthcare systems. This trend is well-aligned with recent Healthcare 4.0 which is a continuous process of transforming the entire healthcare value chain to be preventive, precise, predictive and personalised, with significant benefits to elder care. But empowering the utility of multimodal wearable intelligence technique for elderly care like people with dementia is significantly challenging considering many issues, such as shortage of cost-effective wearable sensors, heterogeneity of wearable devices connected, high demand for interoperability, etc. Focusing on these challenges, this paper gives a systematic review of advanced multimodal wearable intelligence technologies for dementia care in Healthcare 4.0. One framework is proposed for reviewing the current research of wearable intelligence, and key enabling technologies, major applications, and successful case studies in dementia care, and finally points out future research trends and challenges in Healthcare 4.0

REM sleep behavior as a preclinical risk factor for Synucleinopathies

Thesis (M.A.)--Boston UniversityObjective: To determine the prevalence of REM behavior disorder in the synucleinopathy patient population, treatments used, and effectiveness of these treatments. Background: Rapid eye movement (REM) sleep behavior disorder (RBD) is a sleep disorder characterized by loss of muscle atonia during the REM sleep stage, often manifesting in shouting, flailing, and kicking behaviors. These behaviors are generally associated with the content of the dream and patients report these dreams as unusually vivid. We have evaluated patients with Synucleinopathies (Multiple Systems Atrophy, Parkinson’s disease, and Dementia with Lewy Bodies) to examine the prevalence of RBD in this population and the presence of screening practices. In addition to the typical motor symptoms of these diseases, RBD, as a non-motor symptom, is a common precursor to these disorders. Methods: This study was conducted via a retrospective chart review and analysis of 278 patients in the movement disorders clinic at Boston Medical Center from 2011. Results: These patients had an average age of 71.6 years (± 8.4 years). Of these patients, 36.8% of those with Parkinson’s Disease, 66.6% of those with Multiple system atrophy, 61% of those with Lewy Body Dementia and 17.9% of those with Parkinsonism were comorbid for RBD. Of all charts reviewed 73.7% of the patients were screened for RBD and 46.8% of those with this disorder were undergoing treatment for it, 37.8% were taking melatonin(average 3.5mg ±1.1mg) with a 57.1% improvement, while 62% were on Clonazepam(average .5mg ±.16mg) with a 56.5% improvement. 32.9% of our RBD population was found to be on SSRIs. 72.2% of our RBD population was male. Conclusion: It is evident that RBD has a high prevalence in this population and may be able to serve as a pre-clinical risk factor and diagnostic measure. Further study of the correlation between RBD and Synucleinopathies may allow for earlier and more accurate diagnosis, thereby having implications in the treatment of these neurodegenerative disorders

Abstract Book

Proceedings of APP 11th ANNUAL CONVENTION AND 5th INDO SWISS CONFERENCE 16 – 17, DEC-2022 &nbsp

The SHAPES Smart Mirror Approach for Independent Living, Healthy and Active Ageing

The benefits that technology can provide in terms of health and support for independent living are in many cases not enough to break the barriers that prevent older adults from accepting and embracing technology. This work proposes a hardware and software platform based on a smart mirror, which is equipped with a set of digital solutions whose main focus is to overcome older adults’ reluctance to use technology at home and wearable devices on the move. The system has been developed in the context of two use cases: the support of independent living for older individuals with neurodegenerative diseases and the promotion of physical rehabilitation activities at home. Aspects such as reliability, usability, consumption of computational resources, performance and accuracy of the proposed platform and digital solutions have been evaluated in the initial stages of the pilots within the SHAPES project, an EU-funded innovation action. It can be concluded that the SHAPES smart mirror has the potential to contribute as a technological breakthrough to overcome the barriers that prevent older adults from engaging in the use of assistive technologies.Los beneficios que la tecnología puede brindar en términos de salud y apoyo para la vida independiente en muchos casos no son suficientes para romper las barreras que impiden que los adultos mayores acepten y adopten la tecnología. Este trabajo propone una plataforma de hardware y software basada en un espejo inteligente, la cual está equipada con un conjunto de soluciones digitales cuyo enfoque principal es superar la reticencia de los adultos mayores a usar tecnología en el hogar y dispositivos portátiles en movimiento. El sistema se ha desarrollado en el contexto de dos casos de uso: el apoyo a la vida independiente de personas mayores con enfermedades neurodegenerativas y la promoción de actividades de rehabilitación física en el hogar. Aspectos como la fiabilidad, la usabilidad, el consumo de recursos informáticos, el rendimiento y la precisión de la plataforma y las soluciones digitales propuestas se han evaluado en las etapas iniciales de los pilotos del proyecto SHAPES, una acción de innovación financiada con fondos europeos. Se puede concluir que el espejo inteligente SHAPES tiene el potencial de contribuir como un avance tecnológico para superar las barreras que impiden que los adultos mayores se involucren en el uso de tecnologías de asistencia