Dementia patients could remain at home longer thanks to ground breaking technology

Innovative new technology could enable people with dementia to receive round the clock observation and live independently in their own homes, a new study reports. | University of Surrey | via ScienceDaily

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Researchers from the University of Surrey in partnership with Surrey and Borders Partnership NHS Foundation Trust have developed state of the art Artificial  technologies, powered by machine learning algorithms, to monitor the wellbeing of people with dementia.

The study known as Technology Integrated Health Management (TIHM) for dementia, uses the ‘Internet of Things,’ a network of internet enabled devices (sensors, monitors and trackers) installed in homes, which can detect an immediate crisis as well as changes in people’s health and daily routines. Any change could indicate a potential health issue and if identified early could prevent a person from becoming seriously unwell and requiring emergency hospital admission.

The well-being of people with dementia can also be monitored using this innovative technology which can detect agitation and irritability.

Full story at ScienceDaily

Journal reference:  Shirin Enshaeifar, S. et al. | Health management and pattern analysis of daily living activities of people with dementia using in-home sensors and machine learning techniques | PLOS ONE |  2018; 13 (5):

 

 

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‘Exergaming’ may help those at risk of Alzheimer’s or related dementias

Older adults with mild cognitive impairment (MCI) showed significant improvement with certain complex thinking and memory skills after exergaming (video games that also require physical exercise) | Frontiers in Aging Neuroscience | via ScienceDaily

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The results of a new study could encourage health care providers to pursue or prescribe exergames (video games that also require physical exercise) in hopes of slowing the debilitating effects of those with MCI, sometimes a stage between normal brain aging and dementia.

Previously published research had found that seniors who exercise using the features of interactive video games experienced greater cognitive health benefits than those who rely on traditional exercise alone.

For the latest study, researchers wanted to target older adults diagnosed with or at risk for MCI.  Researchers initially enrolled more than 100 seniors for the study. Over six months, 14 (evenly split between men and women) persisted with regular exergaming. The average age was 78.

The first group of seven was assigned to pedal along a scenic virtual reality bike path several times a week. The second group was given a more challenging task for the brain: pedal while playing a video game that included chasing dragons and collecting coins.

The results were compared against data collected from a separate group of eight seniors who played video games on a laptop but did not pedal, and also a group from the previous research who only rode a traditional stationary bike with no gaming component.

At the end of the randomized clinical trial, participants in both the group that pedaled along a virtual bike path and those that chased dragons and collected coins experienced significantly better executive function, which controls, in part, multi-tasking and decision making.

Benefits for both groups were also seen for verbal memory and physical function, suggesting it may be worth the effort for seniors to incorporate exergaming into a daily exercise regime.

The authors acknowledged that further research with a larger sample size is needed to confirm the team’s findings.  In the meantime, the research suggests benefits of exercising while also stimulating the brain with some mental challenge, such as navigating a scenic bike path or interactively playing a video game.

Full story at ScienceDaily

Full reference: Anderson-Hanley, C . et al. The Aerobic and Cognitive Exercise Study (ACES) for Community-Dwelling Older Adults With or At-Risk for Mild Cognitive Impairment (MCI): Neuropsychological, Neurobiological and Neuroimaging Outcomes of a Randomized Clinical TrialFrontiers in Aging Neuroscience, 2018; 10

 

Current evidence on diet, cognitive impairment and dementia.

The Scientific Advisory Committee on Nutrition (SACN) position statement on current evidence on diet, cognitive impairment and dementia.

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This position statement by SACN provides an overview of the currently available evidence on nutrition and cognitive impairment and dementia (including Alzheimer’s disease) in adults. It considers evidence relevant to the prevention – not the treatment – of cognitive impairment or dementia.

The position statement concludes that:

  • the evidence base in this area is very limited
  • there is no evidence that specific nutrients or food supplements affect the risk of cognitive impairment or dementia
  • there is some observational evidence that greater adherence to a Mediterranean dietary pattern may be associated with reduced risk of mild cognitive impairment and dementia

While there is no single Mediterranean diet, such diets tend to include higher intakes of vegetables, fruit, legumes, cereals, fish and monounsaturated fatty acids; lower intakes of saturated fat, dairy products and meat; and a moderate alcohol intake. Mediterranean type diets broadly align with current UK healthy eating recommendations as depicted in the Eatwell Guide (PHE, 2016).

Full document: SACN statement on diet, cognitive impairment and dementias

You can find more information about SACN online.

Dementia-friendly public toilets

Many older adults avoid travelling and social interaction because of the scarcity of public toilets or their inaccessibility. Furthermore, where public toilets are provided, poor design and signage can preclude independent use, particularly for people living with dementia | The Lancet

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Image source: Martin Sotirov – Flickr // CC BY 2.0

In general, there is a gap between current public toilet provision and toilet design appropriate for individuals living with dementia, who might have behavioural change, poor level of motivation, loss of mobility and manual dexterity, or abnormalities in visual information processing. In response to research and anecdotal evidence, many guidelines are available to inform and improve the design and independent usability of toilet facilities for people living with dementia. Examples include the use of familiar or automatic flush systems, non-reflective surfaces, good lighting, contrast between doors and surroundings and between the toilet and toilet seat, sinks that do not resemble urinals, well labelled taps and soap dispensers, and the careful placing of mirrors.

However, as highlighted by a substantial amount of anecdotal evidence, the absence of simple and clear way-out signs negates any positive influence of a well designed toilet facility. Such an omission can result in distress, anxiety, embarrassment, and reluctance to use the toilet in the future. Common examples reported to investigators include instances of people having to enter opposite sex toilet facilities to guide their partners out, or going through the wrong door and into undesired or incorrect locations. A fire exit sign showing someone running with a directional arrow is also easily misunderstood as an exit sign, which can result in misdirection with people ending up outside the building and, in some cases, wandering on to a road. Similarly, doors that are both a fire exit and the route back to a public area can cause confusion, and might elicit a reluctance to open them, primarily because of the fear of setting off a fire alarm.

Full reference: Tales, A. et al. (2017) Dementia-friendly public toilets. The Lancet Vol. 390 (no. 10094) pp. 552–553

Effectiveness of dementia risk reduction messaging in NHS health checks.

NHS health check 40-64 dementia pilot research findings | Alzheimer’s Society

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The NHS Health Check programme is a statutory public health intervention commissioned by all local authorities in England. It aims to improve the health and wellbeing of adults aged 40-74 years through the promotion of earlier awareness, assessment, and management of the major risks factors and conditions driving premature death, disability and health inequalities in England.

The overall aim of the research was to evaluate the pilot and assess the feasibility of extending the NHS Health Check for 40-64 year olds to include a dementia risk reduction component. Specific objectives of the research included first, to understand the impact of the NHS Health Check on an individual’s knowledge and awareness of dementia risk reduction and the impact of the intervention on individuals’ intention to change behaviour.

The second objective was to identify (where sample sizes allowed) whether any differences in the delivery of the intervention between pilot sites had any effect on individual’s awareness and understanding of dementia risk reduction.

The third objective was to understand professional awareness and confidence in promoting dementia risk reduction messages and to identify further training requirements, resources and support.

The final objective was to assess any implications for services and commissioners and provide PHE with advice on any further longer-term evaluation that will be required.

Full report here

Is use of the internet in midlife associated with lower dementia incidence?

Study suggests that use of internet by individuals aged 50 years or older is associated with a reduced risk of dementia

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Objectives: Dementia is expected to affect one million individuals in the United Kingdom by 2025; its prodromal phase may start decades before its clinical onset. The aim of this study is to investigate whether use of internet from 50 years of age is associated with a lower incidence of dementia over a ten-year follow-up.

Methods: We analysed data based on 8,238 dementia free (at baseline in 2002–2004) core participants from the English Longitudinal Study of Ageing. Information on baseline use of internet was obtained through questionnaires; dementia casesness was based on participant (or informant) reported physician diagnosed dementia or overall score on the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Cox proportional hazards regression analysis was used for examining the relationship between internet use and incident dementia.

Results: There were 301 (5.01%) incident dementia cases during the follow-up. After full multivariable adjustment for potential confounding factors, baseline internet use was associated with a 40% reduction in dementia risk assessed between 2006–2012 (HR = 0.60 CI: 0.42–0.85; p < 0.05).

Conclusion: This study suggests that use of internet by individuals aged 50 years or older is associated with a reduced risk of dementia. Additional studies are needed to better understand the potential causal mechanisms underlying this association.

Full reference: Eleonora d’Orsi, et al.  Is use of the internet in midlife associated with lower dementia incidence? Results from the English Longitudinal Study of Ageing
Aging and Mental Health |Published online: 10 Aug 2017