Tackling dementia with IoT
Written by: Philip Mason | Published:

With average life expectancy in the UK increasing markedly in recent decades, Philip Mason explores how the Internet of Things is helping to monitor and treat age-related illness

According to the Office for National Statistics, recent decades have witnessed life expectancy in the UK rising incrementally year-on-year. Statistics suggest that average longevity peaked in the middle of the current decade, at somewhere around the age of 80.

There are a variety of factors explaining this increase, not least the democratisation of healthcare in the years following the establishment of the National Health Service in 1948. There have also been continual advances in medical science, something which has been picking up increasing speed for the past 250 or so years.

The latter is something that continues today, with medical technology increasingly incorporating cutting-edge digital comms. As might be expected, these modern-day advances help doctors in terms of diagnosis and treatment of their patients. At the same time, however, they aid patients in the monitoring, and even the management, of their own conditions.

Most terrifying issue
The opportunity to live longer clearly has its advantages, the most obvious of which being that people now have more time to enjoy their lives. The other side of that, however, is that as the body becomes inevitably more frail with the ravages of age, the quality of life can decline.

With that in mind, arguably the biggest health issue currently facing society, and certainly one of the most terrifying, is dementia. A study published recently by University College London predicts that 1.2 million people in England and Wales are expected to be suffering the disorder by 2040. A central facilitator of this, as per the research, is increased life-span.

Steven Stone is one of the founders of Stonelin, a tech start-up that has recently developed a solution to help give those caring for someone with dementia greater peace of mind. It does this through allowing them to keep track of their loved ones should the disease cause them to put themselves at risk by wandering off.

Speaking of the development of the device, known as D-Trak, he says: “We originally came up with the idea in the light of another of our products, W-Trak, which is designed to help track the movements of domiciliary carers going into clients’ homes. That was intended to monitor time spent working, which can sometimes be a contentious issue in that sector.”

He continues: “Unlike our other solutions, which have evolved out of the needs of the market, D-Trak was born following a specific request from someone who wanted us to create something to help him care for his wife. The lady in question was in the secondary stages of dementia and kept going missing, which was obviously very distressing to her husband.

“We had to act quickly, modifying one of our pet tracking devices, the Z3. This worked extremely well, so we started looking at the possibility of developing a bespoke device, which has attracted massive interest from investors.”

Watches not fobs
D-Trak works by transmitting positional information to an IP-based platform, through which users can keep track of those who have gone missing. It achieves this via the use of an internal sim card, to which end the company has recently partnered with Orange, with the latter providing ‘IoT connectivity services’ for the next five years.

One particularly clever feature of the device is its simultaneous function as a watch, meaning that the user intuitively places it around their wrist. Stone explains the rationale behind this design decision: “We’ve had a lot of feedback from the dementia community, saying that people don’t generally like to wear fobs around their neck,” he says.

“That meant we needed to create something instead which possesses a primary function to the wearer – something which is there to be ‘used’. A watch fulfils that criteria completely while also being something that someone would put on every day, without ever really thinking about it. They’re not even aware of the device’s role as a tracker.”

Discussing battery management, something which has traditionally been an issue in producing tracking devices for the elderly, he continues: “We’re currently developing a two-unit device that has a base station which can also be used as a charger. The two communicate with each other and, together with a custom algorithm, provide significantly improved battery life.

“One real USP of the product is that it doesn’t begin to track until the wearer breaches a virtual fence, which means it’s easy to manage in terms of battery life. It provides something like eight hours of live tracking time. That’s more than sufficient to locate a lost person wearing the device.”

Snoring is a danger sign
Dementia linked to Alzheimer’s is arguably the most dreaded disorder associated with growing older, in large part because of its devastating effects (coupled with the absence of a cure).

It is also frightening, however, because of relative uncertainty regarding the causes of the disease. While not exactly appearing from nowhere, it seems mysterious, currently linked as it is to a range of potential risk factors from genetic predisposition and prior head injury to gum disease.

One potential contributing factor to the onset of Alzheimer’s, at least according to online resource Medical News Today, is sleep apnea – a disorder in which breathing is interrupted during periods of unconsciousness. The condition is also dangerous in its own right, contributing in the worst cases to increased risk of stroke and even heart failure.

Neogia is a French company developing a suite of medical devices designed to monitor patients in their own home, the most high profile of which is a wearable device to help diagnose sleep apnea.

The integrated system uses low-energy Bluetooth beacons positioned around the house to monitor environmental conditions such as humidity, while the wearable device provides ‘subjective’ information on cardiovascular health and so on. The metrics, which are continually updated, are then passed on to those caring for the patient either via an app, or using the company’s web platform.

“A large chunk of the population suffers from sleep apnea,” says Neogia CEO and technology director Mehdi Cheraitia. “When you hear someone snoring, they probably have it to some degree.

“The construction of our wearable [which takes the form of a wrist/armband] to detect the condition is completely non-invasive, using optical LED technology. That has also given us the ability to develop the first passive method of monitoring the level of glucose in the blood. We’re very proud of that.”

Speaking of the system more broadly, as well as the rationale behind it, he says: “We want people to understand the difference between the idea of ‘wellness’ – which is more to do with fitness devices – and health.

“The idea with our technology is that it’s provided to patients via a medical specialist, who can then treat any symptom that is discovered. We’re very much part of the ‘health’ conversation. Clearly, seniors are an integral part of that.”

He continues: “The main breakthrough we’ve made is in relation to SpO2, which is to do with levels of oxygen in the blood. Being able to detect that opens up a lot of possibilities, because if you have a way of telling how the blood is oxygenated, you have the means to discover a lot of other things as well. We’re the first one to have achieved that with something that can be worn on the wrist or the arm at clinical standard.”

Major ethical issues
Both D-Trak, and the Neogia system in particular, signal the beginning of an era in which healthcare might look completely different to what we’ve become familiar with in the years since the NHS was established.

For instance, the emphasis is increasingly likely to move towards prevention. Core to this, meanwhile, will be saving resources by allowing patients to receive a diagnosis without having to visit their doctor. This is central to the Neogia system, as well as efforts already being made by certain GPs pioneering the use of virtual reality.

At the same time, however, creating an almost constant flow of by-definition highly confidential data can’t help but raise warning flags, not least when it comes to issues around privacy. This is something which is in the forefront of Cheraitia’s mind.

“Use of technology could mean you easily create a situation where people are being constantly surveyed,” he says. “There’s certainly an ethical issue around that. That being the case, the next iteration of our technology will be based on artificial intelligence, through which the system will learn from the patient – again, in a non-invasive way.

“Looking forward, we’re going to be able to pre-diagnose certain conditions, as well as being able to predict if people are likely to have accidents or falls in their own homes, looking at environmental factors. That will go into production in 2018, looking specifically at the sleep environment because we already know it so well.”

The development of communications-based solutions in the health sector is a truly fascinating subject, both regarding the technology itself and the implications for us as a species. Increased longevity is central to that conversation, and it is now down to technologists to help mitigate a situation which they, at least in part, have helped to create.

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