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How digital health can address the agetech challenge

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Between 2015 and 2050, the World Health Organisation predicts that the proportion of the world’s population over 60 years old will nearly double from just 12 per cent to 25 per cent.

The pace of population ageing is accelerating at a much quicker pace, and healthcare providers and professionals now face a challenge to ensure they’re ready to cope with this shift.

Agetech World reports on the role digital health can play in addressing this challenge.   

Unfortunately, as Sinead MacManus, senior programme manager at Nesta’s Health Lab, explains, while we may be living longer, we’re not living healthier – which is when the ageing population begins to become a burden on the NHS and other healthcare providers.

According to research from The Kings Fund, around 15 million people in England are living with a long-term condition, with diabetes, chronic pain and arthritis among the most common.

And as you might expect, these illnesses are much more prevalent in older people; 58 per cent of people over 60 live with a long-term illness, compared to just 14 per cent under 40.

With over 50 per cent of doctor’s appointments and 70 per cent of in-patient bed days in hospital due to long-term conditions, it’s crucial we find a solution to support the ageing population to ease the strain on healthcare services and professionals.

Digital health – defined by the FDA as the use of computing platforms, connectivity, software and sensors for health care and related uses – could be the answer.

In a report for the British Council, Sinead explains that big data – huge data sets that are analysed to identify patterns and trends – and artificial intelligence (AI) may have the ability to lead us into a new era for personalised medical treatments, which can be customised for individual patients.

Sinead says: “By bringing together biological, clinical and lifestyle information, we can paint a unique picture of each patient and target therapies to achieve the best outcomes in the prevention or management of a patient’s disease.”

It is hoped that by diagnosing and treating patients earlier with the help of AI and big data, it will limit the number of older adults who are left battling long-term conditions and requiring regular hospital treatment.

But digital health isn’t just about using data and tools such as AI and VR to monitor patients – it can also nip issues that may lead to long-term conditions in the bud.

Take loneliness and social isolation for example; research shows that loneliness can have as great an impact on someone’s health as smoking 15 cigarettes a day, and this has only been exacerbated by the restrictions placed upon us during the pandemic.

By facilitating social experiences and encouraging regular human contact, health technology may be able to reduce both these feelings of isolation and, in the long run, the impact this is having on our minds and bodies.

Similarly, in China, measures are in place to embed monitoring and alert systems for older people living alone, meaning that accidents and falls can be reported quickly and, ultimately, reducing the severity of the incident. These systems are just one of many ways the country is harnessing technology to become more age-friendly and improve care for the ageing population.

Devices such as biometric trackers and AI-aided hearing aids can also protect the elderly against hazards and allow them to monitor their own health.

This technology can also ease the burden on carers and make it easier to offer remote support for the elderly. Wearable devices can track and alert the wearer – and their carer and emergency services – of heart rate, arrhythmias and event lack of exercise.

It is worth noting that one of the main issues healthcare providers and professionals now face is the uptake and willingness to embrace such technologies amongst the older generation.

However, research from Ienca, Schneble, Kressig and Wangmo found an overall positive response to digital health.

The aim of the study was to explore views and perceptions of older adults regarding the use of digital health for healthy ageing, and it was conducted through in-depth interviews with participants with a median age of 79.6 years.

The team state that: “Our study reveals a generally positive attitude towards digital health technologies as participants believed digital tools could positively contribute to improving their overall wellbeing, especially if designed in a patient-centred manner.”

The interviews did find, however, that participants did have some concerns around safety and ethical issues relating to privacy, empowerment and lack of human contact.

These worries were echoed in a study by the Singapore Eye Research Institute (SERI), which contradicted Ienca et al’s research and found that there was low acceptance of digital health services among the elderly.

Supported by the National Medical Research Council, the SERI found that 98.1 per cent of participants has not used digital health services prior to the pandemic. And while 52.2 per cent felt these services could help to reduce non-essential contact – the study primarily evaluated the acceptance of these services during the pandemic – 78.8 per cent of participant were uncomfortable with artificial intelligence software interpreting their medical results and providing automatic advice.

Unfortunately, with over half of the participants of the study being unreceptive towards digital healthcare, this study in particular has highlighted that there may need to be a shift in attitude and improvement in acceptance and adoption before technology can truly benefit the ageing population.

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On a mission to show that hearing loss is not inevitable

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The world’s largest investigation into the effectiveness of hearing training kicks off this week – as part of a movement to prove that hearing loss is not an inevitable part of ageing.

The research project aims to attract a minimum of 10,000 participants to better understand how hearing training impacts auditory processing skills like speech comprehension and the ability to locate where sounds are coming from.

Researchers are interested in the impact of hearing training on users who start training with different hearing ability levels, as well as training adherence in groups with different attitudes to smartphone technology.

Their aim is to find new ways to deliver and improve auditory training at scale and for a wider range of hearing skills; and to measure factors which influence training engagement.

The research is led by health tech firm Eargym. Co-founder Andy Shanks says:  Contrary to popular belief, hearing loss is not an inevitable consequence of ageing. We can take steps to improve and protect our hearing throughout our lives, yet preventative measures like hearing training have traditionally been under-researched.

“Our data shows the transformative impact hearing training can have on our ability to process sounds. Now, we want to deepen and widen our research and use our platform to make hearing training even more effective and accessible. Imagine improving and maintaining your hearing by up to 20% or more: it could make a big difference to the lives of so many people.”

The games on the Eargym app include a “busy barista” exercise, where users must discern speech over a cafe’s bustling background noise; and a “sound seeking” exercise, where users make their way through forests, jungles and oceans to locate the sources of different sounds. Each game is designed to be immersive and to help users practise specific auditory processing skills regularly.

Eargym was set up by former NHS CEO Amanda Philpott and DJ Andy Shanks in 2020, after they were both diagnosed with hearing loss. Amanda has moderate age related hearing loss, whilst Andy has “notch” or noise-induced hearing loss due to DJ-ing. Both found hearing loss isolating and it impacted their ability to socialise and communicate. They created eargym to empower others to better understand their hearing health and take proactive steps to protect it.

Hearing loss currently affects 18 million adults in the UK, with around one billion young people at risk of developing hearing loss due to increased use of headphones. Hearing loss is closely associated with increased dementia risk. Despite this, people wait an average ten years before seeking help for hearing loss.

Eargym plans to publish the findings of its research in early 2025.

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Interview: Exploring electrical stimulation for Parkinson’s disease

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The STEPS II study is investigating functional electrical stimulation (FES) in people with Parkinson’s disease to help improve their walking. Dr Paul Taylor, co-founder and Clinical Director of Odstock Medical Ltd (OML), spoke to Agetech World to tell us more.

Bradykinesia – slowness of movement which can lead to difficulty walking – affects many people living with Parkinson’s disease. The symptom can cause Parkinson’s patients to walk or move slowly, increasing the risk of falls, leading to a reduced quality of life and an increased dependence on others. 

Funded by the National Institute for Health and Care Research, sponsored by Salisbury NHS Foundation Trust, and managed by the University of Plymouth’s Peninsula Clinical Trials Unit, the STEPS II study is exploring the use of an FES device in Parkinson’s patients to help improve bradykinesia. 

The FES device, which has been pioneered by Salisbury researchers as a drop foot treatment for stroke and MS patients, is attached to the patient’s leg and produces small electrical impulses that improve movement.

“If you have Bradykinesia you’re moving slowly. The predominant treatment for Parkinson’s is medication and these can be very effective, but they have the problem of not working all the time,” explains Taylor, co-founder of Odstock Medical Ltd, a company owned by Salisbury NHS Foundation Trust.

”The effects of the drugs will wear off and after a period of time they become less effective, so, there’s a need for improvement.”

Taylor explains that deep brain stimulators are currently available, however, they are very invasive, expensive and can be risky. 

“We’re trying to do something which is a bit simpler and cheaper, which may possibly be able to help people at an earlier stage of Parkinson’s,” Taylor says.

“We’re stimulating the common peroneal nerve, which is the nerve that goes down the leg to the muscles, using a device called a drop foot stimulator. The device is commonly used for stroke and multiple sclerosis.”

A small feasibility study has already been conducted, which showed that FES can help patients walk faster and reduce some symptoms of Parkinson’s. 

In the STEPS II study, researchers hope to confirm the long-term effects of FES on walking speed and daily life with 234 participants at sites across Salisbury, Birmingham, Prestwick, Leeds, Swansea and Carlisle.

Taylor continues: “Our original idea was that we could use electrical stimulation to overcome freezing – which is the effect where people with Parkinson’s will stop walking, particularly when they come to doorways or very narrow areas. It’s to do with the processing of information from the outside world. 

“We wanted to see if we could use electrical stimulation to overcome that freezing and, to a certain extent, we did find that is the case for some patients, but more commonly and with a greater number of patients FES affected bradykinesia – speeding up their movement and helping with more effective walking.”

For the STEPS II study, participants will be randomised into a care as normal group, or a care as normal plus FES group. They will use the stimulator if they are in the FES group for 18 weeks, then the stimulator is taken away, with patients followed up one month later to see if the effects are continued.

Measurements of walking speed and movement will be analysed, along with sensory perception, balance, coordination, muscle strength, as well as secondary effects such as how the device impacts daily living and quality of life.

OML has established clinics around the country with trained therapists where the device will be used if the study is successful. 

“There’s a network of clinics already experienced in using the treatment so we plan to reach those clinics to include Parkinson’s patients in their cohorts,” says Taylor. “Then we’ll work with our contacts to see if we can get it overseas as well.”

OML is currently recruiting participants for the study, to find out more please visit: https://www.plymouth.ac.uk/research/penctu/steps-2 

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Quit Googling to stave off dementia onset, expert urges

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Resisting the temptation to search the web for information that could otherwise be recalled be exercising your brain could help to reduce the risk of dementia.

That is according to Canadian academic Professor Mohamed I. Elmasry who believes simple daily habits such as afternoon naps, memory ‘workouts’ and not reaching for a smartphone can increase the odds of healthy aging.

His new book, iMind: Artificial and Real Intelligence, says the focus has shifted too far away from RI (natural, or real) intelligence in favour of AI (machine, or artificial) intelligence. Elmasry instead calls us to nurture our human mind which, like smartphones, has ‘hardware’, ‘software’ and ‘apps’ but is many times more powerful – and will last much longer with the right care.

Professor Elmasry, an internationally recognised expert in microchip design and AI, was inspired to write the book after the death of his brother-in-law from Alzheimer’s and others very close to him, including his mother, from other forms of dementia.

Although he says that smart devices are ‘getting smarter all the time’, he argues in iMind that none comes close to ‘duplicating the capacity, storage, longevity, energy efficiency, or self-healing capabilities of the original human brain-mind’.

He writes that: “The useful life expectancy for current smartphones is around 10 years, while a healthy brain-mind inside a healthy human body can live for 100 years or longer.

“Your brain-mind is the highest-value asset you have, or will ever have. Increase its potential and longevity by caring for it early in life, keeping it and your body healthy so it can continue to develop.

“Humans can intentionally develop and test their memories by playing ‘brain games,’ or performing daily brain exercises. You can’t exercise your smartphone’s memory to make it last longer or encourage it to perform at a higher level.”

In iMind: Artificial and Real Intelligence Professor Elmasry shares an anecdote about his grandchildren having to use the search engine on their smartphones to name Cuba’s capital—they had just spent a week in the country with their parents.

The story illustrates how young people have come to rely on AI smartphone apps instead of using their real intelligence (RI), he says, adding: “A healthy memory goes hand-in-hand with real intelligence. Our memory simply can’t reach its full potential without RI.”

Published by Routledge, iMind: Artificial and Real Intelligence includes extensive background on the history of microchip design, machine learning and AI and their role in smartphones and other technology.

The book also explains how both AI and human intelligence really work, and how brain function links the mind and memory. It compares the human mind and brain function with that of smartphones, ChatGPT and other AI-based systems.

Drawing on comprehensive existing research, iMind aims to narrow the knowledge gap between real and artificial intelligence, to address the current controversy around AI, and to inspire researchers to find new treatments for Alzheimer’s, other neurodegenerative conditions and cancer.

It argues that current or even planned AI cannot match the capabilities of the human brain-mind for speed, accuracy, storage capacity and other functions. Healthy aging, Professor Elmasry notes, is as important as climate change but doesn’t attract a fraction of the publicity.

He calls for policymakers to adopt a series of key reforms to promote healthy aging. Among such changes, he suggests that bingo halls could transition from their sedentary entertainment function to become active and stimulating learning centers.

As well as napping to refresh our memories and other brain and body functions, he also outlines a series of practical tips to boost brain power and enhance our RI (Real Intelligence).

These include building up ‘associative’ memory – the brain’s ‘dictionary of meaning’ where it attaches new information to what it already knows. Try reading a book aloud, using all of your senses instead of going on autopilot and turning daily encounters into fully-lived experiences.

Other techniques include integrating a day for true rest into the week, reviewing your lifestyle as early as your 20s or 30s, adopting a healthy diet, and eliminating or radically moderating alcohol consumption to reduce the risk of dementia.

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