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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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Early Alzheimer’s prediction platform secures €21 million investment

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PREDICTOM Dag Aarsland. Photo: Frida Moberg.
PREDICTOM's Dag Aarsland. Photo: Frida Moberg.

The project aims to identify people at risk of dementia before symptoms appear.

More than 7 million people are living with dementia in the EU. This number is projected to double, reaching 14 million by 2050.

There is currently no cure for Alzheimer’s disease. Although the search for potential treatments is showing promise, it is anticipated that these medications will be most effective in the early stages of the disease.

The recently launched AI screening platform, PREDICTOM aims to identify individuals at risk of developing dementia, even before symptoms manifest.

The cognitive and biomarker screening platform has this week announced it will be backed by €21 million in funding, with €8 million from the EU, €9 million from industry and €4 million from UKRI.

A consortium of 30 partners from academia, business, civil society and hospitals is steering the project. The Consortium includes partners from 15 countries across Europe, Asia and America and is led by Stavanger University Hospital.

Dag Aarsland, Professor of Old Age Psychiatry at King’s College London and research lead at Stavanger University Hospital, is the leading the project.

“Detecting early signs of dementia is key to slowing its progression. Unfortunately, a majority of those at risk are not identified in time. Our platform seeks to change this by enabling early discovery, allowing timely intervention and preventative treatment,” Aarsland said.

A crucial aspect of PREDICTOM is that much of the screening can be performed by the patients themselves in the comfort of their homes.

By initiating the process at home, the project aims to reduce strain on healthcare services and associated costs. Biomarkers, including saliva, stool, digital markers and blood via prick-tests, will be collected at participants’ homes or GP offices, streamlining a process traditionally carried out in hospitals or specialised clinics.

More than 4000 participants will partake in PREDICTOM’s trial project. The samples will be based on a pool of people from previous initiatives like PROTECT UK, PROTECT Norway and Radar-AD, as well as people from the catchment area of other participating centres in Germany, France, Switzerland, Belgium and Spain.

“If our project succeeds, there will be significant savings in both cost and time,” Aarsland said

After the home collection, samples will be sent to PREDICTOM, where their platform will process the participant data, integrating blood, cerebrospinal fluid, imaging, electrophysiological and digital biomarkers.

AI algorithms will generate risk assessments, early diagnoses and prognoses, laying the foundation for early intervention and treatment.

This project is part of the Innovative Health Initiative (IHI), a public-private partnership (PPP) between the European Union and the European life science industries.

“We are very pleased to have such a robust team with top notch expertise spanning diverse fields, including IT, AI, medicine, ageing research and professionals from both small and large businesses,” Aarsland added.

The project runs from 1st November 2023 to 31st October 2027.

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New partnership to bring dementia-specific programmes to Washington State

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Washington state dementia

The partnership will bring non-pharmacological interventions for dementia and alternatives to high-cost drugs to patients across Washington State.

A new partnership between brain health company, Together Senior Health and accountable care organisation, Rainier Health Network,

The partnership will introduce Together’s suite of dementia-specific programs, including in-home virtual interventions, to patients across Rainier Health Network in Washington state where the organisation oversees the healthcare of over 60,000 Medicare patients.

Alzheimer’s and related dementias affect more than 6.7 million Americans with 14 million projected cases by 2060. The associated healthcare costs for individuals with dementia are among the highest of any condition. Payers and providers face significant challenges in managing this expanding population.

According to a recent survey conducted by Sage Growth Partners, 77 per cent of health plans and value-based care organizations agree the need to address the growing cost of ADRD is urgent or very urgent; however, only 4 per cent have a fully-developed solution in place to support this population.

Approximately half of those surveyed also indicated a concern with the costs of Leqembi and other high-cost pharmaceuticals.

Together’s Moving Together programme offers a non-pharmacological intervention for dementia and a safe alternative to high-cost drugs that are not clinically appropriate for many dementia patients and have potential side effects.

The programme allows payers and risk-bearing healthcare organisations to more effectively manage patients. Together Senior Health says the programme results in improved engagement, reduced costs and improved health outcomes.

Recently, the company has been gaining industry traction. In addition to its partnership with Rainer Health Network, the firm is affiliated with the likes of VNS Health, VillageMD and the Alzheimer’s Association.

“Supporting our members with Alzheimer’s disease and related dementias is critical,” said Dr Francis Mercado chief medical officer and board chair at Rainier Health Network.It’s a vulnerable population and Together Senior Health’s Moving Together™ solution is a proven, natural way to improve their lives and control costs.”

Together’s Moving Together™ programme is based on over ten years of clinical research in neuroscience with the University of California, San Francisco (UCSF) and the National Institutes of Health (NIH).

Results from Together’s randomised control trial show statistically significant improvements in quality of life for individuals with cognitive decline and in caregiver ability to manage stress. The data also shows a reduction in falls and proven annual cost savings of up to $4,300 per participant per year.

Caregivers in the programme have also benefited, reporting enhanced caregiving skills.

Together is in the process of commercialising RADAR, its proprietary dementia identification and stratification algorithm. The algorithm helps payors and risk-bearing healthcare organisations identify people at highest risk for Alzheimer’s disease, dementia and cognitive decline using claims data, electronic health record information and other relevant data.

“We are proud of the positive impact Together is making on the lives of those affected by dementia and are excited to partner with one of the nation’s premier ACOs to extend dementia-specific programs to its patients,” said Alissa Meade, CEO of Together Senior Health.

“Rainier Health Network, Virginia Mason Franciscan Health and Together share a deep commitment to providing holistic dementia solutions that enrich the lives of participants while empowering forward-thinking, risk-bearing organizations to engage and manage this rapidly growing patient population effectively.”

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One in 25 carry genotype associated with shortened lifespan

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Genotype associated with shortened lifespan found in 1 in 25.
Kari Stefansson, Patrick Sulem and Brynjar Örn Jensson scientists at deCODE genetics and authors on the paper

The study used genomic data from 58,000 Icelanders and discovered the presence of a life-shortening genotype across 4 per cent of the population.

Scientists at deCODE Genetics, a subsidiary of Amgen, have published a study on actionable genotypes detected in the Icelandic population and their association with lifespan.

The researchers determined that 1 in 25 individuals carried an actionable genotype and have, on average, a shortened lifespan.

“The identification and disclosure of actionable genotypes to participants can guide clinical decision-making, which may result in improved patient outcomes,” said Kari Stefansson, author of the paper and CEO of deCODE Genetics. “This knowledge therefore has significant potential to mitigate disease burden for individuals and society as a whole.”

The study, published today in the New England Journal of Medicine, focuses on genotypes that increase the risk of a disease for which preventive or therapeutic measures have been established. These genotypes are termed actionable genotypes.

The scientists used a population-based data set, consisting of 58,000 whole-genome sequenced Icelanders, to assess the fraction of individuals carrying actionable genotypes.

Using a list of 73 actionable genes from the guidelines from the American College of Medical Genetics and Genomics (ACMG), the scientists found that 4 per cent of Icelanders carry an actionable genotype in one or more of these genes. The diseases caused by these genotypes include cardiovascular, cancer and metabolic diseases.

The study assessed the relationship between actionable genotypes and the lifespan of their carriers. The largest effect was observed among carriers of cancer-predisposing genotypes, which had three years shorter median survival than non-carriers.

A pathogenic variant in BRCA2, predisposing to breast, ovarian and pancreatic cancer, shortened lifespan by seven years and a variant in LDLR, which causes high levels of cholesterol and cardiovascular disease, shortened lifespan by six years.

“Our results suggest that the actionable genotypes identified in our study, which are all predicted to cause serious disease, may have a drastic effect on lifespan,” said Patrick Sulem author of the paper and scientist at deCODE Genetics.

The results showed that carriers of particular actionable genotypes were more likely to have died from the disease caused by these genotypes. Individuals with a pathogenic variant in BRCA2, have a seven-fold risk of dying from breast, ovarian or pancreatic cancer.

They are also 3.5 times more likely to develop prostate cancer and seven times more likely to die from prostate cancer than those who do not carry the variant.

The results of this study are among the factors that have motivated the government of Iceland to announce a nationwide effort in precision medicine.

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