'Going through the motions' to better treat dementia

October 27, 2004

Doctors are turning to wireless technology in an effort to better treat people with Alzheimer's disease and other forms of dementia. Thanks to a $200,000 grant from the Alzheimer's Association and Intel Corp., psychiatrist Adrian Leibovici, M.D., will explore whether gadgets such as motion sensors and wearable motion detectors can give doctors and nurses a clear picture of patients' lives in their own homes.

The team is focusing on movements of patients with dementia and will compare the findings from the technology to results of traditional methods where doctors and nurses discuss a patient's activities with the patient and his or her family. Such information is crucial for patients to receive appropriate care.

"Behavior changes hour to hour, or even minute to minute, in patients with dementia," says Leibovici, associate professor of Psychiatry at the University of Rochester Medical Center. "It happens all the time. One minute the patient is quiet and calm, and the next minute she might be agitated, anxious or loud. Our traditional ways of evaluating and documenting such behavior may not be adequate. A family might report that a patient has been calm for two weeks, when really the patient was calm only that morning."

Leibovici's team will compare current traditional interviewing methods to the results from the high-tech devices. For one week each month during the three-year study, patients will have their movements monitored inside their home as they go about their daily routines; they and their caregivers will also answer questions about the patient's activity during those weeks. Then Leibovici's team will check whether the reports by patients and family members correlate with information generated by motion sensors.

Even though our movements are so simple and routine that we hardly notice them - actions that are numbingly routine are referred to as simply "going through the motions" - our everyday movements offer a wealth of information to a trained eye. To Leibovici, who often works with older people who are depressed or have dementia, a patient who is pacing back and forth a great deal may be showing signs of agitation, while someone suddenly moving very little might be sinking into depression.

"The greatest source of disability, and the main reason families place a demented patient in a nursing home, is not the loss of cognitive skills," says Leibovici. "It's the psycho-behavioral symptoms of dementia, such as agitation, or depression, or even psychosis. Developing new ways to help such patients is crucial for them as well as their caregivers."

The first stage of the study involves testing technology in the smart medical home located in the University's Center for Future Health. Once calibrated, the wireless technology will be installed inside the homes of patients who volunteer to take part in the study.

The technology has been provided by HomeFree Systems of Milwaukee and GE Infrastructure, Security. HomeFree Systems Ltd. is a global provider of wireless monitoring solutions for the senior housing and homecare markets. GE Infrastructure, Security, is a wholly owned subsidiary of the General Electric Co. focused on communication and information technologies for security, safety and lifestyle enhancements.

The grant was awarded to Leibovici and the Center for Future Health through the Everyday Technologies for Alzheimer Care (ETAC) Consortium, which was founded last year by Intel and the Alzheimer's Assn. This award is one of the first five grants given by ETAC.

"Today, 70 percent of the 4.5 million Americans with Alzheimer's disease live at home where family and friends provide most of their care," says William Thies, Ph.D., vice president for medical and scientific affairs at the Alzheimer's Association. "It is imperative that we explore how technology can be used to save costs associated with institutional care, ease caregiver anxiety and help those with Alzheimer's improve their daily living."
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University of Rochester Medical Center

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