WASHINGTON - Tiny motion sensors are attached to the walls, doorways and even
the refrigerator of Elaine Bloomquist's home, tracking the seemingly healthy
86-year-old's daily activity.
Elaine Bloomquist looks down at a sensor attached to her
refrigerator in her home Monday, June 18, 2007, in Milwaukie, Ore.
[AP]
|
It's like spying in the name of
science - with her permission - to see if round-the-clock tracking of elderly
people's movements can provide early clues of impending Alzheimer's disease.
"Now it takes years to determine if someone's developing dementia," laments
Dr. Jeffrey Kaye of Oregon Health & Science University, which is placing the
monitors in 300 homes of Portland-area octogenarians as part of a $7 million
federally funded project.
The goal: Shave off that time by spotting subtle changes in mobility and
behavior that Alzheimer's specialists are convinced precede the disease's
telltale memory loss.
Early predictors may be as simple as variations in speed while people walk
their hallways, or getting slower at dressing or typing. Also under study are
in-home interactive "kiosks" that administer monthly memory and cognition tests,
computer keyboards bugged to track typing speed, and pill boxes that record when
seniors forget to take their medicines.
More than 5 million Americans, and 26 million people worldwide, have
Alzheimer's, and cases are projected to skyrocket as the population ages.
Today's medications only temporarily alleviate symptoms. Researchers are
desperately hunting new ones that might at least slow the relentless brain decay
if taken very early in the disease, before serious memory problems become
obvious.
So dozens of early diagnosis methods also are under study, from tests of
blood and spinal fluid to MRI scans of people's brains. Even if some pan out,
they're expensive tests that would require lots of doctor intervention, when
getting someone to visit a physician for suspicion of dementia is a huge hurdle.
And during routine checkups, even doctors easily can miss the signs.
Bloomquist, of Milwaukee, Ore., knows the conundrum all too well. She
volunteered for Kaye's research because her husband died of Alzheimer's, as did
his parents and her own mother.
"It's hard to know when people begin Alzheimer's," she reflects. "Alzheimer
people do very well socially for short periods of time. If it's just a casual
conversation, they rise to the occasion."
Measuring how people fare at home - on bad days as well as good ones, not
just when they're doing their best for the doctor - may spot changes that signal
someone's at high risk long before they're actually demented, Kaye told the
Alzheimer's Association's international dementia-prevention meeting last week.
"If you only assess them every once-in-a-blue-moon, you really are at a loss
to know what they are like on a typical day," Kaye explains.
High-tech monitors under study:
_Researchers at New York's Mount Sinai School of Medicine are heading a study
that ultimately plans to recruit 600 people over age 75 to help test in-home
"kiosks" that turn on automatically to administer monthly cognitive exams. A
video of a smiling scientist appears on-screen to talk participants through such
classic tests as reading a string of words and then, minutes later, repeating
how many they recall, or seeing how quickly they complete connect-the-dot
patterns.
_An Oregon pilot study of the motion sensors tracked 14 participants in their
upper 80s for almost a year. Half had "mild cognitive impairment," an
Alzheimer's precursor, and half were healthy. Impaired participants showed much
greater variation in such day-to-day activities as walking speed, especially in
the afternoons.
Why? The theory is that as Alzheimer's begins destroying brain cells, signals
to nerves may become inconsistent - like static on a radio - well before
memories become irretrievable. One day, signals to walk fire fine. The next,
those signals are fuzzy and people hesitate, creating wildly varying activity
patterns.
The pilot study prompted a first-of-its-kind grant from the National
Institutes of Health to extend the monitoring study to 300 homes; 112 are being
monitored already, mostly in retirement communities like Bloomquist's. They're
given weekly health questionnaires to make sure an injury or other illness that
affects activity doesn't skew the results.
_In addition, participants receive computer training so they can play
brain-targeted computer games and take online memory and cognition tests. The
keyboards are rigged to let researchers track changes in typing speed and
Internet use that could indicate confusion.
_Finally, a souped-up pill dispenser called the MedTracker is added to some
of the studies, wirelessly recording when drugs are forgotten or taken late.
Electronics giants already sell various medical warning technologies for the
elderly, including dementia patients, such as pill boxes that sound reminder
alarms at dose time. And the Alzheimer's Association and Intel Corp. are jointly
funding research into how to use television, cell phones and other everyday
technology to do such things as guide dementia patients through daily
activities.
The next step of companies selling early symptom monitoring isn't far off,
and unbiased data on what really helps will be crucial, Kaye warns.