I went to a session on Elderly Patients. I thought this was an interesting session as technology is usually associated with young people, and it is easy to overlook how these technologies can change healthcare in the aged. This breakout session had three reserch discussions and two rapid fire discussions.
The first project was a randomized controlled trial of a web-based intervention to help people with osteoarthritis, The Effectiveness of a Web-Based Physical Activity Intervention in Patients with Knee And/or Hip Osteoarthritis: A Randomized Controlled Trial. According to the authors, osteoarthritis is most common among elderly and overweight patients, two growing populations. The pain causes decreased activity which over time leads to physical and psychological isolation and low self-esteam. According to the authors, increasing physical activity is a primary goal of therapy. Unfortunately, general practitioners are poorly trained and under-prepared to increase physical activity. The authors created a web-based program to increase physical activity over 9 weeks, called Join2Move.
The study randomized 200 elderly with OA to the intervention or control. They had 84% survey response rate at 3 months and 75% at 12 months. 46% of people in the intervention group completed at least 6 of the 9 modules. The results were mostly disappointing. They did not achieve increased physical activity at 3 months, when measured either by self-reporting or by an accelerometer. At 12 months there was increased physical activity but no improvement in physical function.
I applaud the researchers for doing a rigorous RCT and for the conference organizers for providing a prominent position to a negative study. We need to remove the shame from negative studies and learn from failures to move forward. I think that web-based activity trackers and motivators are probably the wrong solution and these programs should move to mobile. The authors would also probably benefit by talking with Susan Michie about the science of motivation to provide more global triggers to change behavior.
The second talk was a fascinating use of tablet apps to reduce social isolation in seniors living in their homes. The authors identified an increasing number of seniors are not living in group homes or institutionalized settings. While this has some advantages it does predispose to social isolation. The authors built an iPad game that provides pictures to seniors and asks them to create stories around the pictures. The authors incorporated seniors in the development of the app. The developers had a good response in early trials that showed increased connections and self-esteem. Users were so satisfied with the game they said they would be willing to pay for it. Preventive Socio-Technology for the Increasing Ageing Population: Apps as a Way to Improve the (social) Wellbeing of Elderly. The website for the application is here and the app for the iPad is available here for free.
The third talk was about designing a device that uses a television to bring seniors together. The Digital Seniors – Interactive eHealth Service Development with Old Citizens. The authors employed elderly, prospective users, to develop the application.
users as designers
After this were two rapid fire presentations. These were both very interesting. The first was an in-depth look at social alarms. Needs and Challenges in the Social Alarm Area. The use of cellular networks, smart phones and wifi has the potential to provide a much more sophisticated electronic safety net allowing increased independence of seniors. The final talk was on using the accelerometers inside cellphones to measure frailty in the elderly. MTUG: an Instrumented Timed Up and Go Extended Test. Imagine being able to get a quantitative assessment of a patient based on their actual movement by checking their cell phone. Awesome potential.
Post written by Dr. Joel Topf, eAJKD Advisory Board member.
Check out all of eAJKD’s coverage of Medicine 2.0’13.