wearables and neurodegenerative conditions

Neurodegenerative conditions are set apart from other conditions, in that many are incurable. This often has  a significant  impact on the emotional and mental state on those living with and around people with these conditions. As the symptoms worsen, it can make it difficult for patients to stay confident that their quality of life will improve. Wearables can play a significant role in securing the right to live with dignity, even as these conditions progress and symptoms worsen.

What role does wearable tech play in the treatment of neurological conditions?

Wearable tech or medical devices can play a variety of roles in treatment. They are mostly geared towards improving quality of life; drugs are being developed in order to tackle the conditions in a more permanent manner, for example by protein delivery for nerve regeneration, but it may take up to 20 years considering the rigorous testing and clinical trials, particularly while there is little publicly available science and few widely known existing drugs to speed up the discovery.

Medical intervention and support systems should be holistic by design. They ought to measure aspects of our health that might not be observed by medical appointments alone, or by patients and their carers or loved ones, and bring  their data together to form a synergetic view of long term health.  Currently, the norm is spot measurements, time limited information with limited value to the progressive health of people living with many long term conditions. A big factor in the observation of these diseases is human fallibility: we can remember how we felt a week or two ago, but diseases can evolve over many months and years. These trends are almost impossible to pick up without relatively continuous measurement through technology. With novel sensing technologies evolving rapidly, a wearable can measure and record our health symptoms over indefinite periods of time. Some measurements could be direct, such as EEG (electroencephalogram) for brain activity, while examples of indirect measurements include heart rate variability monitoring for detection, quantification of stress events, and long term trends in mood and emotional health. 

Wearable tech paired with AI is an enabler for personalised health management. Healthcare can move from the existing sparse support and short interactions, limited by hospital resources and staff availability, to a continuous support. Patients could benefit from an enhanced, ‘always on’ automated support, guided by the doctors and nurses that care for them already.

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Will wearables for neurodegenerative conditions become widely used?

We are at a stage where many devices are in development, but getting the right balance of stakeholder input, funding, and good timing has proven very difficult for many. While this means that widespread adoption has not yet been achieved, there are devices supported by digital services that are starting to gain momentum. 

Empatica’s sensor-based devices monitor human health, with the ability to detect seizures and give a few minutes warning so that the patient can get to a safe place. Meanwhile, Apple seeks to offer tailored and medically certified sensing from its watch platform. It has progressed from detecting falls to monitoring the steadiness of one’s walking pattern. This offers the ability to identify whether someone is at risk of falling as an ‘opt in’ feature, activated by the user. People suffering from dementia have been issued wristbands by Avon and Somerset police so that if they go missing they can be found easily and efficiently, while panic buttons are now widely used by those at risk of falling.

One of the blockers for making wearable solutions mainstream is that decision making can be tricky for patients; for example, starting to use a walking stick makes a statement about patients’ frailty, not something most people want to accept. As a result, there can be some resistance to wearables. As designers of health solutions, we need a sharp focus on the user needs of patients, balancing the excitement of the technical opportunities, otherwise  widespread adoption and patient benefits are limited. This is a key challenge when intervening in medical care, regardless of the patient’s condition.

How can we maximise the use of wearables in this space?

Involving patients early on in development and facilitating communication so that they can express their views, not only on device design, but on data protection, communication, and business sustainability, can mean that the end user becomes a device’s biggest advocate.

Individual devices are typically chosen based on sufferers’ lifestyle or symptoms. For example, they can range from sleep mats to monitor sleep quality,  insoles to measure gait, and heart rate monitors which can be used for a range of different purposes. To augment the use of a variety of different wearables, a central point to collect the data would allow medical professionals to have a holistic view of their patients’ health, as well as providing an improved and simplified UX (user experience). 

Acquiring high quality biodata is of huge importance, especially now, when researchers are exploring and constantly pushing the boundaries of what can be achieved with sensing technology. Product developers should be uncompromising in striving for high quality measurement of raw data at source, looking to overcome the fact that measuring human signals is often impeded by the need for ergonomic form factors and less than optimal sensor positioning. But data acquisition is only one part of the story. The value is in interpreting the data, and that is a cross-disciplinary, multi stakeholder process that should be initiated as early as possible. 

Unfortunately, there are currently some odd blockers in this space. For example, if you have an application which is  classed as a medical device, you are required by medical regulations to have a multi-factor authentication in place. While this is ideal for data protection, it presents a very real problem for people who suffer with conditions such as Alzheimer’s or dementia as their memory problems may prevent them from remembering the answer to security questions. Finding solutions to these problems and making devices easy to access and use is imperative to widespread use and improving care for these patients and represents a classic example of a UX challenge.

Wearable tech can be of huge benefit to patients suffering from neurodegenerative conditions if designed and developed properly. Providing long-term healthcare solutions that add to quality of life and protect patients from harm, it has the potential to become widely used and revolutionise care. Challenges still exist in meeting the UX and systemic issues of adoption, but the tide of change is washing over health systems and medical practitioners are increasingly realising that this space is maturing and offering genuine alternatives. The time saving, patient care benefits and improvements to long term conditions are becoming irresistible.

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