Tech to support aging in place: Help on the horizon?

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By Barbara Greenwood Dufour

More than 90 per cent of Canadians aged 65 and older are currently living in private residences. And most, if not all, of them want to remain there as long as possible. To support this desire to “age in place,” there are many new health technologies being developed that aim to help older adults remain healthier, more productive, and living in their own communities.

In a recent issue of Health Technology Update, CADTH looked at a few emerging technologies that could potentially help support aging in place. CADTH is an independent agency that finds, assesses, and summarizes the research on drugs, medical devices, tests, and procedures to find out what the evidence says. Its Health Technology Update newsletter describes new and emerging health technologies that are likely to have a significant impact on health care in Canada. The technologies described in this recent issue aren’t yet available in Canada, with the exception of the virtual-reality bike, described next.

Virtual reality-inspired exercise bike

A bike ride through places that hold fond memories could be the ticket to improved physical, memory-related, and cognitive abilities. But how can this be made possible? BikeAround combines a stationary bike with Google Street View to create a virtual bike riding experience. It has been developed for use by older adults experiencing physical disabilities, memory problems, or cognitive disabilities such as dementia or Alzheimer disease. The technology allows users to tour their childhood communities, favourite vacation spots, or any other place they wish to revisit simply by typing the desired address into Google on the BikeAround laptop. This activity is intended to improve memory skills as well as provide social engagement for participants, who are encouraged to discuss their ride with an attendant or volunteer assisting with the session. Even users with mobility limitations can experience the cognitive and reminiscent therapy by having a trained assistant navigate the streets for them. BikeAround bikes are typically set up at locations within communities and have been commercially available and distributed in Canada since 2018.

Smart home technology for home-based health monitoring

Older adults experiencing physical and mental decline may eventually need someone to keep an eye on them, either through an in-home care arrangement or by moving to an assisted living or nursing home facility. But smart home technology could someday offer health monitoring that could allow older adults to live independently at home for longer. The concept of wireless smart home monitoring technology isn’t new, but a system that claims to take the concept further is in the works. Called Emerald, it uses radiofrequency signals to track, and differentiate between, multiple individuals; measure breathing, heart rate, and sleep; and learn about patterns of human activity in a house. This could allow the system to detect falls and measure cognitive decline, mental health, and chronic conditions remotely and unobtrusively, allowing older adults to live independently and alleviating the need for trips to the hospital.

Device that monitors age-related macular degeneration at home

Age-related macular degeneration (AMD) is common in older adults. For those with the more advanced, wet AMD — which accounts for 10% of the population — regular visits to the eye doctor are considered critical to ensure that any retinal fluid changes are noticed right away, allowing treatment to be given in time to slow the progression of the condition. A new, at-home device could reduce not only the number of doctor visits but also the worry that retinal changes won’t be caught in time to prevent serious vision impairment. The device, currently under development by Notal Vision, will allow patients to take images of their eyes in the comfort of their own home. The device will analyze the images and, if a change in retinal fluid is detected, notify the manufacturer’s diagnostic testing staff to contact the patient’s eye doctor and set up a follow-up appointment. The device is expected to come to market in the US in 2020.

Wrist-worn device for managing essential tremor

Essential tremor can make daily activities such as eating, brushing teeth, and showering a challenge. But a new device that looks like a smartwatch could provide relief. Essential tremor is a neurological disorder that causes uncontrollable shaking and, while the disorder can affect almost every part of the body, it most often affects the hands. People can develop the condition at any age, but most of those affected are 65 years of age and older. Drug treatment (propanol and primidone) provides adequate relief in only about 25% to 55% of patients, and other treatment options (deep brain stimulation and lesional surgery) involve a surgical procedure on the brain. The Cala ONE device offers a non-invasive option for managing essential tremor. It delivers peripheral nerve stimulation — which has been shown to decrease hand tremor — through the skin whenever the wearer needs it.

As is typically the case with new and emerging technologies, there’s currently only limited evidence on their effectiveness or how they compare with existing treatments. But early awareness of interventions that might come into broad use can help us plan for their possible introduction into the Canadian health care system.

For more information about the technologies covered here, read the related Health Technology Update newsletter: https://www.cadth.ca/health-technology-update-issue-24. If you’d like to learn more about CADTH, visit cadth.ca, follow us on Twitter @CADTH_ACMTS, or speak to a Liaison Officer in your region: cadth.ca/Liaison-Officers. To suggest a new or emerging health technology for CADTH to review, email us at HorizonScanning@cadth.ca.

Barbara Greenwood Dufour is a Knowledge Mobilization Officer at CADTH.