There are no medications for Alzheimer's disease or dementia. But with preventative interventions and an adapted lifestyle, people at risk can actually keep the symptoms at bay for several years. Karolinska Institutet (KI) and EIT have developed two useful apps in collaboration with RISE: Dementia Risk Tool for risk assessment and Health Swipe for inspiration for lifestyle changes.
There is much to be gained by delaying the serious symptoms of dementia, Alzheimer's and other cognitive impairments. Research (The Lancet Commission 2017) shows that if the onset of the diseases are delayed by five years, it would save the patient half of the suffering caused by them. At the same time the cost to society for caring for these people is halved.
The two apps that are now available as prototypes (in Google Play and Apple's Appstore) have been developed by KI and RISE together with the EU-funded EIT (European Institute of Innovation and Technology). Through EIT Health, the EIT supports research that leads to new products that promote health, including through healthier lifestyles and more active ageing.
"The first app is called Dementia Risk Tool. In it, anyone can test if they are at risk", says Mattias Jacobsson researcher at RISE.
The risk of dementia disease is assessed by the app
After the user has responded to questions about age, gender, level of education, height, weight, exercise habits, blood pressure and cholesterol content, the app gives an assessment as a percentage of the risk that the user will develop a dementia disease within 20 years.
"The assessment is based on data from clinical studies that have followed middle-aged people for 20 years and looked at dementia, living habits and more. Therefore, the user can be sure that the risks that are assessed are real and not imaginary. One weakness is that the app is a little blunt as a tool. The questions do not go so deep and in research there are new parameters that did not exist when the study started", says Mattias Jacobsson.
The APP does not take account of genetic factors. This means that in some cases the app can give a risk factor that is too high. On the other hand, those who get a low risk factor may feel calm.
Five parameters you can influence yourself
The purpose of the second app, Health Swipe, is to motivate and inspire as many people as possible in the at risk zone to prevent cognitive impairments, dementia and Alzheimer's through their lifestyle. There are five parameters that you can influence yourself: diet, physical activity, social health, cognitive health (brain health) and heart health.
The APP is built as a digital deck of cards where you can answer questions, get information, solve tasks and accept challenges. This could be memory questions or solving a puzzle.
Weekly goals challenge the user
The user also gets weekly goals where they are challenged to perform various tasks. Anyone who can achieve all the weekly goals moves up a level to one with a slightly higher level of difficulty the following week.
A physical challenge may be that you should walk a certain number of steps each day during the week, while a social one may be to greet someone or to invite someone for dinner.
"Some challenges are certainly easy for some people, while others have to work hard to complete them. The point is that you have the opportunity to think about things that have to do with diet, social interaction and exercise", says Mattias Jacobsson.
We don’t know yet how well the app works, but answers will be coming soon.
"Yes, we will be conducting a preliminary study this year to find out what effects the app has. It is important that interventions or lifestyle changes do not feel too burdensome to implement. If that is the case then it is easy to give up", says Mattias Jacobsson.
Sustained changes in lifestyle are the challenge
The big challenge is to maintain the lifestyle changes achieved. Inspiration from game values, so called gamification, with new levels is a way of retaining the interest of the users.
"That is why we work continuously to create more content for the cards. It must be an experience that lasts a long time. But at the same time we have to find a balance so that it does not become a game where you only accumulate points for the sole purpose of collecting them", says Mattias Jacobsson.
The apps provide the user with knowledge
One goal with both apps is to give the users knowledge to take with them if they need to contact healthcare services. And that as many people as possible make contact in time. Among those who suspect that they are suffering from some form of cognitive impairment, it takes an average of two years before they seek help.
"At that time one third are in an early phase and would benefit greatly from Health Swipe, and a further third are on the verge of getting clear symptoms and can use the app as an aid at the memory clinic. But the final third already has a highly-developed disease. Their hope is that there will soon be medications", says Mattias Jacobsson.
The Health Swipe prototype is so far only available in English and is at level 6 on the TRL (Technical Readiness Level) scale, which runs from 1 to 9.
"We are looking for funds to be able to work further with content and other languages. We are also looking at a possible business model and a partner who wants to be part of developing the app into a commercial product", says Mattias Jacobsson.