The touch-screen app — classified by the Food and Drug Administration as a “daily activity assist device” — runs about $90 per month to provide reminders, music, videos, and connections to caregivers and doctors. It is one of a growing number of technological interventions that have emerged in recent years to help people with dementia and their caretakers.
It comes at a time when the search for treatments to slow or cure the condition seems to have stalled.
In the past 20 years, the FDA has approved only five drugs for Alzheimer’s disease. Memantine, designed to treat confusion, was most recently approved in 2003.
According to the World Health Organization, about 50 million people worldwide have dementia, with that number rising to an expected 82 million by 2030 and 152 million in 2050. Alzheimer’s accounts for 60 to 70 percent of dementia cases. Other major forms include vascular dementia, Lewy body dementia and frontotemporal dementia.
While medical breakthroughs have fallen short, robotics and digital devices to help with coping are taking off.
Technologies that 'fill a void'
Among the new technologies available or in development, some of which were on display at the annual Alzheimer’s Association International Conference last summer in Los Angeles, are: lifelike robotic companion pets, other robots to help patients remember to complete a task, GPS tracking tools to help find someone who has wandered off, virtual reality systems that can mentally transport patients outside the four walls of their homes or assisted-living facilities to other parts of the world, and even to other decades.
“In this challenging era of many failed drug trials to slow cognitive decline, a parallel track of research continues in search of better ways to help patients cope with existing symptoms,” said Seth Gale, instructor of neurology at Harvard Medical School and associate neurologist at Brigham and Women’s Hospital. “There is emerging evidence to show that interventions like robotic pets and home monitoring devices for caregivers can help reduce many of the common neuropsychiatric symptoms, including depression, agitation and anxiety.”
“These technologies fill a void,” said George Perry, professor of biology at University of Texas at San Antonio who serves on the scientific advisory board of the Alzheimer’s Foundation of America. “They can make a tremendous difference in having the disease and changing how patients deal with it.”
Stephanie Rohlfs-Young, director of volunteer programs at the Alzheimer’s Association, said “almost every caregiver is looking for ways to make the burden lesser, and we hear from a lot of people, especially in the earlier stages of the disease, that certain devices or apps are helping.”
The PARO, for example — a six-pound robotic baby seal that has sweet brown eyes and blinks its long eyelashes while it squeaks — was developed in Japan by Takanori Shibata with the hope that it might bolster the mood of someone with dementia and help improve communications skills, like a robot version of pet therapy.
A small 2014 study found that dementia patients laughed more frequently and seemed more verbal and engaged when interacting with the PARO than with a stuffed animal (which may not be all that surprising). On the other hand, the animated companion will cost you $6,000.
Robotic companions might also reduce the risk of dementia, according to a 2018 study from the Florida State University College of Medicine. It looked at data from 12,000 participants collected over 10 years and found that loneliness appeared to be a significant health hazard — including potentially increasing the risk of dementia by 40 percent.
A group of researchers in New Zealand and South Korea, meanwhile, are working on a home-care robot, Pomi 2, a 3-foot-tall robot that glides along on a set of wheels and has two “eyes” displayed on its round face. Its primary function is to help its owners remember to complete tasks, said Elizabeth Broadbent, professor of health psychology at the University of Auckland in New Zealand and a researcher working on Pomi 2.
The robot is programmed before use with specific reminders and instructions designated by family and others involved with care. It can map the floor plan of a house and is equipped with sensors to avoid running into walls and furniture. The robot is also programmed with various memory games to play with its owner.
“Say if it was asking you to check if the windows are closed, it follows you to confirm that you’re doing it,” Broadbent said.
In South Korea, researchers are working to build facial recognition software into the robot to help track a user’s facial expressions and recognize his or her emotions.
GPS and virtual tools
Researchers said one of the most valuable devices for people with memory impairments and their caretakers are GPS tracking tools to prevent dangerous and even deadly wandering episodes.
Project Lifesaver, for example, attaches to the wrist or ankle and uses radio frequency technology to find a lost person. The device emits an inaudible pulse each second, which is picked up by a handheld antenna. According to the Alzheimer’s Association, six out of 10 people with dementia will wander.
Other tools aim to allow patients to wander, but only virtually, to places that have been, or are, meaningful to them — with the hope that the experience will help preserve memories and prevent a decline in communication skills.
MyndVR, a health and wellness company, has developed a virtual reality system in use in about 40 assisted-living facilities that is designed to help patients rediscover obscured or vanished memories by taking them back to cities where they previously lived, or to musical performances that remind them of a different time.
“There’s a lot of loneliness and isolation attached to aging. And when disease sets in, there’s almost a one-for-one in terms of depression that follows this,” said Chris Brickler, chief executive and co-founder of MyndVR. “We want to bring the world to these folks,” some of whom may have dementia but also many who do not.
Brickler recalled a 94-year-old man in the throes of late-stage dementia who used virtual reality to experience a sunrise in Costa Rica. For 10 minutes he spoke quietly to himself about past vacations with his wife and children, Brickler said, and seemed to come out of it “with a much higher level of communicative spirit.”
But Brickler is careful to note that this technology is not a cure for the disease. MyndVR provides its system only to health-care facilities and charges $350 to $2,000 per month for it. Virtual reality systems do exist for individuals, but they haven’t been developed specifically for those with dementia.
'She laughs more'
The Alzheimer’s Association’s Rohlfs-Young says these technologies do not reduce the importance of having involved caregivers or the need for medical breakthroughs that could eventually stop or reverse Alzheimer’s.
“The reality is that the technologies that exist don’t replace the need for caregivers to be involved,” she said. “While the technology may be beneficial today, the nature is that Alzheimer’s and dementia are progressive. They need a holistic plan of care.”
For Doris Moss — who took the medication Aricept, which aims to enhance cognition improving function of the brain’s nerve cells, until it stopped working for her — technology is the only thing now that offers some help.
Pearson looks through older photos of her mother before she began using the SimpleC Companion and sees a difference in her eyes. She used to have a faraway gaze, and now she engages more, Pearson said.
“She didn’t seem to be as alert or involved in what was going on around her,” Pearson said. “Since then, she laughs more.”