Technology's Evolving and Expanding Role in Dementia Care, Prevention and Alleviating Burden

LOS ANGELES, JULY 14, 2019 — New studies reported at the Alzheimer’s Association International Conference (AAIC) 2019 in Los Angeles demonstrated the utility of technology to address Alzheimer’s disease and other dementias from three different angles — direct care of people living with the disease, assistance for caregivers, and prevention education for young people.

“While methods may exist to manage costs through public policy, expanded training, and health systems optimization, interactive technologies offer opportunities in the short-term to reduce the burden of hospitalizations and in-person care, while simultaneously expanding access to support services and educational materials,” said Joanne Pike, DrPH, Alzheimer’s Association chief program officer.

Research reported at AAIC 2019 found that:

• Remote telephone consultation with a health care provider can be effective in reducing emergency department visits among people with dementia in senior living communities.
• 70% of callers to the Alzheimer’s Association 24/7 Helpline put action steps into place within one week of using the service, and nearly 30% reported lower levels of emotional distress.
• A multimedia resource and video series called “MyBrainRobbie” was effective in teaching French schoolchildren brain-healthy behaviors as a potential early intervention to prevent cognitive decline and dementia.

“Providing high quality, person-centered care for people with Alzheimer’s disease and other dementias is an important but costly proposition,” said Joanne Pike, DrPH, Alzheimer’s Association chief program officer. “The cost of providing care for people with dementia in the United States in 2019 was estimated at $290 billion, according to the Alzheimer’s Association 2019 Alzheimer’s Disease Facts & Figures report.”

“While methods may exist to manage costs through public policy, expanded training, and health systems optimization, interactive technologies offer opportunities in the short-term to reduce the burden of hospitalizations and in-person care, while simultaneously expanding access to support services and educational materials,” Pike added.

Telemedicine Programs Can Decrease Emergency Department Use by People With Dementia
Studies have shown that people with dementia have higher rates of emergency department use compared to age-matched peers without a dementia diagnosis. Not only can these visits be particularly stressful for people with dementia, but they incur additional costs to the health care system. Telemedicine, or remote consultation with a health care provider, represents an alternative to in-person health care that could lead to better quality care at lower cost.

Manish Shah, MD, MPH, Professor of Emergency Medicine and Geriatrics and the John & Tashia Morgridge Chair of Emergency Medicine Research at the University of Wisconsin-Madison, investigated the effectiveness of remote telemedicine intervention in reducing emergency department usage in older adults living with dementia in senior living communities.

The program consisted of a staff member working with the study participant to collect current medical information and history, plus images, audio and video. The information was uploaded into a medical records system that could be accessed by the telemedicine program’s physician, physician’s assistant or nurse practitioner. As appropriate, the clinician then conducted video conferences with the person with dementia, a caregiver, or both. Clinicians could order laboratory tests or x-rays, order medicine or other interventions such as antibiotics, and provide care instructions. The program staff member working with the study participant was available to facilitate the care.

The researchers enrolled 731 people with dementia from 22 senior living communities in a northeastern U.S. city in this prospective cohort study. Of these, 220 study participants had access to telemedicine care, while 511 did not (control participants). In total, 201 telemedicine visits were conducted during the study. Over 3.5 years, the researchers found that the telemedicine intervention reduced emergency department visits by 24% (p<0.05) in this high-risk population. The intervention did not change the number of face-to-face visits to their primary care physician.

“Telemedicine, in the way we implemented it, works to decrease emergency department visits in people with dementia who live in independent or assisted living communities,” said Shah. “Future research is needed to confirm our findings and examine changes in the overall cost of health care delivered to these persons.”

Alzheimer’s Association Helpline Helps Caregivers Take Action, Relieve Stress
Family caregivers often find themselves isolated, stressed and overwhelmed as they try to manage care for family members with dementia. The Alzheimer’s Association Helpline is an easily accessible and free resource available 24 hours a day, 365 days a year in which master’s degree-level clinicians offer confidential emotional support, valuable and actionable information and referrals to additional resources in the local community.

To assess the effectiveness of the Association’s Helpline, Nancy Hodgson, PhD, RN, FAAN, associate professor and Anthony Buividas Term Chair in Gerontology at the University of Pennsylvania School of Nursing, conducted a pilot survey of 185 caregivers who used the service between January and October 2018.

The study found statistically significant improvements in caregiver’s emotional health, including a 27% improvement in caregiver emotional distress and 29% improvement in ability to manage stress. Additionally, 70% of callers surveyed put action steps into place within one week of calling the Helpline, 80% of callers put action steps into place within one month. Finally, 65% of callers were able to access additional dementia support services.

“Family caregivers of people with dementia often experience social isolation and limited access to emotional support,” said Hodgson. “This pilot study provides initial evidence of the profound impact that resources like the Alzheimer’s Association Helpline can have to reduce caregiver emotional stress and anxiety, and improve the ability of callers to ‘take action’.”

MyBrainRobbie Uses Video, Animation to Promote Brain Health Early in Life
A growing initiative in global public health efforts to reduce Alzheimer’s and dementia is encouraging healthy lifestyle choices such as regular exercise, good sleep habits and a balanced diet throughout life. Eleonore Bayen, MD, PhD, assistant professor at Sorbonne University–Pitié Salpêtrière hospital, Paris, and Atlantic Fellow at Global Brain Health Institute (GBHI), and colleagues created a multimedia resource called MyBrainRobbie, centered on short videos featuring an animated brain to teach children brain-healthy behaviors. MyBrainRobbie is funded by GBHI and the Alzheimer’s Association.

The program was piloted in June 2018 with 303 French schoolchildren aged 6-11, in 13 classes at three elementary schools. It included (1) a seven-minute video of a brain character, “Robbie,” who helps children learn about eight healthy lifestyle habits, (2) a website with links to educational packs for public health interventions in schools and (3) a curriculum of brain health educational classes in elementary schools.

The eight healthy lifestyle habits discussed in the video are: Learn, Be active, Avoid head injuries, Have a healthy diet, Avoid dangerous substances, Sleep well, Take good care of your health, and Spend time with family and friends. They closely parallel the Alzheimer’s Association’s 10 Ways to Love Your Brain.

A survey of the students found:

• High levels of satisfaction with the video; 64% rated it “excellent” and 30% said it was “good,” with highest levels in the youngest students.
• The video was rated “very easy” to understand by 68% and “easy” to understand by 25%.
• Students were able to recall seven of the eight brain-healthy behaviors, on average. (SD=1.3; min=1, max=8)

“Using child-appropriate language, MyBrainRobbie’s gentle narrative brings positive health messages to children while pointing out that lots of pleasant daily life activities are good for the brain,” Bayen said.

“We hope to increase global public awareness of the importance of brain health across the lifespan in an engaging way while reducing social health inequities,” said Bayen. “Five more international versions of MyBrainRobbie’s video, website and educational packs will debut this year in Spanish, Portuguese, Chinese, Turkish, and Arabic, joining the suite of materials already available in English and French.”

About the Alzheimer's Association International Conference^® (AAIC^®)
The Alzheimer’s Association International Conference (AAIC) is the world’s largest gathering of researchers from around the world focused on Alzheimer’s and other dementias. As a part of the Alzheimer’s Association’s research program, AAIC serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community.
AAIC 2019 home page: aaic.alz.org
AAIC 2019 newsroom: aaic.alz.org/pressroom.asp

About the Alzheimer's Association^®
The Alzheimer’s Association is the leading voluntary health organization in Alzheimer's care, support and research. Our mission is to eliminate Alzheimer’s disease through the advancement of research, to provide and enhance care and support for all affected, and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer’s. Visit alz.org or call +1 800.272.3900.

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• Manish Shah, MD, MPH, et al. High Intensity Telemedicine Reduces Emergency Department Use By Older Adults with Dementia in Senior Living Communities. (Funder(s): Agency for Healthcare Research and Quality; U.S. National Institute on Aging)
• Nancy Hodgson, PhD, RN, FAAN, et al. The Alzheimer’s Association Helpline: Preliminary Effects on Family Caregivers. (Funder: Alzheimer’s Association)
• Eleonore Bayen, Md, PhD, et al. An Evaluation of the Implementation of MyBrainRobbie in School-Age Children in France. (Funders: Global Brain Health Institute; Alzheimer’s Association)

Media Contacts: 
Alzheimer’s Association Media Line, +1 312.335.4078, media@alz.org
AAIC 2019 Press Office, aaicmedia@alz.org

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