Early detection of dementia stage transition through habit recognition

by Gibson Chimamiwa

Older individuals prefer to age in their home environments despite their vulnerability to chronic diseases and frailty. To make it easier for individuals suffering from dementia to live in their own homes for as long as possible, new smart home solutions are needed. Due to their cognitive decline, they are prone to frequent habit changes at various dementia stages, and hence they need particular support to manage these situations.

In order to meet the care needs of the patients at different stages of the cognitive impairment, smart home solutions need to know and reason upon the activities and habits of the patients and also be able to recognise habit changes in real time. The changes in habits indicate the transition of the patient from one stage of dementia to the other. Early recognition of such stage transitions could assist caregivers in providing treatment or other interventions to slow the progression to late-stage dementia.

The state-of-the-art in smart homes for dementia have focused on activity recognition. However, dementia patients experience changes in habits and therefore there is need to extend activity recognition to habit recognition. In habit recognition, the aim is to capture one or more activities that are performed in a regular and repeated way such as detecting that the user usually sleeps for 8 hours per day. Observed deviations from the habits could indicate that the patient is moving from one stage of dementia to another.

Overall, while smart home solutions based on activity recognition for dementia patients exist, they are insufficient to support patients with changing habits such as dementia patients. Our ambition is to extend activity recognition to habit recognition system in order to detect habit changes and determine dementia stage transition. The habit recognition system could eventually be implemented in patients’ homes to assist caregivers to slow the progression to late-stage dementia through treatment or other interventions. These interventions will also enable patients to remain longer in their preferred environments thereby reducing societal costs.

Is Attention Deficit/Hyperactivity Disorder (ADHD) only a problem in childhood? A case for older age ADHD and its relationship with age-related disorders

By Maja Dobrosavljevic

With the growing population of older individuals, age-related disorders receive increasing attention as both an individual and public health concern. ADHD is usually associated with younger age; however, in approximately 60% of children and adolescents with ADHD, significant problems with attention and everyday functioning can persist to middle and older age. Although an increasing number of older adults has started seeking help in relation to ADHD symptoms, we still do not know what proportion of older population can be classified as having ADHD. This is because previous studies have been mostly conducted in children, adolescents and adults younger than 50.

Available research has shown that ADHD is linked to higher mortality rates and to a wide range of physical health problems, such as cardiovascular diseases and diabetes, as well as to mental health and behavioral problems. Additionally, recent studies have indicated that ADHD might be a risk factor for dementia. However, the available scientific literature has provided only sparse and inconclusive insights in how ADHD is manifesting in older individuals in relation to their health.

Having in mind the striking knowledge gap in what we know about ADHD in older adults, our first step is to conduct a systematic review of available literature. This will help us to identify more precisely the proportion of the older age population with ADHD, as well as to gain better understanding of manifestation of ADHD in this age group. In the next step, we aim to investigate a potential association between ADHD and age-related disorders, by using large-scale Swedish population registries.

Our findings can be applied in shifting the focus of health providers and research community to this, mostly unrecognized, population. Also, age-specific prevention programs could be developed that might help older people with ADHD to prevent certain health issues by employing small changes in their eating habits or physical activity. Finally, viewing ADHD as a life-long, chronic condition, rather than a developmental condition, can provide new insights into neuropsychological aspects of ageing.

Lifelong learning for older adults: between wellbeing & social change!

Hany Hachem, PhD candidate in Education, Successful Ageing Programme, Örebro University.

People generally are living longer, in western as well as in none-western nations. It is even projected that in future decades the proportions of older people will increase significantly to form bigger parts of the general populations. An increase in the demographics of older people is expected to induce more pressure on established welfare systems, as much as it could make it harder for developing nations to sustain the rights of its greying population. Uncritical models of ageing are dictating what they claim to be a healthy and productive, passe-partout model of ageing which is expected to work for older people around the globe. Lifelong learning is being promoted as a technique or a strategy to help older people lead a healthy and productive life. Learning for older people, just like the models of ageing that promote it, are far from critical. The main aim for this kind of learning is the wellbeing and happiness of older adults. While this might suit privileged segments of older adult populations, it means nothing to excluded and oppressed older people. If we want to put it clearly, what would an Opera lesson do to a sick older person who cannot afford healthcare? What do cultural trips mean to a 75 years old woman who needs to work still so she can afford food and accommodation?

I assume the image I drew above speaks for itself to the fact that Lifelong Learning for older people that is supposed to be a democratic institution of inclusion becomes the spiritual food of the privileged. Only those can actually live by models of ageing that shed their meaning at the doorsteps of the deprived. It is time that education for older people opens its doors to accommodate the needs of the wealthy as well as the poor. A communal approach to older adult learning can unify the interests of well-off and oppressed older adults by providing spaces for wellbeing, as well as, for fighting hegemonies, ageism and oppression.

Yes, it is time that education for older people awakens to the necessity of physical and nominal inclusion of all older people. It is time to focus on empowerment and social change as by-products of education in later life. To do that, a shift in research on older adult education is needed too. The outcome of this shift is to contribute to ongoing debates between those who think education should be only fun, and those who think education is a drug against oppression and social inequalities.

I, myself, am committed to the restatement of the principles of older adult education to give the freedom to older people to choose their own ageing model and lifestyle. Most importantly, that their choice of an ageing model is based on a critical awareness rather than survival and fitting in. The war is on, and we are ready!

Successful Ageing in the Oldest-Old: Living longer. Living well?

A mixed-methods systematic review of the perspectives of older people on successful ageing

by Andreea Badache

Throughout the world, the fertility rate is declining while the life expectancy is rising which leads to an increase of the population of older people. Globally, the number of people 80 years of age and above, termed as the oldest-old, is the fastest growing segment of the population and it is projected to triple by 2050.

Due to the increase of the ageing population, new concepts with the attempt to define ageing processes throughout the lifespan have emerged. One of the most studied and discussed concept among scientists, clinicians, researchers, academicians, and philosophers is the concept of “successful ageing,”(SA) which up to date has no standard definition or criteria for assessment. Previous studies have defined successful ageing as the absence of disease and disability or maintaining positive functioning as long as possible, not taking into consideration the individual heterogeneity, the multi-dimensionality of the concept or the perspectives of the older adults themselves. Only a few studies have focused on the older people’s views of the concept.

The existing models of SA does not seem to include older adults who suffer from chronic diseases or live with disabilities but still enjoy and are satisfied with their lives, people who might consider themselves as aging successfully. In our first study we will therefore synthesize the available published articles and include the views of older adults regarding successful aging in order to supplement the already existing theories with the perspective from older people and subsequently redefine the concept of successful ageing.

Older offenders: Understanding the relation between criminal behavior, mental and physical health disorders in ageing.

by Carmen Solares Canal

There is no novelty in saying that the world´s population is getting older but, how does this increasing ageing phenomenon impact in specific contexts and vulnerable population groups such as criminal offenders and inmates? In the present research, we aim to investigate the relation between criminal behavior, health status and ageing.

Previous research suggests that the proportion of prisoners over 50 years old represent between the 10 and 19 percentage of the prison population in different western-countries. However, little is known about the specific health disorders, the psychological traits and the social situation of older offenders. Criminal behavior in ageing and long-term patterns of deviant behavior along the lifespan is associated with different sociodemographic, socioeconomic, medical and psychological risk factors that may influence the mental, neurocognitive and physical health as well as the psychosocial well-being of older offenders. Psychological research face a challenge and a unique opportunity to investigate different ageing trajectories and to develop comprehensive population-based studies to understand the special needs of this specific but fast-growing population. This will help to understand what ageing means for older offenders, but also, to support the development of more adjusted interventions in order to improve their life conditions behind bars and to boost a successful re-enter in their communities.

In doing so, the first stage of my doctoral research is to investigate the state of the art of this new research field in order to understand what has been done and what is known about the health and psychosocial needs of older offenders. Thus, this first study is a systematic review and a meta-analysis of the literature aimed at exploring three main questions: 1) What are the most common mental and physical health disorders in older offenders?; 2) Does the health profile of older offenders differ to the health of older adults without a criminal history? and; 3) how do different psychological, sociodemographic and health variables associated with criminality contribute to cumulative health and social disadvantages in ageing?. The preliminary results show a high burden of cardiovascular disease, multimorbidity, geriatric conditions (ie. functionality problems, cognitive impairment) and depression among other mental and physical health disorders.

Inflammatory bowel disease in older adults. Does age influence the diagnosis?

by Sarita Shrestha

Inflammatory bowel disease (IBD) consists of a group of disorders that involves lifelong inflammation in the digestive tract (mouth to anus). The main types of IBD include Crohns disease and ulcerative colitis that normally develop in young adulthood. Recent evidence indicates that the number of older adults, above the age of 60 years, diagnosed with IBD is increasing.

However, the underlying explanation for this observation is unknown. Most evidence on the disease diagnosis, prognosis, treatment and management is based on the studies from the younger adults. This leads to misdiagnosis and treatment delays for many older patients with IBD. The overall aim of the project is to explore whether the age influences the immune mediated manifestation of IBD.

Study-I of my thesis aim to determine whether the information on International Classification of Diseases (ICD) codes registered in the Swedish national patient register (NPR) can be used to predict subgroups of IBD such as those affected by the disease later in life.

Prevalence of multiple life-long illnesses and extraintestinal manifestations when IBD affects other organs such as the skin and eyes has not yet been explored. Thus, the total number of people with the existing diseases in relation to genetic makeup, shared environmental factors and inflammation will be explored in studyII-IV of my thesis. We will make use of secondary data from the national patient registers in Sweden and Denmark. By conducting these studies, we attempt to facilitate the accurate diagnosis and identify risk factors related to the disease. It will help to promote health and develop policies for prevention of IBD in older adults.



Successful ageing, what is it?

 Welcome to the Successful Ageing blog

Örebro University’s strategic initiative on Successful Ageing currently consists of two graduate research schools focusing on interdisciplinary research. The PhD students spend four years on their own research while being part of the strategic initiative.

At the research school on Successful Ageing, research is being carried out on ageing and the opportunities offered by successful ageing. We are developing theories on successful ageing and relating them to a contemporary Nordic perspective. The graduate school is international with 18 doctoral students from several different countries.

The Newbreed PhD programme is partly financed by the EU Horizon 2020 programme, Marie Skłodowska-Curie Actions, Co-funding of Regional, National and International Programmes (MSCA COFUND). During 2018, 16 international doctoral students were recruited from 14 different countries, each working on a project of their own choice within four thematic areas.