By Ilan Mester
Picture this: a person living with the early stages of Alzheimer’s Disease (AD) attends their grandchild’s seventh birthday party. They want to remember that moment, but realize the memory will likely escape them. So with a simple click of a button, they capture part of this precious moment on a device that will play it back to them later in a similar way to the hippocampus – the part of the brain that’s strongly linked to memory and is affected in people experiencing AD.
This is the type of innovation the Centre for Aging + Brain Health Innovation (CABHI), led by Baycrest Health Sciences, is helping to nurture. Established in 2015, CABHI is a solution accelerator that collaborates with researchers, point-of-care clinicians and entrepreneurs across Canada and globally. The organization provides support to innovations (technologies, interventions, knowledge translation initiatives) that directly impact seniors living with dementia and other conditions associated with aging, along with projects that affect their caregivers and providers.
Here is an in-depth look at a trio of unique senior-sector innovations that are in the pipeline:
Project Lead: Dr. Morgan Barense, cognitive neuroscientist
Site: University of Toronto’s Memory & Perception Lab
The sci-fi-esque Hippocamera is a digital memory augmentation device that acts like an external hippocampus. “The memories that are lost in people with Alzheimer’s Disease are the events of one’s life that are happening on a day-to-day basis,” explains neuroscientist and project lead Morgan Barense. “Recent events, they slip away as quickly as they occur. So what we want to do with a digital device is to capture those events and store them in a memory that saves on these smartphones. We don’t want the memories to only be on the phones; we need to get them into the user’s brain somehow.”
The “trick,” according to Barense, is mimicking the hippocampus. “The hippocampus takes a memory and essentially broadcasts it to the rest of the brain through a process called hippocampal replay. It basically teaches the rest of the brain these memories. And the students of the hippocampus are the parts of the brain that are still intact in Alzheimer’s Disease, so it’s like our phone is the hippocampus and we’re trying to teach the rest of the brain those memories.”
In its current iteration, the Hippocamera is an app that users can download to their smartphone. “So the user takes the device out when it’s a memory they want to remember,” adds Barense. “They take a video of it and then the phone stores that video and it plays it back on a steady schedule and with certain parameters. We’ve changed the video in such a way that we think mimics what the hippocampus is doing.”
The device is currently being trialed through Barense’s lab. Her team is using narratives and neuro-imaging to determine whether the Hippocamera improves memory retention and if it changes how the brain represents these memories.
So far, the feedback from users has been overwhelmingly positive. One senior who chose to remain anonymous notes the experience was “very motivational.”
“I started to have more confidence in myself and started to be more aware of things around me,” they added.
Barense says CABHI has been instrumental in moving the project forward. Her team received support through the Research-Clinician Partnership Program (R2P2), which connects clinicians with university-based researchers to collaboratively design and test products or services in real-world settings.
“CABHI’s financial support is helping with machine learning advancements for the Hippocamera,” says Barense. “And it’s also giving us extra fire power in terms of validating the device in a larger-scale clinical trial.”
SOS Checklist App
Project Lead: Raquel Meyer and Jennifer Reguindin
Site: Centre for Learning, Research & Innovation in Long-term Care
Like many innovations in healthcare, the Sensory Observation System (SOS) Checklist App came about after a clinician noticed an issue in practice. “There is room to improve communication in long-term care,” says Jennifer Reguindin, a nurse and interprofessional educator for the Centre for Learning, Research & Innovation in Long-term Care. “I hear staff say, ‘I need your help with a patient’ and it isn’t specific enough. So a typical response would be, ‘I’ll help later.’ This sometimes results in in an unnecessary escalation or uncovers a concern that was already addressed.”
The SOS Checklist App offers care providers a common language they can use with healthcare providers. “Communication accounts for 80 per cent of medical errors,” adds Reguindin. “So here’s a resource that can support communication using a framework. Here’s an easy way if you take the time to pause and think about what you want to say and activate the team accordingly.”
That data includes everything from incremental changes in appetite, self-care abilities and mood changes, among other things. The goal is to offer care providers a common language, a secure space for observable changes to be stored and shared, and potentially reduce unnecessary hospital admissions for seniors.
“I believe that this app can increase the accuracy of patient reports in the clinical setting, as well as recognize any acute changes that the patient is experiencing,” shares Anthony Saceda, a newly graduated registered practical nurse who has used the app in practice. “As a new graduate, there will be signs and symptoms that I can possibly miss when assessing my patient, of which some can be critical. This app also allows me to explore different possible outcomes that may arise as I assess my patient.”
At first, the SOS app was meant solely for care providers such as nurses and PSWs. However, Reguindin realized its potential benefits to caregivers and is now testing it among people caring for elderly family members.
In addition to financial support, Reguindin says CABHI has provided guidance and feedback opportunities. For example, Reguindin participated in a focus group with CABHI’s Seniors Advisory Panel – a diverse group of seniors who meet bi-weekly to share their input on CABHI-related innovations.
Reguindin adds that CABHI’s involvement has been crucial to access business support. “I’m a nurse – how do I learn how to get this app out to people? I don’t know how. With CABHI’s support, someone will be able to coach us on getting the app to market when the time is right.”
Memory and Aging Program (MAP)
Project Lead: Dr. Angela Troyer, neuropsychologist
Site: Baycrest’s Neuropsychology and Cognitive Health Program
Transforming a clinically validated intervention into an e-learning tool takes a lot of work. Just ask Cindy Plunkett, a project manager for CABHI’s e-Learning and Educational Technologies division. Cindy and her team work in-house at CABHI to develop and leverage e-learning opportunities for CABHI-supported projects.
One of those is the Memory and Aging (MAP) program, an educational intervention for older adults dealing with age-related memory changes. The clinically validated, five-week program has been running onsite at Baycrest Health Sciences for 20 years. “It gives participants practical memory strategies that they practice during the different weeks to help them continue to have a very vibrant lifestyle,” Plunkett explains.
CABHI saw an opportunity to bring this well-researched program outside of Baycrest’s walls through e-learning, expanding its reach well beyond Toronto and into national and even international territory. The key, however, is to ensure MAP continues to have the same feel as the original in-person intervention. “We wanted to recreate the feeling of that small, 15-person discussion in the classroom in the online environment,” adds Plunkett.
To do this, Plunkett and her team have drawn on a number of interactive components, such as a polling system and a curated discussion to increase engagement.
“The face-to-face version has been rigorously tested,” she adds. “And we will be doing the same with the online version, and then doing some comparisons to see if we are getting the same gains as we were getting in the face-to-face version.”
So far, the online version of MAP has been piloted twice and a few more iterations are in the works. There has been cross-Canada representation and even some international users.
“I think because you’re doing something interactive, it keeps you more connected and engaged,” shares Shirley Criscione, a senior who participated in one of the pilots. “You’re not just sitting and listening to someone.”
She’s already recommended the program to a friend who’s starting to experience memory changes. “What I liked about it is you could do the program in your own time and your own space. You didn’t have to travel somewhere to participate in the workshop. That’s really important because as people age and want to take advantage of this program, it’s going to be easier if they can do it in their home rather then having to go somewhere in a car or take transit.”
Criscione adds that she’s still using many of the strategies she learned in the online group. “The memory program teaches you about how important it is to stay physically active, stay social and of course, mentally active as well. The relaxation strategies that are part of the program to keep yourself calm and stress free — I think all of those units are really important for people to access and try and hone.”
These are just three of more than 70 exciting projects currently underway at the Baycrest-led Centre for Aging + Brain Health Innovation. To learn more about CABHI and its programs, visit cabhi.com or email firstname.lastname@example.org.