As part of the Cognitive Empowerment Program (CEP), Georgia Tech researchers first explored the People Power IoT System in the technology-equipped Aware Home, a 5,000 square foot home designed to facilitate research. The CEP’s technology team focuses on designing interventions and applications, as well as collecting data in the homes of study participants including sleep patterns, bathroom and kitchen habits, and more.

The team will use the data to empower CEP members and their care partners, through mobile apps and in-home interventions supporting independence. They'll also share key information with the CEP therapeutic team to identify where members may need further training on strategies to compensate for cognitive impairment.

“Changes in daily habits provide key indicators for informing lifestyle interventions that combat a decline in cognitive function. Through this collaboration, we have the unique opportunity to collect critical data to inform care and empower people with MCI and their care partners,” said Elizabeth Mynatt, executive director of the Institute for People and Technology and co-director of the CEP technology core.

In the Aware Home Research Initiative (AHRI), the People Power IoT System will provide device and data management and a framework for creating machine learning microservices, allowing researchers to more effectively conduct long-term studies and collect and view data, according to Brian Jones, director of the Aware Home initiative.

“What People Power is providing is the opportunity to hit the ground running on this project,” said Jones. “We can have different studies running, view all of the homes in each study, and through a web browser see the status of in-home devices that provide the system with data.”

Although the joint effort between IPaT and People Power currently focuses on adults with MCI, Jones envisions expanding it to other data science research at Georgia Tech.

People Power is a leading provider of consumer and institutional services for senior care, energy management and home security. The company’s recent introduction of a comprehensive senior care solution that brings together agencies, caregivers, clients and their families for improved senior care reconfirms their mission of helping with life’s important challenges with easy-to-use technology.

“Collaborating with Georgia Institute of Technology’s Aware Home Research Initiative is a real honor for our company,” said Gene Wang, CEO and co-founder of People Power Co. “As a technology provider for senior care solutions that address technical, design and social challenges of aging, we are delighted to assist in this important research initiative with one of the top research universities in the country.”

The company also recently partnered with the University of California Berkeley to design senior care technology for people with dementia. Learn more about People Power on their website.

People with MCI have difficulty with memory, problem-solving, or spatial ability. The condition affects an estimated 15 - 20% of people over the age of 65. In January 2020, the Georgia Institute of Technology and Emory University’s Brain Health Center will open CEP, which is funded by $23.7 million in grants from the James M. Cox Foundation and Cox Enterprises. 

The program includes four components: the therapeutics core, built environment core, technology core, and the innovation accelerator. The Innovation Accelerator (IA) is supporting the seed grant program and engaging academic and research faculty to lead teams of students and persons with MCI to identify needs and explore creative solutions together through a multidisciplinary, co-design process. 

In many cases, solutions developed to support people with MCI may have broader applicability to other user groups, and the wider community interested in health, aging, and cognition. 

Each year for the next three years, the CEP's Innovation Accelerator (IA) will award $150,000 in seed grants to grow the body of literature in the MCI space. This inaugural seed grant year, the IA has awarded five seed grants to interdisciplinary teams from Georgia Tech and Emory. Here are the seed grant recipients for 2019 - 2020: 

Everyday Memory Intervention for Caring Dyads

Principal Investigators:

Ann Pearman, Georgia Institute of Technology

Chris Hertzog, Georgia Institute of Technology

Collaborator:

Ken Hepburn, Emory University

This intervention is designed to help both CEP members and their care partners (caring dyads) learn new techniques to help improve their everyday memory and functioning. Investigators will teach both people strategies to manage their everyday functioning with a focus on self-regulation and dyadic interaction.

Identifying Barriers and Technological Interventions to Support Adherence Behaviors in Mild Cognitive Impairment 

Investigators:
Kayci L. Vickers, Emory University School of Medicine (PI)
Dr. Felicia C. Goldstein, Emory University School of Medicine (Co-I)
Maribeth Gandy Coleman, Georgia Institute of Technology (Co-I)
Laura Levy, Georgia Institute of Technology (Co-I)

Past research has shown that up to 40% of older adults do not adhere properly to prescribed medications, and that these rates are higher among individuals with Mild Cognitive Impairment (MCI). Although it has been less well-studied, there is growing evidence that behavioral recommendations such as changing one’s diet, exercising more, becoming more cognitively active, and engaging in regular social activities are more difficult to carry out and therefore are likely to result in even higher rates of non-adherence. The proposed study aims to understand the major barriers to adherence to these types of regimens in individuals with MCI and their care partners, and to co-design technological solutions for overcoming these barriers. 

Development and Testing of a Social Game with the Therapeutic Potential for Individuals with MCI and their Families

Investigators:

Chantal Kerssens, Georgia Institute of Technology (PI)

Maribeth Gandy Coleman, Georgia Institute of Technology (Co-I)

Laura Levy, Georgia Institute of Technology (Co-I)

Subject Matter Experts:

Cecile Janssens, Emory University

Tracy Mitzner, Georgia Institute of Technology

Dr. Molly Perkins, Emory University School of Medicine

Suzette Binford, Emory University

The proposed project aims to create, implement and test an adapted version of a well-known game, such as Scrabble, for people with MCI and their family members. Many couples and families seek opportunities to stay active, physically and mentally, to support their brain health. 

Feasibility of Using Tele-Technology for Mind-Body Interventions for People with Mild Cognitive Impairment

Investigators:

Tracy L. Mitzner, Georgia Institute of Technology

Dr. Patricia C. Griffiths, Emory University

Group mind-body classes, such as tai chi and mindfulness, have the potential to provide both physical and social health benefits. Unfortunately, there are substantial logistical, cultural, and structural barriers for adults aging with cognitive disabilities, such as Mild Cognitive Impairment (MCI), to engage in group exercise classes. Barriers include lack of transportation to classes, fear of negative stereotypes, and a dearth of instructors with appropriate training. Teletechnology, such as videoconferencing with audio and video exchange, provides the opportunity for people to deliver and attend group exercise classes remotely, with great potential to support people with MCI.

Feasibility of Measuring Natural Gait Speed In-Home to Quantify Falls Risk in Individuals with MCI

Investigators:

Jon Sanford, Georgia Institute of Technology

Joe Nocera, Emory School of Medicine

Dawn Fletcher, Brain Health Center (Co-I)

The purpose of the proposed pilot project is to demonstrate the feasibility of using continuous measures of naturalistic gait speed during an individual’s normal, everyday activity in the home environment and if the captured measures can provide a more reliable assessment of mobility and fall risk in individuals with MCI. 

Read full descriptions of each project on the Institute for People and Technology website.

The Institute for People and Technology (IPaT) at the Georgia Institute of Technology is working to help people take their power back through an array of research initiatives, centers, and partnerships, including the new Cognitive Empowerment Program in collaboration with the Emory Brain Health Center at Emory University.

“With our work in aging, we want to help people achieve the priorities and goals they have for their third stage of life,” said Beth Mynatt, executive director of IPaT and Regents Professor in the College of Computing at Georgia Tech. “We think technologies and different healthcare approaches, like help at home and a focus on social connections and community, can help people do this.”

Improving Health Outcomes

Tele Tai Chi

Tracy Mitzner, a research scientist in the School of Psychology, is working on an evidence-based program with world-renowned tai chi instructor Paul Lam on a project designed to help older people with mobility impairments increase both their activity level and their social connections. 

"A strong social connection has very significant health outcomes,” said Mitzner, who’s also co-director of TechSAge, a collaborative research center with the University of Illinois at Urbana-Champaign, which supports aging-in-place for people with long-term disabilities. “And a lack of social connection increases your mortality risk. So, it's not just about feeling good; it's directly tied to your health.”

The Tele Tai Chi program brings together a group of older adults through OneClick.chat, a web-based video conferencing platform. They will not only learn tai chi through the system, but they’ll also participate in social time, much like one does in a traditional class.

Measuring gait speed

Known as an extremely accurate, fast, and simple health indicator, doctors use walking speed and changes to predict significant health issues like physical and cognitive decline, quality of life, hospitalizations, and even mortality. 

Brian Jones, director of the Aware Home Research Initiative, is collaborating with Ted Johnson, director of the Center for Health in Aging at Emory, to test a system they placed in doctor’s offices and medical centers in Atlanta and Oregon. It measures a person’s gait speed as they walk from the waiting room to the exam room, and is designed to be a quick and unobtrusive method for detecting issues that otherwise may go unnoticed.

Enhancing the Quality of Life

Smart Bathroom

Jones has also just completed a trial testing a bathroom that helps people get on and off the toilet. It uses off-the-shelf technology to observe the person’s gait, posture, and their speed of movement. The Smart Bathroom uses that information to raise or lower the toilet and grab bars to assist with the mount or dismount. 

“Our next trial of the Smart Bathroom will involve testing it with people who use a wheelchair and people who use a walker,” said Jones. 

HomeLab

To learn if people can and will use a piece of assistive technology in the home, it pays to test it in their home. “There’s only so much you can do in the lab,” said Brad Fain, director of HomeLab and principal research scientist at Georgia Tech Research Institute. “People get tired, and older adults get tired even quicker.”

HomeLab deploys products in the home to observe how people interact with them over time so the lab can test assumptions or make improvements. With a network of more than 600 homes of people aged 50 and older, HomeLab has assessed systems such as a wearable device that reminds users when its time for their medication, an in-home medication dispenser, and a smart mirror.  

“It's real-world, and it gives people a lot more experience with the product or service we’re testing,” added Fain.

 A recent trial involved testing commercial activity trackers (FitBit, Nike+ Fuel Band, Striiv, and MyFitnessPal) with older adults to see if knowing their actual level of daily activity would inspire them to change their behavior. 

“We saw real change with people trying to increase their activity level by adding just a bit more to what they’re already doing, like taking the long way when they went for a walk or took the dog for a stroll,” said Fain. 

Everyday Memory Intervention

One of the more frightening aspects of aging is a dwindling memory. “It’s something other people may be aware of before you are,” said Christopher Hertzog, a professor in Georgia Tech’s School of Psychology. 

Scientists typically measure memories with diaries people use at the end of each day. "But they forget what happened during the day, and often once they’ve forgotten it, then it’s gone,” said Hertzog. 

One of his current projects, Everyday Memory Intervention, gets around that end-of-the-day problem by using a smartphone for people to record the events as they happen. It’s an attempt to overcome the difficulties of measuring memory in the real world. One of the problems with current mnemonics training is that while people can learn to memorize the information, they have more difficulty transferring that training into something useful in real life. 

“What we’re doing,” he said, “is turning that on its head and focusing on helping people remember the target behavior in their everyday life,” basically cutting out the middleman.

Cognitive Empowerment Program

In January 2020, IPaT, in partnership with the Emory Brain Health Center and the SimTigrate Design Lab in Georgia Tech’s College of Design, will open the Cognitive Empowerment Program (CEP) at Emory's Brain Health Center. The program is made possible by $23.7 million in grants from the James M. Cox Foundation and Cox Enterprises. CEP has four major pieces: the therapeutics core, built environment core, technology core, and the innovation accelerator. Together they will provide a holistic approach to managing mild cognitive impairment (MCI), a neurological condition that occurs between the typical cognitive decline of aging and dementia.

Memory problems, as well as difficulties with language, judgment, and general thinking to a degree that is greater than typically experienced in healthy aging, all characterize MCI. People with MCI may stay at that stage, or the condition may be a precursor to a dementia disorder such as Alzheimer’s disease, vascular dementia, or another neurological condition. It rarely reverses. The American Academy of Neurology estimates that about 14.9 percent of Americans over the age of 65 develop mild cognitive impairment.

“There’s a use it or lose it type of aspect about human cognitive capabilities,” said Mynatt. "So, if we can delay, stop, or even reverse the trends associated with cognitive decline, we can help people improve their quality of life.”

This year the World Health Organization released a report on reducing the risks of cognitive decline and dementia. Chief among its recommendations is for people to increase their physical activity. 

“The idea behind the empowerment program was really to put a structure to the recommendations given by a physician for how patients can manage their diagnosis,” said Amy Rodriquez, director of therapeutic programs at CEP and assistant professor in Emory School of Medicine’s Department of Neurology. “We’re saying we can support these patients in making changes that could impact the course of their condition.”

A person with MCI may find that the instrumental activities of daily living are more difficult than before, said Rodriguez. Things like managing finances, getting to places on time, navigating, even dressing, become challenging. 

Emory’s cognitive neurology clinic will refer older adults to the program where they can engage in a host of activities known to stimulate their cognition. They’ll also have the opportunity to join groups to learn strategies for supporting memory, exercise, including strength training and yoga, take part in a book club or art class, and cook in the demo kitchen. These are all activities meant to empower people with MCI, boost their social engagement, and support their continued independence. 

Craig Zimring, director of the built environment core at CEP and director of the SimTigrate Design Lab, is overseeing space design. Zimring’s team will concentrate on how the center’s environment impacts people’s behavior. Made with the principles of universal design, it will be easy to navigate no matter what physical ability a person possesses. It’s also a visually open space with generous natural lighting, a layout intended to encourage interaction and co-design between program participants and researchers. The team will survey how people use the center; are they being social, reaching out to others? They'll analyze the environment, including noise and temperature.

“I want people to be able to look in at the research we're doing and say, 'That looks neat. What are you creating? Lemme tell you my thoughts about it,” said Jennifer DuBose, director of the innovation accelerator core at CEP and associate director of the SimTigrate Design Lab.

The innovation accelerator will offer seed grants to support research aimed at developing, testing, and disseminating evidence-based interventions for MCI. DuBose is also getting students in on the action. They will be busy developing solutions related to some of the difficulties people with MCI experience in their daily lives. The most promising solutions will be picked up and worked on by researchers at CEP, who will test some in the real world.

The technology core, directed by Mynatt, will design interventions and apps, as well as sense and gather data, connecting the program to participant’s homes and daily activities. One of her projects involves creating a Siri-like social assistant for people with MCI and their care partners. Key goals driving work in participant homes include facilitating important activities such as physical exercise and healthy nutrition while detecting and reversing harmful situations such as poor sleep.

While they have funding for three years, Rodriguez said, they’re working to create ways to sustain the center that empowers patients, families, and staff as co-designers.

“First and foremost, it’s about empowerment; how can we systematically increase people’s sense of empowerment?” said Mynatt. “You can take scans of people’s brains all day long, but we want to empower the people.”

Writer: David Terraso

The vision of the Mild Cognitive Impairment Empowerment Program (MCIEP) is to revolutionize the experience of people affected by MCI by creating a comprehensive approach that can be replicated nationally and internationally.

 With the aim of speeding up development, testing and dissemination of evidence-based interventions for MCI, the Innovation Accelerator (IA) core is offering seed grants to support research in the following areas: therapeutic programming, technology, and the built environment. 

The funded projects should result in innovative solutions, strategies or methodologies developed through a culture of collaboration among students, researchers, clinicians, and people with MCI in less than 12 months’ time.

Beginning in the fall of 2019, $150,000 in seed grants will be available each year for the next three years. Proposals can range from semester to year-long research projects and smaller proposals can target funds to convene valuable discussions, gather data, develop methods and metrics or to prototype new designs and technologies.

See the related file to the right for more information on the pre-proposal call and how to apply.

All pre-proposals will be evaluated by a review committee comprised of representatives from all cores of the MCIEP and individuals affected by MCI. Feedback from the committee will be given to all pre-proposals. Those selected for full proposals will be contacted by the end of the day on September 10. 

For additional information or questions regarding the seed grant process email kimberly.seaton@design.gatech.edu 

Looking forward to reading your pre-proposals,

Jennifer DuBose,
MCIEP's Innovation Accelerator Director 


 

Jennifer DuBose, associate director of SimTigrate and principal research associate in the College of Design, will lead the innovation accelerator, working across the three cores and engaging people with MCI, students, researchers, and industry to learn best practices and create, test, and implement tailored solutions.

The focus of the innovation accelerator is to expedite MCI research and break down barriers to innovation and collaboration by providing resources and expertise and connecting with other resources in the Atlanta community. Annual seed grants will promote innovation in brain health. Collaborators in the innovator accelerator will capitalize on current MCI research to improve the lives of people with MCI.

For DuBose, her work has special significance. She has a family history of Alzheimer’s and said it’s important to direct a program that will engage with people with MCI as co-designers.

“Innovation in healthcare often takes too long to go from the bench to the bedside. We have the opportunity to break down some of the barriers that exist between research and therapy and between departments and institutions. This is an opportunity to more quickly make a difference in people’s lives,” DuBose said. “Time is a luxury people with MCI don’t have. MCI will rapidly impact our society and we need to address as quickly as we can.”

She continued, “We also want to honor and respect what people with MCI have to offer and they will be as fully engaged in the innovation as they want to be.”

Learn more about Emory Health Sciences and the James. M. Cox Foundation at their websites.