- The Pros and Cons of Health-Tracking Devices
- Healthcare and Wearable Technology Devices for the Elderly
- Arthritis (and other types of chronic pain)
- Kidney Disease
- Cognitive Conditions – Dementia, Alzheimer’s Disease
- Chronic Obstructive Pulmonary Disease (COPD) (and Asthma)
- Other Conditions and Impairments
- More to Come
- Modeling The Economic And Health Impact Of Increasing Children’s Physical Activity In The United States
- Activity trackers predict 5-year death risk better than smoking
- 20 measures of activity
- Lack of activity midday
- Can your fitness tracker catch the first signs of coronavirus?
The Pros and Cons of Health-Tracking Devices
The idea is undeniably appealing: Slap this strap on your wrist or clip a doodad onto your shirt, and you can monitor everything from mood to motion, optimizing each breath and step. We bought into the promise of these intriguing new health trackers, but we wanted the experts to reality-check them.
THE GOAL: Ballerina posture
Photo: Courtesy of Lumo Bodytech Inc.
THE TRACKER:Lumo Lift ($100; lumobodytech.com
) is an oval magnet that attaches to your shirt or bra strap and buzzes if you slump for more than, say, 15 seconds.
THE IDEA: You'll be gently reminded to sit up straight.
EXPERTS SAY: Standing (or sitting) tall is a worthy goal, says Laura Deon, MD, an assistant professor in physical medicine and rehabilitation at Chicago's Rush University Medical College. “Good posture can keep your bones and joints aligned, preventing pain and improving your mood and appearance.” Keep in mind, though: To see the benefits, you'll need to wear it all the time.
THE GOAL: A more zen frame of mind
Photo: Courtesy of Garmin Ltd.
THE TRACKER:Garmin vívosport ($170; garmin.com) assesses stress levels by tracking heart rate variability (HRV), a measure of the variation in time between heartbeats.
THE IDEA: You check your levels to see whether stress is getting the better of you; if it is, the tracker can lead you through a slow breathing exercise designed to calm you.
EXPERTS SAY: “This is an okay source of data on HRV, which can absolutely be influenced by stress,” says Richard Gevirtz, PhD, a psychology professor at San Diego's Alliant International University. And breathing exercises have been shown to help bring HRV into line. Yet HRV can be affected by many other things, exercise, illness, depression, and fatigue, notes Gevirtz.
THE GOAL: More and better sleep
Photo: Courtesy of Fitbit, Inc.
THE TRACKER:Fitbit Alta HR ($150; fitbit.com) is a wristband that uses an accelerometer and heart rate monitor to chart your sleep cycles.
THE IDEA: You'll see an estimate of the number of hours you spent in the phases of REM, deep, and light sleep, as well as your cumulative snooze time.
EXPERTS SAY: “It's valuable to know how much time you spend sleeping,” says Katherine Sharkey, MD, PhD, an associate professor of medicine at Brown University.
“But the only way to accurately tell when you're in the restorative REM phase is by looking at brain waves.
” If you're exhausted but your tracker confirms you're getting seven to eight hours of shut-eye, talk to a doctor about sleep disorders.
THE GOAL: Boosted mood
Photo: Courtesy of SunSprite
THE TRACKER:SunSprite ($100; sunsprite.com) clips to your shirt and uses sensors to detect exposure to bright light (from the sun or a light-therapy box).
THE IDEA: Bright light is linked to improved mood. This device tells you if you’re getting 30 minutes a day, the amount the company's experts say is enough to help us feel sunny.
EXPERTS SAY: “Research shows that many people who spend most of their time indoors need more bright light than they routinely get,” says Norman Rosenthal, MD, a psychiatrist and seasonal affective disorder researcher. “Thirty minutes a day is a reasonable goal, but there's no specific amount of exposure that would benefit every person.” Start with the minimum; see how you feel.
THE GOAL: A healthy heart
Photo: Courtesy of AliveCor, Inc.
THE TRACKER:KardiaBand ($199 plus $99 per year; alivecor.com) is a wristband that attaches to an Apple Watch face to track irregular heartbeats (arrhythmias).
THE IDEA: If you're alerted that your heart rate seems too fast or slow (or if you feel you're having palpitations), hold your thumb over the band's sensor to get an EKG reading.
EXPERTS SAY: “It's very good at detecting the arrhythmias that can increase your risk of stroke or heart failure,” says Gordon Tomaselli, MD, chief of the cardiology division at Johns Hopkins University, “and can be useful if you have a diagnosed arrhythmia.” For everyone else: The Apple Watch itself measuresbeats per minute to show how hard your heart is working.
Healthcare and Wearable Technology Devices for the Elderly
Updated: December 12, 2019
In general, except for smartwatches and fitness trackers, most healthcare and wearable technology devices for the elderly are healthcare-related or are multifunction devices incorporating some healthcare-related functions. While are considered the “gold standard” and are typically used along with a stethoscope, although the greatest accuracy is probably not the most important thing in most use cases.
A few years back my doctor suggested I test my blood pressure, so I got an upper arm electric unit, used it for a while and haven’t again for quite some time. I now only have it measured when I see a doctor, and that is also via an electric upper arm machine.
I believe that wearable blood pressure monitors will become very popular as there is considerable value to continuous monitoring. Other body locations than the wrist are being researched for wearable blood pressure monitors.
There are no devices specifically for people with high cholesterol, and maybe there never will be. I have slightly high cholesterol and family history with heart issues.
As high cholesterol is one of the top risk factors for heart-related conditions (cardiovascular disease (CVD)), wearable technology to monitor the heart (see above) is why I have an Apple Watch 4. I expect that a future version will also be able to monitor blood pressure.
Determining cholesterol levels requires blood tests. However, un with diabetes, there is no compelling reason for continuous monitoring. The frequency of these blood tests may be determined by the severity of one’s levels, and for me, it is once per year with my annual physical.
I can envision a (distant) future with “things” in our bloodstream constantly monitoring for everything that could impact our health.
As with many other health issues, diet and exercise are recommended to deal with cholesterol. So, fitness tracking is another wearable technology function applicable to those with high cholesterol. There are also apps which help with fitness and diet.
Arthritis (and other types of chronic pain)
There are over 100 types of arthritis! Osteoarthritis (joints) is the most common and is typically age-related. There are a number of technology products that are designed to provide pain relief from a variety of sources, arthritis included.
Below are two notable wearable devices using TENS, which stands for Transcutaneous Electrical Nerve Stimulation, for people wishing to avoid drugs. There are many other TENS devices available, but most require pads with wires.
The Omron Healthcare Avail TENS Unit can be placed on various body locations where some pain is experienced. In addition to being well reviewed, this product is from a very large, international, Japanese company, with a significant U.S. presence.
The Qwell Wearable Pain Relief Technology Kit has received some very positive reviews and 80 percent of subjects in a study reported improvement of their chronic pain. There is a 60-day money-back guarantee for the other 20%. This device can be worn day and night.
It provides “wearable intensive nerve stimulation” (WINS), said to be a form of TENS, differing as it is worn on the calf rather than over the area of pain. This technology results in the body’s production of its natural pain control system.
Contour NEXT EZ
This traditional home blood sugar testing kit and seems to be considered among the best, considering both price and accuracy.
However, another class of device, continuous glucose monitoring (CGM) systems are becoming the preferred solution.
They are beginning to integrate with smartphone apps instead of special-purpose devices to capture, store and communicate the continuous readings.
Medicare coverage of smartphone-connected CGM devices was announced on June 13, 2018, and should increase the adoption of this class of device.
FreeStyle Libre System
CGM systems and other approaches aim to reduce or eliminate, the main negative aspects of older technology.
Negative aspects include blood sampling (finger pricks), real-time data and trends with alarms, and the ability to immediately determine the impact of foods on your blood sugar. There is also the option of being able to remotely monitor the user’s data. And some integrate with insulin pumps.
The pictured system includes a small round disposable sensor and a separately purchasable reader device. There are now is a smartphone app that eliminates the need for the reader and another app to share information with others. Another leading competitor’s offering also offers a smartphone app. Both require a prescription.
There are a number of innovative technologies under development, but don’t count on anything any time soon. One long-term partnership between a leading CGM manufacturer and the Alphabet (aka Google) medical technology operation has been “redefined” after a joint product had been expected in 2018.
Work on three fronts has been underway for quite a while with the usual speculation of possible availability within the next few years. The large majority of patients must visit dialysis centers.
While home dialysis equipment exists, it accounts for a small percentage of the market, but some major companies are reported to have projects to address the obstacles.
A second area is ongoing research into a wearable artificial kidney (“WAK”). And a third area is a project to create a surgically implanted bioartificial kidney.
There are a variety of different types of depression, with different causes, and with varying degrees of severity.
The most common forms of treatments are medications and psychotherapy. For a number of patients, the treatments are not satisfactory.
A number of brain stimulation technologies have been developed to treat depression and other brain-related conditions. An introduction to them can be found on this page from Johns Hopkins.
Most of them can only be used under medical direction. However one type, Transcranial direct current stimulation (tDCS), is available in products for home use, some without a prescription, such as the one pictured.
There are a growing number of these devices and they are also marketed for other purposes such as mood improvement, athletic performance, pain reduction, and sleep improvement.
Cognitive Conditions – Dementia, Alzheimer’s Disease
GPS tracker shoe insert
There is a broad spectrum of memory-related conditions. Some of the devices referred to above regarding depression are touted as helping memory (and other brain-related conditions). The product shown is helpful for seniors that have a tendency to wander off.
Conversational assistants, such as Alexa and Google Home, are being reported as helpful for milder situations, such as this report by an early-onset Alzheimer’s sufferer.
In more severe cases, many other conditions, medications are frequently the treatment. But new technology developments are showing the promise of drugless treatment.
Here is an example: A collaboration between a startup, SimpleC, and IBM, providing technology solutions to patients, their families, and clinicians.
Another technology showing promise is Virtual Reality.
Chronic Obstructive Pulmonary Disease (COPD) (and Asthma)
Microlife PF 100 Peak Flow Meter
Chronic bronchitis and emphysema are older terms for some types of COPD. Asthma has similar symptoms but is a different condition with, in general, different treatments. COPD is more (old) age-related. The device pictured measures Peak Expiratory Flow (PEF) and Forced Expiratory Volume in 1-second (FEV1).
PEF is the fastest speed air can be blown the lungs after inhalation. FEV1 measures the volume after exhaling in 1-second. Peak Flow (PEF) and Forced Expiratory Volume in 1-second (FEV1) measurements can tell how well lungs are breathing by monitoring airflow.
The device keeps a record of the measurements which are reported to the patient’s doctor. In Europe, similar devices use a smartphone app for the recording function.
Another device, also used for COPD monitoring under physician oversight, is a pulse oximeter, which usually attaches to a fingertip to measure the amount of oxygen carried in the blood. An oxygen level of 95% or above is good and 92% or below is a concern. Pulse is also measured.
Other Conditions and Impairments
Many conditions, including those above, and impairments impacting the elderly also affect the younger population in large numbers. Some of these, such as vision and hearing, are general population issues, while others, such as balance and osteoporosis (both will be added later), are primarily found in the older population.
DOT WATCH – Braille & Tactile Smartwatch
Vision impairment spans just needing reading glasses all the way to complete blindness. There are many types of solutions for a variety of different types of vision impairment.
Braille was, and remains, very important, and is now implemented in various devices, including the pictured smartwatch. A standards group that includes Apple, Microsoft, and Google, recently announced a new standard for braille displays.
The standard will allow the displays to be used in a similar fashion to a mouse or keyboard across different operating systems and devices.
Legal and competitive market requirements have spurred accessibility features to be included in computer, smartphone, and tablet operating software, as well as some websites.
There are also quite a few apps that are designed with the vision-impaired in mind.
Oticon Opn Hearing Aids
The hearing aid, the most important hearing-related technology, has come a long way.
I hadn’t heard the term “Hearables” before. Initially, it was derived from wearables and headphones.
Hearables now refers to multipurpose, technically advanced, electronic-in-ear-devices, including advanced hearing aids.
The Oticon Opn pictured is an example of one from a leading hearing aid manufacturer and was the first internet-connected hearing aid.
Some hearables include biometrics and connectivity with smartphone apps.
Per the National Institutes of Health (NIH):
Sleep plays an important role in your physical health. For example, sleep is involved in the healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, and stroke.
Sleep tracking is becoming a very prevalent feature of many devices such as smartwatches and fitness trackers. For those not keen on wearing them at night (or needing to charge!), there are a number of devices the one pictured, and even beds with built-in sleep monitoring technology.
More to Come
Over time additional conditions, impairments, diseases, etc., will be added in updates to this article.
Modeling The Economic And Health Impact Of Increasing Children’s Physical Activity In The United States
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Activity trackers predict 5-year death risk better than smoking
Wearable activity trackers are a more reliable measure of physical activity and better than patient surveys and other methods physicians use to assess five-year risk of death in older adults, researchers report.
The research adds to evidence that an accurate and objective accounting of physical activity from mechanical sensors worn a watch, belt, or bracelet to track movement outperforms traditional predictors of mortality within five years, such as age, smoking, diabetes, alcohol use, or history of cancer or heart disease.
these findings, the researchers say physicians can confidently use the devices’ fitness profiles to help patients change unhealthy behaviors, increase physical activity, and, potentially, extend healthy lifespans.
While the study is far from the first to report an association between physical activity and risk of death, researchers say the findings, reported in the Journal of Gerontology: Medical Sciences, is among the first to offer solid evidence that wearable activity trackers provide key predictors of mortality that outperform other measures.
“People can overestimate or underestimate on surveys how much and when they move, but wearable devices provide accurate data that cuts through the bias and guesswork,” says Jacek Urbanek, assistant professor of medicine at Johns Hopkins University School of Medicine. “The technology is readily available and relatively inexpensive, so it seems feasible to be able to incorporate recommendations for its use into a physician’s practice.”
“We’ve been interested in studying physical activity and how accumulating it in spurts throughout the day could predict mortality because activity is a factor that can be changed, un age or genetics,” says Ciprian Crainiceanu, professor of biostatistics.
20 measures of activity
For the new study, the researchers focused on the total amount of physical activity and times the participants were most active during the day.
First, using data from the National Health and Nutrition Examination Survey (NHANES) the US Centers for Disease Control and Prevention (CDC) conducted, researchers looked at 33 predictors of five-year all-cause mortality, including 20 objective measures of physical activity, such as total activity, amount of time not moving, or amount of time doing moderate to vigorous activity.
In this way, they ranked physical activity and other factors, such as total cholesterol, smoking status, and having cancer or diabetes, to identify which ones best predict mortality within the following five years of the study population.
For their look at physical activity, the researchers used activity tracker data from nearly 3,000 adult Americans collected during the NHANES 2003-2004 and NHANES 2005-2006 surveys.
Individual data came from responses to demographic, socioeconomic, and health-related survey questions, along with information accessed from medical records and clinical laboratory test results. Participants wore an activity tracker device at the hip for seven consecutive days, removing it only when sleeping, showering, or swimming.
The average age of people in the study group was 65.9, and all participants were between 50 and 84 years old. While the gender proportion was nearly even—men made up 51%—a larger percentage of the men, 65%, died within five years of the study’s follow up efforts.
After studying each individual variable associated with mortality—including education, sedentary time, and ethnicity—the researchers concluded that the total measure of physical activity accumulated during each day was the strongest predictor of five-year mortality, followed by age and moderate-to-vigorous activity.
When comparing the data of a person who died within five years and a person who survived, researchers say they could correctly rank the mortality risk using activity trackers 30% more accurately than using information about smoking status and 40% better than using information about whether a person suffered a stroke or had cancer.
Lack of activity midday
With a focus on fragmented activity, researchers also collected data for two-hour spans throughout the day in order to look at patterns in physical activities.
Their analysis showed that physical activity—or lack thereof—between noon and 2PM was the highest predictor of mortality risk, outperforming more commonly considered risk factors such as diabetes, cancer, and alcohol consumption.
While the researchers caution they didn’t design the study to establish cause and effect, they did note that the data suggests sedentary behavior during the day links to higher mortality.
“The most surprising finding was that a simple summary of measures of activity derived from a hip-worn accelerometer over a week outperformed well-established mortality risk factors such as age, cancer, diabetes, and smoking,” says lead author Ekaterina Smirnova, assistant professor of biostatistics at Virginia Commonwealth University.
“While this study affirmed a link between physical activity and short-term mortality risk in an older population, the data don’t guarantee that one’s risk of mortality is going to be lower with more physical activity,” notes coauthor Andrew Leroux, a PhD candidate at Johns Hopkins.
“However, our findings do indicate that an accurate measure of physical activity is a more reliable way for doctors and patients to assess physical activity and intervene to increase it as a potential way to improve health.”
The researchers hope to use their data to help design clinical trials that could confirm the potential for physical activity to increase lifespan. One caveat to the study is that researchers aren’t able to distinguish sedentary behavior from sleep or if someone has removed the device.
Additional coauthors are from the University of Montana, Old Dominion University, and Johns Hopkins. The National Heart, Lung, and Blood Institute; the National Institute of Neurological Disorders and Stroke; and the National Institute on Aging funded the work.
Source: Johns Hopkins University
Can your fitness tracker catch the first signs of coronavirus?
Researchers have recently estimated that between one-quarter to half of people with COVID-19 are asymptomatic, meaning they are most ly unaware that they have the virus at all.
It poses a dangerous situation for so many Americans, especially when some state governments are making moves to reopen their economies, and testing is only available for those exhibiting surefire symptoms of the coronavirus.
In an effort to better identify asymptomatic people, researchers are now exploring whether wearable fitness trackers may provide early clues for those who may be infected with the coronavirus but are not yet aware by using the health data tracked on such devices — heart rate, sleep cycle and body temperature.
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One such study is being conducted by Finnish health start-up Oura, which is sponsoring research at the University of California, San Francisco (UCSF) to study whether physiological data collected by the Oura ring, combined with responses to daily symptom surveys, can predict illness symptoms. The study aims to build an algorithm to help UCSF identify patterns of onset, progression and recovery for COVID-19.
Bringing fitness trackers to the front line
The research study is being called TemPredict, and will include two groups: front-line health care workers and the general population.
More than 2,000 health care workers, including doctors and nurses who are in daily contact with patients afflicted with COVID-19 at UCSF campuses, have already received Oura rings.
By letting health care workers track changes in their body temperature, respiratory rate and heart rate, Oura believes the workers may be better equipped to understand early warning signs of infection within the group and to take necessary actions to prevent the spread and look after their own health.
Oura is also conducting a national study with the West Virginia University Rockefeller Neuroscience Institute, one that seeks to look at individuals even more holistically, integrating physiologic measures with psychological, cognitive and behavioral biometrics, such as stress and anxiety.
In real-time, this integrated approach can provide an early and more comprehensive assessment, tracking the mind-body connection and homeostasis in the context of asymptomatic infection, allowing the team to hopefully forecast and predict the onset of fever, cough, fatigue and other physical symptoms linked to viral infections.
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The study is also open to all of Oura’s approximately 150,000 ring users, should they decide to opt in.
By taking daily symptom surveys, willing study participants directly contribute their observations paired to their data to the UCSF team, allowing researchers to use this information as they attempt to identify patterns that could predict onset, progression and recovery in future cases of COVID-19. If this approach is successful, it could open the door for research into tracking and managing other illnesses and conditions.
“At Oura, we’ve heard firsthand from our users how the physiological signals tracked by the ring have predicted the onset of the virus before other symptoms manifest,” Harpreet Rai, CEO of Oura Health, said. “We’re grateful we can apply this knowledge to help vulnerable caregivers swiftly identify the earliest signs of the disease, and take the appropriate protective measures to limit its spread.”
Monitoring your health at home
Rai told Changing America about one Oura user in Finland, named Petri Hollmen, who posted publicly on about how his Oura ring accurately reported an increase in his body temperature.
The change signaled the onset of the coronavirus, even though he wasn’t exhibiting any of the other symptoms at the time.
Petri subsequently tested positive for COVID-19 and was able to self-quarantine before further spreading the disease.
Oura isn’t the only company to take notice of the potentially life-saving benefits of wearing a fitness tracker.
Other makers of health-monitoring technology are now offering ways to track possible coronavirus symptoms, even big names Apple.
Apple Watch owners were recently told they can now monitor their response to symptoms of infections COVID-19 using a new feature introduced by heart health app Cardiogram.
Will Ahmed, CEO of the fitness tracking Whoop Band, said recently that they were doing research on the body changes that appear to be linked to coronavirus infections, identifying four patterns: decreasing heart rate variability, increasing resting heart rates, decreasing recoveries and a higher respiratory rate.
“We believe that a noticeable increase in respiratory rate is a measurable precursor of COVID-19 symptoms individual cases that we have seen in our data,” Ahmed said in a statement. “Whoop data may be able to help identify the coronavirus during the incubation period before someone feels sick.”
The technology is now being utilized around the world
As China continues their recovery from the coronavirus pandemic, their doctors and health officials are beginning to shift their focus from emergency wards to those who have already been discharged from them. To keep track of the health of these former COVID-19 patients, a team of medical experts is seeking the help of Huami, the Xiaomi-backed maker of Amazfit smartwatches.
Huami’s devices are designed to monitor the same statistics one might see in the fitness trackers listed above, heart rate, sleeping patterns and workout data.
Some are even equipped with GPS, allowing those monitoring the data to know where a user has been and how far they’ve walked — data that is especially important considering that recent study in Hong Kong showed some survivors felt short of breath during brisk walks, and up to 10 percent of recovered patients in Wuhan, the epicenter of the outbreak, have tested positive for the virus again.
Germany, which is among the five countries with the highest number of coronavirus cases worldwide, is also beginning to utilize fitness-tracking technology.
The Robert Koch Institute, the federal agency responsible for disease control and prevention, teamed up with healthtech start-up Thryve to develop a mobile application called Corona-Datenspende, which translates to “corona data donation.”
The app syncs up to smartwatches and fitness wristbands from companies Apple, Fitbit and Garmin, and collects user information on activities walking, exercise and rest, as well as data on blood pressure, heart rate and body temperature. It also accounts for sociodemographic data such as age, gender and weight.
“Digital applications can usefully supplement the previous measures to contain Covid-19,” said Robert Koch Institute president Lothar Wieler in a statement at the launch of the app on April 7. “If the sample is big enough to capture enough symptomatic patients, that would help us to draw conclusions on how infections are spreading and whether containment measures are working.”
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