4 April 2017
Five ways digital health tools can help everyday brain health
Dr Jenny Barnett, Chief Scientific Officer for Cambridge Cognition looks at how digital innovations are helping our brain health.
As mentioned in my last post looking at the five reasons brain health is primed for digital innovation, digital technology has the power to transform healthcare and research, tackling some of the long-standing unknowns that limit the hunt for new treatments for neurological and psychiatric conditions. Right now, for example, we just don’t know what different subtypes of depression there are, or how best to treat each of them. Near-patient smartphones and wearable tools will allow unobtrusive, long-term monitoring of multiple aspects of depression: not only mood but also cognition, sleep, exercise, social interaction and stress responsiveness. Accruing large multimodal datasets and studying them may help us find patterns of symptoms and behaviour that reflect different subtypes of depression. Understanding these subtypes should lead to a better understanding of treatment efficacy: who would benefit most from a particular type of antidepressant drug; who would respond better to a talking therapy. Scalable, cost-effective ways to collect large scale real world data is just one way in which digital technology can contribute to improving mental health research. Cambridge Cognition have been working in partnership with Ctrl Group to develop Cognition Kit, a mobile and wearable software which takes research out of the lab and into daily life, collecting high-frequency data to better understand and improve day-to-day brain health. But how are these digital technologies supporting the assessment of brain health?
1. We can make assessment more objective
Most of a mental health assessment is essentially subjective – it’s based on either the doctor’s opinion of the patient or the patient’s description of their current experience. Tools like Cognition Kit do not know what someone is thinking or feeling, but using brief cognitive assessments they can measure problems with memory or concentration, distractibility or impulsiveness, being more indecisive or more sensitive to negative emotions than usual. Using sensor data from smartphones or consumer wearables, Cognition Kit can accurately measure if someone has been less physically active than usual, if they are engaging in fewer social interactions, or if they are showing physiological measures of increased stress, such as lower heart rate variability. These digital measurements provide the objective data to help inform a more holistic view of a patient’s brain health.
2. We can measure what happens in between clinic visits
The typical mental health consultation or therapy session starts with the clinician asking ‘how have you been since we last met?’. Not only is this a subjective question, it is asking someone who may be experiencing problems with their memory to report how things have been over a period of weeks or perhaps months. Understanding what has happened in between visits is key to deciding whether a particular drug or therapeutic approach is working, whether the dose should be increased or decreased, whether any side effects are getting worse or better, how long the clinician should wait before meeting the patient again. Providing patients with a way of monitoring their own symptoms on a day-by-day basis gives patients and doctors a shared understanding of trends over time on which to base these decisions. It may also identify patterns between symptoms and trends in behaviour (for example diet, sleep and activity) or external factors (such as effects of season or work schedule) that can considerably impact mental health.
3. We can measure symptoms, behaviour and physiology in real time and in the real world
New treatments are approved on the basis of data from rigorously controlled clinical trials which show the treatment significantly improves some important symptom. But to be valuable to patients, healthcare systems and payers, a new treatment needs to ultimately improve a patient’s quality of life, help them to function better in their work and social lives, or save a healthcare system money by reducing their use of expensive treatments or resources. Tools like Cognition Kit allow unobtrusive gathering of data from a patient as they go about their daily life, allowing the effects of a drug on real-world outcomes to be assessed earlier and more easily in the drug development process. Delivered on wearables, such tools give two-way connectivity, allowing data to be analysed in real-time prompting in-the-moment reminders, hints or advice to be automatically communicated back to the patient.
4. We can link psychological and physical biomarkers and wellbeing
Brains and bodies are intrinsically linked. There is increasing evidence that physical health changes can influence mental health and vice versa. Non-pharmacological treatments increasingly take advantage of this, including exercise as a treatment for low-level depression, meditation and breathing techniques to manage symptoms of anxiety, and diet as a driver of cognitive decline in old age. Consumer technology such as and smartphones give us a way to measure and manage multiple aspects of physical and mental health simultaneously. Doing so will help increase understanding of these links for researchers and patients alike.
5. We can collect and use data about brain health far more quickly
In a single study, Cognition Kit can gather tens of millions of data points linking cognition, well-being and physiological measures of stress. While such large datasets bring their own challenges, Big Data can improve the clinical and neuroscientific knowledge base in ways that will increasingly help patients with brain health disorders. Advances in psychiatric treatment lag behind cancer, cardiovascular, or metabolic medicine, in part because far less money is spent on researching them. Digital health tools will allow research to be conducted in much larger studies, and at a far faster rate of progress than traditional psychiatric research.
Innovative digital health tools like Cognition Kit will allow long-term monitoring and objective measurement of treatment outcomes in ways that can enable much more personalised and effective treatment.Cognition Kit is a joint venture between Cambridge Cognition and Ctrl Group formed to develop digital health tools on mobile and wearable devices.
For more information visit www.cognitionkit.com
Dr Jenny Barnett
Chief Scientific Officer