Co-creation of smart socks (MPATIX) with sensors and AI to monitor physiology, understand behaviour and predict problems for people with dementia living in the community

痴呆症护理既具有挑战性又昂贵，在英国花费了350亿英镑。根据人口趋势，在不到30年的时间里，英国痴呆症患者的数量将激增至160万，对健康和社会护理提出了前所未有的需求。英国目前有92万痴呆症患者（阿尔茨海默氏症协会），其中大多数（56万或61%）生活在社区（卓越社会护理研究所-2020）。这些人中约有一半经历了与无法控制的痛苦相关的具有挑战性的行为症状（攻击、焦虑、激动）（Anatchkova-2019）。痛苦行为：*是护理人员负担的主要来源（Tsai-2021），也是家庭决定将亲属送入养老院的因素(herman -2006；英国阿尔茨海默氏症研究中心)*在英国每年花费超过20亿英镑(Morris-2015)*反映出可解决的潜在问题，例如患者无法沟通的不适/缺乏疼痛管理（Cohen-Mansfield-2000）当护理人员未能识别/解决痴呆症患者的需求时，就会发生痛苦行为，他们通常无法识别或沟通为什么/他们处于痛苦之中（Algase-1996）。对技术解决方案的需求尚未得到满足，这些解决方案支持护理人员迅速响应个人的独特需求和情境触发因素，以防止行为升级（Martínez-Raga-2018）。新兴的解决方案现在专注于使用皮肤电活动来识别躁动的生理前体，从而改善管理（Kikhia-2016; Melander-2017/2018）。到目前为止，这些设备使用的是腕式生理传感器。然而，腕式传感器一直难以获得用户/护理人员的接受，导致不安、污名化（Hassan-2017）和移除（Bankole-2011）。在阿尔茨海默氏症协会的资助下，Milbotix开发了MPATIX智能袜子，配有舒适的电子纺织品传感器，可以测量脉搏、汗液、温度和运动。利用我们新颖的机器学习算法和移动应用程序，我们可以提醒痴呆症护理人员注意痛苦的早期迹象，以促进主动/预防性管理。MPATIX袜子外观和感觉都和普通袜子一样，可以机洗，不需要充电。英国痴呆症研究所（DRI）的Minder平台将传感器和设备连接到临床仪表板上，已经改善了痴呆症患者的生活。Milbotix与伦敦帝国理工学院的英国DRI护理研究与技术中心的合作意味着远程临床医生可以注意到行为变化和认知/生理状态的改变，这是现有设备无法做到的。在该项目期间进行的用户研究、技术试点和可行性研究将有助于确保MPATIX满足最终用户的需求，并收集证据证明生活在社区中的痴呆症患者及其护理人员受益。

Dementia care is challenging and expensive, costing £35 billion in the UK. Following demographic trends, the number of people living with dementia in the UK will surge to 1.6 million in less than three decades, placing unprecedented demand on health and social care.Of the 920,000 people currently living with dementia in the UK (Alzheimer's Society), the majority (560,000 or 61%) live in the community (Social Care Institute for Excellence-2020). Around half of these people experience challenging behavioural symptoms (aggression, anxiety, agitation) linked to unmanaged distress (Anatchkova-2019).Distressed behaviours:* Are a leading source of burden for carers (Tsai-2021), and factor into families' decisions to place relatives into care homes (Hermann-2006; Alzheimer's Research UK)* Cost over £2 billion/year in the UK (Morris-2015)* Reflect resolvable underlying issues such as discomfort/lack of pain management which the person cannot communicate (Cohen-Mansfield-2000)Distressed behaviours occur when carers fail to recognise/address the needs of people with dementia, who often cannot identify or communicate why/that they are in distress (Algase-1996). There is an unserved need for technological solutions that support carers to promptly respond to individuals' unique wants and situational triggers to prevent escalations in behaviour (Martínez-Raga-2018).Emerging solutions are now focusing on using electrodermal activity to identify the physiological precursors of agitation enabling improved management (Kikhia-2016; Melander-2017/2018). To date these devices have used wrist-mounted physiological sensors. However, wrist-mounted sensors have struggled to gain user/carer acceptance, causing agitation, stigmatisation (Hassan-2017), and removal (Bankole-2011).With funding from Alzheimer's Society, Milbotix has developed MPATIX smart socks with comfortable e-textile sensors that measure pulse, sweat, temperature, and motion. Utilising our novel machine learning algorithm and mobile application, we can alert dementia carers to early signs of distress to promote proactive/preventative management. Looking and feeling like normal socks, the MPATIX socks are machine washable and won't require charging.The UK Dementia Research Institute (DRI) Minder platform connects sensors and devices to a clinical dashboard and is already improving the lives of people affected by dementia. Milbotix's collaboration with the UK DRI Care Research & Technology Centre at Imperial College London means that remote clinicians can be alerted to changes in behaviour and altered cognitive/physiological states, which is not possible with existing devices.User research, a technology pilot and a feasibility study performed during this project will help to ensure that MPATIX meets end users' needs, and collect evidence of benefits for people with dementia and their carers living in the community.