Behavioral Interventions for Alzheimer’s Management Using Technology: Home-Based Monitoring

Purpose of Review: Dementia is a progressive brain disease that affects 5.8 million people in the USA. In 2018, more than 16 million Americans provided unpaid care for persons with dementia (PWD). Most of this care is provided by family members and friends yielding 18.5 billion hours of unpaid care worth $233.9 billion.Novel technological approaches to assist caregivers and improve health and function of PWD are being explored. Models to assess and predict behaviors may provide greater quality of life (QOL) for both PWD and their caregivers. The purpose of this paper is to review current available technologies for behavioral interventions in persons with Alzheimer’s disease or other related dementias who live in the home setting. Recent Findings: High-quality systematic reviews have studied behavioral or psychological symptoms, some with non-pharmacological interventions (NPI). Some of these involve technology, but others address functional and safety issues. The most frequent behaviors identified in PWD were aggression, agitation, wandering, apathy, and disturbed sleep. There is some evidence of a beneficial effect of NPI on depression and ADL, but no impact on overall behavioral and psychological symptoms of dementia (BPSD), anxiety, or agitation. Technological interventions including combined phone and web impacted caregiver burden and depression. Multimodal sensors to detect agitation show moderate correlation and in-home video recording can improve caregiver’s competence and lessen depression. Summary: Acceptance and adherence in use of technologies are essential for PWD and their caregivers in the home setting. There is a need for more RCT’s and individualization of technologies and research must also involve both caregivers and PWD. Systematic reviews addressing behavioral symptoms identify music as the most effective NPI for improving overall BPSD.