Ohio State Studies If High-tech Vest Can Help Manage Heart Failure at Home

Newswise, June 27, 2017– Doctors at The Ohio State University Richard M. Ross Heart Hospital are testing a high-tech vest which measures fluid inside the lungs from outside a person’s clothing. It could be a new way to prevent repeated trips to the hospital for the nearly six million Americans living with heart failure.

The SensiVest, created by Sensible Medical, uses radar technology that was first used by the military and rescue teams to see through walls and rubble in collapsed buildings.

“Now the technology has been miniaturized and put into a form that allows the radar to go through the chest wall and get an accurate measurement of water inside the lungs,” said Dr. William Abraham, director of the Division of Cardiovascular Medicine at Ohio State Wexner Medical Center. “With heart failure, the heart isn’t strong enough to keep up with the body’s needs and fluid stays in the lungs. Too much fluid makes it hard to breathe.”

Until now, cardiologists haven’t had a non-invasive way to proactively monitor for fluid changes. The standard has been to rely on patients weighing themselves daily and reporting symptoms such as swelling or shortness of breath. By then, it could be serious enough to require treatment in the hospital.

“We’ve learned these methods don’t catch the disease progression early enough, and that’s why hospitalization and re-hospitalization rates for heart failure have changed very little in the last 20 to 30 years,” Abraham said.

So doctors are testing the vest in a national, randomized clinical trial to see if it effectively monitors and manages lung fluid, reduces hospitalizations and improves quality of life. Abraham leads the trial that includes approximately 40 sites across the country.

All patients enrolled in the trial receive the highest standard of care for heart failure. Those randomized to the treatment group will also use the lung fluid monitor at home to take daily readings. The vest is worn over clothing and a reading takes approximately 90 seconds. The data is uploaded to a secure server where the patient’s cardiologist or nurse can review it.

“We can use that data to see when the lungs are trending towards being too wet and make adjustments to the medication on an outpatient basis or over the phone,” said Dr. Rami Kahwash, director of the Heart and Vascular Research Organization and site leader for the trial at Ohio State. “The goal is to keep the patient within a normal range, feeling well and out of the hospital.”

A previous, small observational study compared hospitalizations before and after using the vest. That study showed an 87 percent reduction in heart failure hospitalizations with vest lung fluid monitoring.

Kenny McIntyre, 59, of Columbus, has been hospitalized twice in the three months since he was diagnosed with heart failure. He recently joined the trial and says the vest is easy to use.

“I’m the type that, unless something hurts me, I don’t want to go to a doctor,” McIntyre said. “I just put the vest on, lay back, hit a button, and let it take my measurements. Every now and then they alter my medications."

Patients in the trial will be followed for up to nine months.

Tech Adoption Climbs Among Older Adults

Roughly two-thirds of those age 65 and older go online and a record share now own smartphones – although many seniors remain relatively divorced from digital life

BY MONICA ANDERSON AND ANDREW PERRIN

A record 46 million seniors live in the United States today, and older Americans – those age 65 and older – now account for 15% of the overall U.S. population. By 2050, 22% of Americans will be 65 and older, according to U.S. Census Bureau projections.1

At the same time America is graying, recent Pew Research Center surveys find that seniors are also moving towards more digitally connected lives. Around four-in-ten (42%) adults ages 65 and older now report owning smartphones, up from just 18% in 2013. Internet use and home broadband adoption among this group have also risen substantially.

 Today, 67% of seniors use the internet – a 55-percentage-point increase in just under two decades. And for the first time, half of older Americans now have broadband at home.

Yet despite these gains, many seniors remain largely disconnected from the digital revolution. One-third of adults ages 65 and older say they never use the internet, and roughly half (49%) say they do not have home broadband services. Meanwhile, even with their recent gains, the proportion of seniors who say they own smartphones is 42 percentage points lower than those ages 18 to 64.

And as is true for the population as a whole, there are also substantial differences in technology adoption within the older adult population based on factors such as age, household income and educational attainment.

Seniors ages 65 to 69 are about twice as likely as those ages 80 and older to say they ever go online (82% vs. 44%) or have broadband at home (66% vs. 28%), and they are roughly four times as likely to say they own smartphones (59% vs. 17%).

Adoption rates also vary greatly by household income. Fully 87% of seniors living in households earning $75,000 or more a year say they have home broadband, compared with just 27% of seniors whose annual household income is below $30,000. Educational differences follow a similar pattern, with college graduates adopting technology at much higher rates than seniors with lower levels of formal education.

These younger, relatively affluent and/or highly educated seniors are helping to drive much of the recent growth in technology adoption among the older population as a whole. For example, smartphone ownership among seniors whose annual household income is $75,000 or more increased by 39 percentage points since 2013 – 15 points higher than the growth reported among seniors overall.

It also remains the case that older adults face unique barriers to using and adopting new technologies. Some 34% of older internet users say they have little to no confidence in their ability to use electronic devices to perform online tasks, while 48% of seniors say that this statement describes them very well: 

“When I get a new electronic device, I usually need someone else to set it up or show me how to use it.”

Still, older Americans who use the internet tend to view technology in a positive light and incorporate digital technology into their everyday lives. Fully 58% of adults ages 65 and older say technology has had a mostly positive impact on society, while roughly three-quarters of internet-using seniors say they go online on a daily basis – and nearly one-in-ten go online almost constantly.

These findings are based on several nationally representative Pew Research Center surveys. 

he main findings on technology adoption are from a phone survey of 3,015 U.S. adults conducted Sept. 29-Nov. 6, 2016. The margin of sampling error at the 95% confidence interval for results based on the total sample is plus or minus 2 percentage points. Details about the other surveys used in this report are available in the methodology. The terms “seniors”, “older Americans” and “older adults” are used interchangeably in this report to denote adults living in the U.S. who are ages 65 and older.

1. Technology use among seniors

BY MONICA ANDERSON AND ANDREW PERRIN

Although seniors consistently have lower rates of technology adoption than the general public, this group is more digitally connected than ever. In fact, some groups of seniors – such as those who are younger, more affluent and more highly educated – report owning and using various technologies at rates similar to adults under the age of 65.

Still, there remains a notable digital divide between younger and older Americans. And many seniors who are older, less affluent or with lower levels of educational attainment continue to have a distant relationship with digital technology. 

Four-in-ten seniors now own smartphones, more than double the share that did so in 2013

With smartphone ownership in the U.S. more than doubling in the past five years, Americans are embracing mobile technology at a rapid pace. And while adoption rates among seniors continue to trail those of the overall population, the share of adults ages 65 and up who own smartphones has risen 24 percentage points (from 18% to 42%) since 2013. Today, roughly half of older adults who own cellphones have some type of smartphone; in 2013, that share was just 23%.

Smartphone ownership among seniors varies substantially by age: 59% of 65- to 69-year-olds own smartphones, but that share falls to 49% among 70- to 74-year-olds. Smartphone adoption drops off considerably among adults in their mid-70s and beyond. Some 31% of 75- to 79-year-olds say they own smartphones, while only 17% of those ages 80 and older are smartphone owners.

Smartphone ownership is also highly correlated with household income and educational attainment. Fully 81% of older Americans whose annual household income is $75,000 or more say they own smartphones, compared with 27% of those living in households earning less than $30,000 a year. 

Additionally, around two-thirds of seniors with bachelor’s or advanced degrees report owning smartphones (65%), compared with 45% of those who have some college experience and 27% of those who have high school diplomas or less.

Seniors in these high-adoption groups have seen the largest growth in smartphone ownership in recent years. Since 2013, smartphone adoption among older adults who live in households earning $75,000 or more a year has increased by 39 percentage points; those with at least bachelor’s degrees, as well as those who are ages 65 to 69, have each seen a 30-point increase in smartphone adoption over that time.

Internet use and broadband adoption among seniors varies across demographic groups

As is true of the population as a whole, internet adoption among seniors has risen steadily over the last decade and a half. When the Center began tracking internet adoption in early 2000, just 14% of seniors were internet users. But today, 67% of adults ages 65 and older say they go online.

The share of seniors who subscribe to home broadband services has also risen – albeit at a slower rate than internet use. Around half of seniors (51%) now say they have high-speed internet at home. This represents a modest uptick from 2013, when 47% of older adults were broadband adopters.

As is true of the general public, internet and broadband adoption among older adults varies substantially across a number of demographic factors – most notably age, household income and educational attainment.

Younger seniors use the internet and subscribe to home broadband at rates that are comparable to the overall population. Fully 82% of 65- to 69-year-olds are internet users, and two-thirds say they have broadband internet connections at home. (Internet use and broadband adoption rates for the overall population are 90% and 73%, respectively).

On the other hand, fewer than half of seniors ages 80 and up (44%) report using the internet and just 28% say they have home broadband service. Adoption rates for seniors in their 70s fall in between these two groups.

Internet and broadband adoption rates also differ considerably by household income and educational attainment. 

Around nine-in-ten seniors whose annual household income is $75,000 or more say they go online (94%) or have high-speed internet at home (87%). Those shares drop to 46% and 27%, respectively, among older adults living in households earning less than $30,000 a year. 

College graduates are far more likely than those with high school educations or less to say they use the internet (92% vs. 49%) or have home broadband service (82% vs. 30%).

Tablet ownership grows among older Americans, while e-reader adoption stalls

Roughly one-third (32%) of seniors say they own tablet computers, while about one-in-five (19%) report owning e-readers. While this represents a double-digit increase in tablet ownership since 2013, the share of older Americans who own e-readers has stayed largely unchanged over that time period. (This mirrors adoption trends in the broader population as well).

Tablet ownership is especially common among seniors with more education and those living in higher-income households. Some 62% of older adults with annual household incomes of $75,000 or more say they own tablet computers, while 56% of college-degree earners say the same. 

Each represents a more than 20-point increase since 2013 (at that point, 39% of high-income seniors and 31% of college graduates in this age group owned tablets).

By comparison, fewer than one-in-five seniors in households earning less than $30,000 a year (16%) or who have high school diplomas or less (18%) own tablets. E-reader adoption follows a similar pattern, albeit from a lower baseline level of overall ownership.

Younger seniors are also more likely than their older counterparts to own tablets or e-readers, although these differences are especially pronounced in the case of tablets. Some 41% of 65- to 69-year-olds report having tablet computers, compared with 20% of those ages 80 and older. The age gap in e-reader ownership is narrower: 21% of 65-to 69-year-olds and 13% of those ages 80 and older are e-reader owners.

Social media use among older Americans steadily increases

Social media is increasingly becoming an important platform where people find news and information, share their experiences and connect with friends and family. And just as internet adoption and smartphone ownership has grown among seniors, so has social media use.

Today, 34% of Americans ages 65 and up say they ever use social networking sites like Facebook or Twitter. This represents a seven-point increase from 2013, when 27% of older adults reported using social media. Still, a majority of seniors do not use social media, and the share that do is considerably smaller than that of the general population.

As with other forms of digital technology, younger seniors are more likely than their older counterparts to use social media. More than four-in-ten (45%) seniors under the age of 75 say they ever use social networking sites, compared with 20% of those ages 75 and older. Social networking use is also relatively common among those who have at least some college experience and those whose annual household income is $50,000 or more.

2. Barriers to adoption and attitudes towards technology

BY MONICA ANDERSON AND ANDREW PERRIN

Digital technology has transformed the way people communicate, get news, shop and even find love. And as more tasks migrate online, there are unique barriers and challenges that may hinder some older Americans from going online and using new technology. But despite these challenges, many seniors have a positive outlook about technology and the benefits it can provide. And once online, many older adults engage deeply with online content and activities.

Older adults face unique barriers to adoption, ranging from physical challenges to a lack of comfort and familiarity with technology

One challenge facing older adults with respect to technology is the fact that many are simply not confident in their own ability to learn about and properly use electronic devices.

For example, just 26% of internet users ages 65 and over say they feel very confident when using computers, smartphones or other electronic devices to do the things they need to do online, according to a 2015 Pew Research Center survey. Roughly one-third describe themselves as only a little (23%) or not at all (11%) confident in their ability to use electronic devices to do necessary online activities.

Similarly, a 2016 report from the Center found that “digitally ready” Americans – meaning those who are confident in their digital skills and in their ability to find trustworthy information online – tend to be disproportionately under the age of 65. Meanwhile, older groups make up a larger share of those who are described as “digitally unprepared.”

Hand in hand with this lack of confidence in their own ability to use digital technology, seniors are also more likely than those in other age groups to say they need others to show them how to use new devices. Around three-quarters of Americans ages 65 and up say the statement, “When I get a new electronic device, I usually need someone else to set it up or show me how to use it,” describes them either very (48%) or somewhat (25%) well.

Older adults may also face physical challenges that might make it difficult to use or manipulate devices. Some 28% of U.S. adults ages 65 and up say they have health problems, disabilities or handicaps that keep them from participating fully in work, school, housework or other activities.2 And seniors who report that they have a disability are less likely than those who do not to utilize a variety of digital assets – from the internet in general, to devices such as smartphones or tablet computers.3

Once seniors are online, they engage at high levels with digital devices and content

Once online, most seniors make the internet a standard part of their daily routine. Roughly three-quarters of older internet users go online at least daily, including 17% who say they go online about once a day, 51% who indicate they do so several times a day and 8% who say they use the internet almost constantly. 

Among older adults who own smartphones, this figure is even higher: 76% of these smartphone-owning older adults use the internet several times a day or more.

Similarly, a relatively small share of older adults use social media – but those who use these platforms tend to be highly active and engaged. For instance, fully 70% of older adults who use Facebook indicate that they log in to the service on a daily basis. Other Pew Research Center surveys have found that older adults who say they get news on social media engage with news on these platforms at similar rates as social media news consumers who are ages 18 to 29.

And even though playing video games is much more common among younger adults, many seniors are taking part in this tech-based activity. One-in-four adults ages 65 or older say they play online video games, according to a Pew Research Center survey conducted in 2015.

Most older adults say technology has had a mostly positive impact on society

Despite these concerns and challenges, there are a number of areas in which seniors hold relatively positive views of technology and technology-related topics. For instance, at a broad level, 58% of seniors feel that technology has had a mostly positive effect on society, while just 4% feel that impact has been mostly negative.

Although older adults are less inclined than other age groups to say they like trying new technology, some seniors do show a strong preference for early tech adoption. On a six-item index that classifies Americans’ preferences for new technology and products, around one-in-five adults ages 65 and older (21%) hold strong preferences for being early tech adopters.4

Seniors also place a high value on the importance of home broadband service, according to a survey conducted by the Center in 2017. The vast majority of adults ages 65 and older say they believe having access to high-speed internet at home is either essential (42%) or important (49%). This puts older Americans on par with Americans of other ages when it comes to the importance of home broadband service.

Learning by Listening: Penn Physicians Say Online Reviews Can Improve Health Care

Newswise, January 3, 2017 – Online platforms that allow users to read and write reviews of businesses and services afford health care providers an opportunity to learn by listening, Penn Medicine physicians say in a new Viewpoint published today in JAMA.

The authors point to a growing body of literature supporting the value of unstructured reviews in supplementing ratings from formal sources such as the Hospital Consumer Assessment of Heathcare Providers and Systems (HCAHPS). They call on hospital leaders to pay attention to online reviews to show current and prospective patients that they are being heard.

“Reviews posted to sites like Yelp or TripAdvisor are the modern day version of word-of-mouth testimonials, providing insight into millions of consumer experiences that are not only influential to other consumers, but can and should be influential to service providers,” said lead author Raina M. Merchant, MD, MSHP, an assistant professor of Emergency Medicine in the Perelman School of Medicine at the University of Pennsylvania, and director of Penn’s Social Media and Health Innovation Lab.

“It’s understandable that in a high-stakes setting like health care, providers may be concerned about these reviews not accurately describing parts of care visible or only understood by other care professionals. But, while we cannot control how these platforms operate, what we can do is take stock of what the reviewers are saying and find ways to make them feel like their concerns or questions are heard.”

Each month, more than 80 million users read and write reviews on Yelp alone. Of those, roughly 42,000 describe U.S. hospital experiences, with most comments addressing “patient experience” issues such as parking, the cafeteria, wait times, and navigating the facility.

But, results of a recent study of more than 16,000 Yelp reviews about U.S. hospitals showed that many of these services, which are areas of key importance for patients and guests, are not captured by standardized quality surveys like HCAHPS.

That survey measures impressions of 11 different domains, including discharge information and the overall hospital environment. The researchers say the content contained in Yelp comments could be organized into an additional 12 areas, including amenities, compassion of staff, and family member care, an area which the authors say addresses an influential group often overlooked by service providers: family and friends.

“Most organized approaches to evaluating care focus specifically on the patient, but many online reviews seem to include either input from or focus on caregivers, friends, family and others who are often bypassed by formalized surveys,” said David A. Asch, MD, MBA, a professor of Medicine and Medical Ethics and Health Policy and director of the Penn Medicine Center for Health Care Innovation.

“Family members and friends are powerful advocates for vulnerable patients and also experience health services and shape patient perceptions of it. Incorporating these insights from reviews on Yelp and other consumer review platforms can be a powerful differentiator for a business.”

While health professionals look for ways to use online platforms to deliver messages to patients, the authors say it’s crucial to recognize that the internet is a two-way street, where patients are also sharing important ideas.

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Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania(founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $5.3 billion enterprise.

The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 18 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $373 million awarded in the 2015 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report -- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2015, Penn Medicine provided $253.3 million to benefit our community.

Breakthrough in Cybersecurity Is No Phish Story

UB researcher develops SCAM model to explain why people fall for spear phishing

Newswise, April 14, 2016 – Corporations, small businesses and public sector entities have tried unsuccessfully for years to educate consumers and employees on how to recognize phishing emails, those authentic-looking messages that encourage users to open a cloaked, though malicious, hyperlink or attachment that appears harmless.

In casual conversation, the problem sounds like a nuisance; on balance sheets, however, it’s monstrous. The estimated financial tally from information loss, identity theft, service disruptions and additional security costs related to phishing exceeds $1 trillion. In fact, phishing accounts for more than one-third of the nearly 800 percent increase in cybercrimes since 2007, according to the Government Accountability Office.

The problem appears unstoppable, but a University at Buffalo cybersecurity expert may have finally hooked the phish that existing training methods have so far been unable to land.

Arun Vishwanath, an associate professor in the Department of Communication at UB, whose research specializes in how to stop online deception, has developed a groundbreaking comprehensive model that, he says, for the first time accounts for the multiple influences that contribute to the success of these attacks.

Vishwanath’s model is a breakthrough in understanding why people fall for these schemes and could finally tilt phishing’s dynamic from successful deception to effective detection.

The study, published in the latest issue of journal Communication Research, proposes and empirically tests a theory-based model that identifies specific user vulnerabilities that arise in a given user.

“When I talk to cybersecurity experts in companies or even in the U.S. government — and I’ve presented this to many of them — I’m told that the model provides a ready framework to understand why their employees fall prey to such attacks,” says Vishwanath.

“This is so important.”

The model encourages a new approach to training that is based on individual, predictive profiles of computer users, rather than relying on the current blanket training approach for everyone, a method that previous research has shown to be of limited effectiveness because people are often victimized hours after they’ve finished their training, according to Vishwanath.

“Using this model, organizations can come up with a dynamic security policy, one that takes into account employee cyber-behaviors and allows access to systems, software and devices based on these behaviors,” he says. “It can also be used to develop a risk-index that assesses the overall risk threshold of individuals and groups.”

Vishwanath’s study, which is part of a larger research program to understand the people-problems of cybersecurity, tested the model by actually simulating different types of phishing attacks on real-world subjects.

“Calling people into a lab doesn’t work for this kind of research because there is a heightened sense of awareness,” he says. “Subjects in labs look at a screen and are asked if they believe they’re looking at a phishing email. In reality, most people don’t focus on emails and appear to be far less suspicious and far more susceptible than when they are in a lab.

“Methodologically, the premise I work with is that we have to play the role of the ‘bad guys’ in order to study how and why people are victimized.”

The Suspicion, Cognition and Automaticity Model (SCAM) explains what contributes to the origin of suspicion by accounting for a user’s email habits and two ways of processing information: heuristics, or thumb rules that lead to snap judgments about a message’s content; and a deeper, systematic processing about an email’s content.

“A fourth measure, cyber-risk beliefs, taps into the individual’s perception about risks associated with online behaviors,” he says.

Vishwanath’s model accounts for these layers and the relationships among them with each measure providing a brush stroke that composes an overall portrait of the different reasons people fall victim to such attacks.

“These things matter,” he says. “Once we understand why certain people fall for attacks we can target them with the appropriate training and education.”

Current training is based on simply teaching people how to recognize a phish that only addresses one of the reasons why people fall for phishing. No wonder training has had limited overall effectiveness in stopping cyber breaches.

The point for Vishwanath is that most anti-phishing measures are trying to stop attacks under the assumption that they know why people fall prey to such attacks, rather than actually figuring out why the attacks are working.

With phishing losses mounting at alarming rates and the level of phishing sophistication evolving in step, Vishwanath says adopting the model is critical.

Millions of phishing attacks occur daily, many following recurring patterns, such as the emails that come now during tax seasons. 

These, too, have grown in rate and intensity. For instance, the number of malware-laden IRS phishing emails this month has already gone up by 400 percent.

The malware in these emails open back doors to computer networks that provide hackers with access to people’s personal information. Some intrusions install key loggers that track what the person in typing or the sites they visit. 

And a new class of “ransomware” encrypts every file on a hard driver or server, holding the data hostage until users pay an untraceable ransom in bitcoin.

“If the Internet were the real world it would be the most dangerous city on earth,” he says.

Research Team at IUPUI Develops Social App to Support Alzheimer's

Newswise, March 28, 2016— Every day, more than 15 million unpaid caregivers provide care to people with Alzheimer’s disease, with little outside support and often at the risk of their own health.

Now a team of researchers, including David Wilkerson at the Indiana University School of Social Work at Indiana University-Purdue University Indianapolis, will use an innovation grant awarded by the Regenstrief Institute to see whether a social microvolunteering app developed for Facebook could help provide support many caregivers are now lacking.

The team, which also includes Dr. Daniel Bateman, a gerontology psychiatrist with the IU School of Medicine and Erin Brady, a faculty member at the School of Informatics and Computing at IUPUI, hope to have an answer to that question by early fall.

The three met through their participation in the Sandra Eskenazi Center for Brain Innovation eHealth group and decided to join forces to explore the possibility that their social microvolunteering application could aid caregivers.

The social microvolunteering app communicates with a Facebook community and can push and retrieve information to and from the entire community or only selected groups within the community.

Social microvolunteering is a simple and brief form of volunteer service usually done virtually through social networks and requiring no long-term time commitment.

It connects an individual with a question to a group of potential answerers, leveraging the social networks of a core group of supporters to expand the scale of answerers available and increase the speed of responses.

Brady developed and researched the social microvolunteering idea in an application for people with limited vision. Bateman will help the team understand the needs of caregivers.

Wilkerson's interest has to do with patient-centered care and creating a holistic care environment that includes caregivers and strengthens the resource of caregiving.

If the research project shows the application is effective, it could prove to be an inexpensive way to provide support to millions of caregivers.

The numbers of unpaid caregivers trying to maintain their own lives and care for loved ones with Alzheimer's disease is staggering. In 2014, 15.7 million unpaid caregivers took care of people with Alzheimer's disease, providing a total of 17.9 billion hours of care, according to the Alzheimer's Association.

Providing care comes with its own problems. Experts say caregivers have higher rates of depression, anxiety, insomnia, cardiovascular disease and health care resource use, making caregiver self-management an important target for intervention, according to research studies.

Wilkerson said the team will be investigating small groups of five to eight caregivers; each group will have a Facebook account.

The group will be asked what informational and emotional support questions it would like to get answered in alternating weeks of the research. This aspect of group discussion is anticipated to be a first step in the development of mutual support and will generate questions that will be pushed to the larger Facebook community for the purposes of social microvolunteering.

The social microvolunteering app retrieves their answers, and relevant answers are sent back to the caregiver group for deliberation. The online caregivers' group will discuss online which answers seem the most relevant and then take action. Wilkerson said the caregivers would give authorization through their Facebook page to use the application for the test period.

The team expects to recruit 24 to 26 people, who will be divided up into four groups by April, and then start the project in May

"If our intervention can increase support, it can potentially improve caregiver health and, in conjunction with primary health care interventions, extend the amount of time that people with Alzheimer's can remain at home," Wilkinson noted.

Using a Computer, Social Activities Tied to Reduced Risk of Memory Decline

Newswise, March 18, 2016– Keeping the brain active with social activities and using a computer may help older adults reduce their risk of developing memory and thinking problems, according to a study released today that will be presented at the American Academy of Neurology’s 68th Annual Meeting in Vancouver, Canada, April 15 to 21, 2016.

“The results show the importance of keeping the mind active as we age,” said study author Janina Krell-Roesch, PhD, with the Mayo Clinic in Scottsdale, Ariz., and member of the American Academy of Neurology. “While this study only shows association, not cause and effect, as people age, they may want to consider participating in activities like these because they may keep a mind healthier, longer.”

For the study, researchers followed 1,929 people, age 70 and older, who were part of the larger Mayo Clinic Study of Aging in Rochester, Minn. The participants had normal memory and thinking abilities at recruitment to the study. They were then followed for an average of four years until they developed mild cognitive impairment or remained impairment-free.

Participants were asked about their engagement in mentally stimulating activities such as computer use, reading, crafting and social activities within 12 months before participation in the study using a questionnaire.

The investigators then wanted to know if participants who engaged in mental activities at least once per week had a lower risk for new onset of mild cognitive impairment as compared to those participants who did not engage in these activities.

The study found that people who used a computer once per week or more were 42 percent less likely to develop memory and thinking problems than those who did not. A total of 193 out of 1,077 people (17.9 percent) in the computer use group developed mild cognitive impairment, compared to 263 out of 852 (30.9 percent) people in the group that did not report computer use.

People who engaged in social activities were 23 percent less likely to develop memory problems than those who did not engage in social activities. A total of 154 out of 767 (20.1 percent) people in the social activities group developed problems, compared to 302 out of 1,162 (26.0 percent) people who did not participate in social activities.

People who reported reading magazines were 30 percent less likely to develop memory problems. Those who engaged in craft activities such as knitting were 16 percent less likely to develop memory problems. Similarly, those who played games were 14 percent less likely to develop memory problems.

The study was supported by the National Institute on Aging, National Institute of Mental Health, the Robert Wood Johnson Foundation, the Robert H. and Clarice Smith and Abigail Van Buren Alzheimer’s Disease Research Program, the European Regional Development Fund and the Arizona Alzheimer’s Consortium.

Learn more about memory and thinking problems at www.aan.com/patients.

The American Academy of Neurology, an association of 30,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy.

Popular Blood Pressure App Misses the Mark

Study in 85 volunteers found highly inaccurate measurements and showcases weakness of unregulated mobile health applications, researchers say

Newswise, March 3, 2016 — A popular smartphone app purported to accurately measure blood pressure simply by placing a cellphone on the chest with a finger over the built-in camera lens misses high blood pressure in eight out of 10 patients, potentially putting users’ health at risk, according to research from Johns Hopkins.

Although the app, called Instant Blood Pressure, is no longer available for purchase, it was downloaded more than 100,000 times and is still functional on phones, the researchers say.

“We think there is definitely a role for smartphone technology in health care, but because of the significant risk of harm to users who get inaccurate information, the results of our study speak to the need for scientific validation and regulation of these apps before they reach consumers,” says Timothy B. Plante, M.D., a fellow in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine.

The study, described at the American Heart Association’s Epidemiology and Lifestyle meeting and concurrently online March 2 in JAMA Internal Medicine, was conducted by Plante and Seth Martin, M.D., M.H.S., an assistant professor in the Division of Cardiology at the Johns Hopkins University School of Medicine.

Blood pressure is best measured, the researchers say, using the well-established technique of inflating a cuff attached around the brachial artery in the arm to detect the force of blood flowing when the heart is beating and at rest. Either a trained medical professional or a machine “listens” to sounds from the brachial artery as blood flows under variable pressure from the cuff.

Plante and Martin undertook the study because “we were skeptical that even very talented people could design an app that could accurately measure blood pressure in such a different way,” Martin says. “Because of the absence of any rigorous scientific testing, there was no evidence that it worked or didn’t work.”

To conduct such testing, Martin, Plante and colleagues recruited 85 adult volunteers among patients and staff members in clinics associated with Johns Hopkins Medicine. The participants self-reported a range of body mass measurements, races and ethnicities, all factors known to influence blood pressure.

Each participant had his or her resting blood pressure measured twice using a reliable automated blood pressure monitor commonly used in research studies to avoid measurer variation or error. Participants also used the app to measure their own blood pressure twice on the same day.

Results showed that blood pressures measurements from the app were overwhelmingly inaccurate. Close to 80 percent of those with clinically high blood pressure, defined as 140/90 millimeters of mercury or above, measured by the automated blood pressure monitor showed normal blood pressure with the app.

The authors say that it is unclear how the app arrives at a blood pressure number. They suggest in the study that, rather than attempting to measure true blood pressure, the app gives a population-derived estimate based on the user’s age, sex, height, weight and heart rate, the latter of which could be detected by the phone’s microphone.

“Because this app does such a terrible job measuring blood pressure,” says Plante, “it could lead to irreparable harm by masking the true risk of heart attacks and strokes in people who rely on the accuracy of this information.”

Martin and Plante note that mobile health smartphone applications are becoming more commonplace, and many have the potential to greatly improve health by putting personalized medical resources and information literally in the hands of patients through cellphones.

Though the results of this study were discouraging, they say improvements in the technology could make blood pressure measurement apps accurate and useful. The app studied here, which cost $4.99 when it was sold, was removed from Apple’s App Store in late August 2015 for reasons that are unclear.

“The next big step in health care is to further engage folks in their own care and motivate them to reduce risks associated with diseases like high blood pressure,” Plante says. “But care must be taken to make sure they get the accurate ways to do that.”

Other researchers who participated in this study include Bruno Urrea, M.D.; Roger S. Blumenthal, M.D.; Edgar R. Miller III, M.D., Ph.D.; and Lawrence J. Appel, M.D., M.P.H., all of Johns Hopkins, and Zane T. MacFarlane, of Pomona College.

The work was funded by the PJ Schafer Cardiovascular Research Fund.