List of questions

Do smart inhalers have a long-term future?

Smart inhalers currently record when, where and how many times an inhaled medication was taken, but not why it was taken. How can they be improved?

Will selfcare respiratory monitors improve Patient Activation Levels in the elderly?

How can we develop medical devices to help manage chronic respiratory conditions such as COPD, asthma and congestive heart failure which are motivational to an aging population?

What technologies exist to promote behaviour change and healthier lifestyles in the young old?

Given the cost of long term conditions, delaying their onset by reducing risk factors through healthy living is important. What technologies exist that could nudge people over 55 to change their behavior?

Traditionally healthcare innovation (and the associated intellectual property) has been aimed at treating specific diseases.

With a shift to strategies for disease prevention (and even the question of whether ageing represents a “disease”) what challenges are faced in defining endpoints and illustrating that these have been met?

Why do so many "lunatic fringe" technologies get so much academic attention in the field of hip protection and falls detection sensors?

1). April 2014 – Professor Miodownik of UCL's exoskeleton smart pants!
2). December 2016 – The "Hip-Hope" inflating/exploding airbag to protect hips. https://www.youtube.com/watch?v=4Diugqvovng#t=188
3). 2015 "Vigi'Fall" EU-funded but no practical application

Do you see truly predictive markers of frailty offering effective prediction in terms of years or even decades emerging anytime soon?

Age-related frailty often leads to disability. A universal definition of frailty is critical if we are to effectively identify and manage the condition, to prevent its progression to disability. Currently, methods to define, predict and diagnose frailty, such as grip strength are imprecise, give very little warning of development and have tenuous association with the most clinically significant concerns – such as trips and falls. Furthermore, the diagnostic and widely used Fried’s Frailty Criteria fails to take cognitive status into account. Recent work with laboratory based –omic biomarkers in the FRAILOMIC study, spanning genomics, transcriptomics, proteomics, metabolomics and serum biomarkers suggest that we may find associations between key biomarkers and frailty but it remains unclear as to whether these can be given clinical relevance.

At what level would you expect to see support in terms of reimbursement for clinical tests on frailty? Do you see such positive tests being used to burden the individual, in the form of long term health payments on insurance requirements, or do you see governments picking up the cost?

We are currently working to identify factors that predict the development of frailty into disability. Blood and urine biomarkers from biobanks of over 75,000 individuals are being investigated in the FRAILOMIC Initiative. It is hoped that any associated biomarkers with frailty can be combined with classical markers to identify robustly these individuals at risk of developing clinically significant disease.

Do you envisage any effective agent ever being discovered that will be able to halt or even reverse ageing and if so when?

We are seeing promise in the form of predicting the incidence of frailty in individuals and are gaining a better understanding of the underlying biology and pathophysiology. Several different science based anti-ageing approaches are already in the proposal stages.

What are the best approaches to get older generations to commit to lifestyle changes that can improve their overall health and attenuate the consequences of age-related diseases?

Age-related diseases such as diabetes are associated with increased frailty and an accelerated decline in the ability to carry out everyday tasks. Research such as the MID-Frail study, in almost 1000 individuals aged 70 ≥years with Type 2 diabetes, shows that structured multi-modal interventions that include regular exercise reduce the burden of disease. However, greater efforts are required to get older people involved in exercise, adopt a healthy diet and engage with modern technologies that can help them achieve this.

What is the long term planning for the ageing population and what are the financial resources?

N/A

What are the major trends in care for an ageing population driving medical device development

Owen Mumford is a global industry leader in medical device design and manufacturing.

What are the major trends in care for an ageing population driving assisted living technologies

Owen Mumford is a global industry leader in medical device design and manufacturing.

What are the major trends in care for an ageing population driving diagnostics

Owen Mumford is a global industry leader in medical device design and manufacturing.

What objective or subjective measures will elderly adults use to actually drive lifestyle change and disease prevention?

Counter-intuitive results of step counters not leading to higher weight loss.

What technology will prove most useful to support aging in place, especially for chronic patients?

Many technologies are hyped at this time, but what do you expect to have the potential to make a difference in the home?

General life quality/ Health

How does the ageing population (with breakouts by age : 50-65, 65-80, 80+) feel about their general QOL today (quality of life), and what do they think could possibly improve it?
What tasks around the home do seniors (split by age and type of disease) find most challenging?

What is the most difficult physical obstacle in performance of daily activities ability to walk, going from lying to sitting , ability to bathe, to eat and to dress themselves, ability to housekeep, prepare meals, use telephone, take medications – e.g. is the biggest obstacle flexibility? Muscle tone? General weakness? Ability of brain to process?
(can we have breakouts by age)

What are the biggest challenges to ‘healthy’ independent living? And why is the ageing population more susceptible?
 Weaker immune system? Disease
 Poor diet? Lack of interaction with others? Depression?

Are there segments of the population that get sick (colds, flu, etc) more than others, and will adjustment to the home environment at the microbiome level help them? What type of adjustment could be needed (need to control pollen, particulate…?)

How spending their free time compare now vs. 20-30 years ago?
What is the main source of information for seniors? How influential are their close friends, online discussion group, their own children on their purchasing decision? What triggers them to try a new product?
where this target finds out about new ways to care for their home? And how they prefer to shop for it?

Packaging and elderly

What sort of packages are the most difficult and frustrating to open? To read and locate in the store?
which packages or products or general product forms (wipes, sprays, liquids, pods, etc) are easiest to use, open, and store in their homes? Specific examples would be great.

50+ being care givers of older relatives (urine)

Amongst the 50+ “Care givers” caring for an elderly parent, what are the most difficult tasks to do when it comes to cleaning of the house or cleaning of the person (exc administrative paperwork,social activities…) ?

Is there any care / nursing home establishment that has a good reputation in the UK ? What makes it so famous ?

What is the most common medicine used in care home that can be retrieved in urine and change urine color and smell ?

When aging and increased incontinence issue, what is the average urine quantity to hold (is it increasing with age, with disease)

50+ and smell

Did we measure the impact of scent/smell on care home residents quality of life and more precisely on short term memory or dementia prevention ? (effect on long term memory well know but what about short term and enabling keeping memory for longer)

How is smell detection evolving with age ?
How does ODT evolve with age ? which smell are better smelled than others ? why ?
What are the olfactory (odor) receptors involved into short term memory and how evolve other time ?

50+ and Oral care

What is the role for good Oral Health for elder people – e.g. is this social, is this pivotal, is this ethical –
What are the biggest barriers to maintain a good oral health routine – this is about understanding the biggest burden (e.g. physical/cognitive capabililies) with progressing ages. Can we have a split by age

What are the physiological changes happening in mouth (including teeth and gum) with age ? Any difference between age and or disease (does dementia affect mouth conditions?

50+ and their body (Hair,skin, shaving)

How does ‘skin as a barrier’ change over time (my understanding is that skin gets thinner and more sensitive)?
How is Hair changing with time and disease (thickness, composition…) ? what are the key benefits beyond cleaning that people need

How does the daily grooming routine now compare vs. 20-30- years go (# of times they brush their teeth, take shower, shave, go to bathroom, change clothes, etc…)
What type of food they like to eat now vs. 20 years ago – and why – taste? Texture? Color?

What do they drink and why – temperature for the drink, flavor of the drink? Alcohol level? Coffee? Tea?

How difficult / easy is it to take shower / bath – why? What are the main tension points ?

What factors are of particular importance regarding concordance to prescription medicines in the older population.

NA

Active and healthy ageing (AHA) is one of the societal challenges we will be facing in the upcoming decades. What about out-door healthy life style for ageing people ?

Is it possible to quantify benefits due to out-door activities in the natural environment in improving health key parameters e.g. in the field of cardiovascular health, osteoporosis, sleep deprivation and physiological issues ? For example , is there an important difference related to the exposure to solar radiation and a regulated out-door safe physical activity with respect in-door activities ? Has the out-door activity also an impact on nutrition parameters and on the diet ?

How do you identify and prioritize the prominent needs of an ageing population when designing targeted medical devices for the geriatric generation?

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Partnerships

I would like to discuss development partnerships for our technologies.