Introduction

Lewy body dementia is a progressive brain disease that results in a decline of cognitive function (thinking ability) over time. It is characterised by the presence of Lewy bodies – abnormal clumps of protein (alpha-synuclein) in the brain. Abnormal aggregates of this protein can similarly be found in Parkinson’s disease. Lewy bodies often cause damage in areas of the brain linked to dopamine production – the ‘reward centre’ – leading to symptoms such as impaired movement, hallucinations and sleep disturbances.¹

Individuals with Lewy body dementia and their carers can be assisted by several technological advances, which will be discussed in this article.

Assistive technologies for patients

Assistive technology is one-way patients with Lewy body dementia can retain or improve their day-to-day function.

Cognitive support tools

People with Lewy body dementia often experience problems with cognition which causes them to experience difficulties related to thinking, reasoning, or learning.

Memory aids

Lewy body dementia can cause people to experience short-term memory loss, making it hard to remember recent events. Some technological memory aids that can help with this include:

• Smartphones and smartwatches
• Tablets
• Alarm apps
• Task reminders

These can help patients to remember appointments, medications, and other daily tasks. Apps have been trialled to assist patients with facial recognition, using an image gallery with related descriptions of loved ones and past events.

Brain training apps

Although brain training apps have not been proven to prevent the progression of dementia, they are useful tools to keep the mind engaged. The ‘use it or lose it’ principle states that regularly challenging your brain can help build a mental skill reserve for later life.² These brain training apps provide various exercises that can help improve cognitive function.

Motor assistance devices

Problems with movement seen in Parkinson’s disease (Parkinsonism) can also be present in Lewy body dementia. Any one of the symptoms associated with the classical triad of Parkinson’s disease – bradykinesia (slow movement), rigidity, and tremors – can be used to support a diagnosis of Lewy body dementia.^{3, 4}

Devices, such as wearable sensors and smartwatches, can be used to reduce the risk of falls and monitor patients' physical activity. Sensors can be trained to recognise behavioural symptoms associated with dementia, such as agitation.⁵

Mobility aids with technology integration

Some mobility aids integrate new technology which can provide a greater sense of comfort to caregivers and patients with Lewy body dementia. Smart walkers are one example of a device that includes GPS tracking. This allows for location monitoring by the caregiver, for example, if a patient is wandering in unfamiliar surroundings.

Speech and communication tools

Patients with Lewy body dementia can encounter difficulties speaking or communicating what they need. This can lead to misunderstandings between the patient and caregiver. 

Text-to-speech communication tools

Voice assistants – such as Alexa, Bixby, Echo and Siri – are text-to-speech tools that can help patients with dementia to communicate their needs with clarity. Embedded in phones or smart speakers, these devices can read out lines of text or perform simple functions e.g. calling a loved one or controlling the lights in your home.

These text-to-speech tools can make a positive impact by assisting individuals with everyday tasks.

Visual communication aids 

Visual aids, such as physical colour-coding or cue cards, are available to help patients with Lewy body dementia communicate. The power of these tools can be enhanced with the use of technology.

Picture boards or enlarged phone icons can make it easier for patients to identify or request information.

Support for caregivers

Carers are integral to a patient’s quality of life. However, the sustained nature of assistance required can leave caregivers exhausted. Multiple aids exist to help caregivers.

Remote monitoring systems

These are systems that can help caregivers look after their patients remotely, allowing some respite. Monitoring devices include: 

• Motion detectors
• Cameras
• Smart-home systems 

Providing caregivers with cameras to monitor patients with Lewy body dementia, and, crucially ensure their safety, can bring added peace of mind.

Wearable health monitors

As well as tracking location, smartwatches (or similar devices) can measure a patient’s heart rate and sleep patterns. Caregivers accessing this information can tackle any potential distress signals arising at the time and track a patient’s general health. 

Health apps

These can provide support to caregivers by automating routine tasks. 

Medication management apps

Alarm apps that set reminders for medications, or automated pill dispensers, can be deployed in some settings to ensure the correct timing and dosage for medications.

Care coordination platforms

Caregivers may appreciate apps that facilitate event scheduling across multiple devices, thereby alerting key people of upcoming appointments or important dates. This can make it easier to coordinate care efforts between families and healthcare providers.

Virtual support networks

These allow carers to connect with a network of people in similar situations, facilitating the sharing of experiences and resources online and fostering a sense of community for those struggling.

Online communities for caregivers

Forums on Alzheimer's UK and relevant podcasts allow caregivers to voice their feelings and learn more about their role while balancing these responsibilities with their personal lives. Support groups can also be found on social media platforms, such as Facebook, Twitter, Reddit and WhatsApp.

Telemedicine services

Services offering remote medical care negate the need to travel to unfamiliar healthcare settings and, crucially, avoid long hospital waits that can be unsettling for patients with dementia.  Patients can instead receive expert consultations from the comfort of their own homes, allowing carers more agency over their time.⁶

Advanced technologies and future research

Although not currently in widespread use, new technologies offer the potential to improve the lives of patients with Lewy body dementia in the future.

Artificial intelligence (AI) and machine learning

Patients may benefit from AI technologies in the future, to receive personalised care, with extra insights into their health.

Predictive analytics for symptom management

AI systems analysing patient data may aid in the diagnosis or detection of certain behaviours. This can in turn predict outcomes for patients and caregivers, helping them to prepare accordingly.

Customised care plans

AI is also able to create personalised treatment recommendations for patients based on their symptoms and genetic profile. This means patients can benefit from the best possible care, tailored specifically to their needs.⁷

Virtual reality (VR) and augmented reality (AR)

Virtual reality is an immersive 3D-simulated environment. Augmented reality on the other hand is partially immersive: elements are taken from the real world with some additions. These technologies are being used to help patients with dementia in their everyday lives.

VR for cognitive stimulation

VR can provide a virtual environment for memory exercises, enhancing mental engagement for patients and reducing anxiety. VR has also been proposed as a potential tool to help identify signs of cognitive impairment.⁸

AR for navigation and activities of daily living 

AR glasses are one example of a way patients can safely navigate through their homes, as a display alerts them to upcoming hazards. The same system can be used as a prompt for medications or to provide cues for names of objects patients might have trouble remembering.⁹

Robotics

Interestingly, robots offer the potential to assist Lewy body dementia patients as a social interface or for physically demanding tasks. 

Companion robots

Advanced, interactive therapeutic robots like Paro the seal, or Pepper, provide emotional support and companionship to patients which can reduce loneliness. Communication is facilitated by text responses for patients with Lewy body dementia, eliciting a sense of connection for patients who may feel isolated. To maximise the benefits, companion robots should be used as a supplement to human interaction – not a replacement for it.

Robotic assistants for physical tasks

Robots have been trialled to help patients reach for objects and provide an interface for teleconsultations, thereby improving quality of life from both a social and physical standpoint.¹⁰ These robotic assistants can alleviate a caregiver’s workload and also give patients a renewed sense of independence.

Future challenges

Several challenges must be overcome for this technology to be implemented successfully:

• Given their evolving nature, it may take time for patients to access many of these novel technologies 
• Learning curve for users, especially the elderly who may have difficulty adapting to new technology 
• Privacy and security concerns, for instance, data collection from remote monitoring

Summary

Technology can assist with the management of Lewy body dementia by providing support for patients in many aspects of their lives – whether by improving their general health, providing comfort socially, or helping with physical tasks. This can enrich the lives of patients with Lewy body dementia and help maintain a sense of normality while also alleviating some of the burden on caregivers. Efforts should be made to make devices accessible to patients and their caregivers, who will benefit immensely from this new technology. An approach encompassing robotics, social therapy and engagement with other assistive technologies holds the potential to improve outcomes for patients with Lewy body dementia in the future.

Useful links 

Some examples of brain training apps include:

• Lumosity
• CogniFit
• Elevate