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The role of AI in early detection of dementia
By Mike Battista, Director, Science and Research, Creyos
Dementia is a debilitating condition affecting millions all over the world, characterised by a decline in cognitive functions such as memory, reasoning, and communication.
Early detection is advantageous in planning for and managing diseases that cause dementia, as early detection can identify mild issues with cognition while pathology in the brain is still minimal, and potential interventions have the greatest chance of slowing decline.
Early modification of lifestyle and medical risk have been estimated to prevent 40 per cent of dementia cases.
Artificial Intelligence (AI) is emerging as a ubiquitous tool in healthcare, offering new hope for early dementia detection through advanced data analysis and pattern recognition.
Dementia consists of a range of symptoms that can include memory loss, confusion, atypical behaviour, and difficulty completing everyday activities.
Mike Battista
Diagnosing dementia early is challenging with traditional methods, as so many of the most common diagnostic tools rely on significant cognitive decline.
However, early detection can lead to better management of dementia slowing the progression of symptoms and improving the overall quality of life for patients.
With these benefits in mind, innovative uses of AI are needed to create more sensitive tools that can detect the most subtle signs of dementia earlier than ever before.
AI in Identifying Dementia Markers
In relation to dementia, AI can search extensive datasets to find markers indicative of the condition.
Then, by analysing massive amounts of data, AI is advancing healthcare capabilities by identifying patterns indicative of the condition that clinicians might miss.
Understanding these data markers is imperative for accurate detection.
For instance, AI can analyse cognitive performance, language use, and even facial expressions to differentiate between healthy individuals and those showing early signs of dementia.
A strong understanding of these markers comes from reviewing scientific literature and adopting a data-driven approach.
For researchers, AI systems can be trained on large datasets to help discover the subtle differences in performance and behaviour associated with early dementia.
Clinicians can make use of the models trained by researchers to accurately identify patients with early signs of dementia.
Data from clinicians can also be used to further train AI models, improving the accuracy of early detection over time.
The Importance of High-Quality Data
High-quality, clean data are essential for AI to function effectively in detecting dementia.
These data must be accurate and comprehensive, containing the “truth” about individuals’ health status.
One of the biggest challenges in healthcare AI is obtaining this level of data, as it involves building a repository of information that includes both individuals with dementia and healthy individuals.
To overcome this challenge, there are various initiatives to gather diverse data.
These include gathering diagnostic information from patients and creating data partnerships between healthcare practices and research organisations.
These data partnerships are not only interesting for research purposes but also help gather high-quality real-world data from patient populations that can be used to train AI systems for practical clinical application.
Longitudinal datasets are also key to achieving early diagnosis.
They are required to answer research questions about which early signs progress into dementia, which lifestyle factors slow progression over time, and more.
However, gathering these datasets is a complex process.
It requires collecting data from a large group of healthy individuals at a specific time and tracking who develops conditions like mild cognitive impairment or dementia over time.
This involves at least two time points with good follow-up, minimal dropout, and accurate diagnoses, making it a complicated dataset to get right.
Additionally, there is a great deal of selection bias in the patients who are repeatedly tested.
That is because these patients are likely more proactive about addressing their health, and/or more likely to already have issues and seek medical attention because of concerns about their cognition.
What is needed are large scale, randomised controlled studies where people are recruited ahead of time and followed throughout their health journey with state-of-the-art tools to assist in the process.
For example, the Maintain Your Brain trial followed thousands of older participants over three years to examine the effectiveness of lifestyle interventions meant to slow cognitive decline.
They used online cognitive testing from Creyos to ensure that testing was easy for participants, but provided high-quality data for the researchers.
A normative dataset from healthy individuals allows researchers to compare individuals with a known condition to the general population, ensuring AI models can accurately distinguish the two groups.
Building and maintaining these datasets is a complex process but is critical for the success of AI applications.
An example of successful implementation of machine learning is the Creyos dementia screener, which used data from thousands of neurology clinic patients and a health normative database to train a model that accurately detects individuals with subtle cognitive impairments.
Current Success and Future Potential
Several success stories illustrate AI’s potential in early dementia detection.
For instance, pilot programmes using AI have shown promising results in identifying early cognitive decline through routine health assessments and patient interactions.
Examples of how AI recorded observations include:
- How the patient moved the computer mouse while performing assessments
- The time taken by the patient to read the tutorial
- Passive data gathering such as device motion data (noting a person’s gait) handwriting, virtual reality integration (to test for driving ability), facial expression and speech pattern analysis.
These pilot programmes demonstrate novel ways to exploit AI’s capability to provide real-time monitoring and personalised treatment plans, tailored to individual patients’ needs.
It’s clear that the future potential of AI in dementia care is immense.
As technology advances, AI could enable even more precise and individualised healthcare, offering the earliest interventions and continuous monitoring that could further slow the progression of dementia.
This proactive approach could revolutionise how we manage and treat dementia, improving patient outcomes.
Ethical Considerations and Challenges
While AI offers great potential, it also raises ethical considerations and challenges.
Privacy concerns regarding patient data must be addressed, ensuring that data is securely handled, and patients’ confidentiality is maintained.
Additionally, the bias that can get baked into some AI systems must be scrutinised to maintain accuracy, and avoid false positives and negatives, which could lead to misdiagnosis and inappropriate treatments.
Ethical use of AI in healthcare involves balancing technological advancements with patient rights.
Furthermore, AI cannot replace human decision-making. Machine learning models and AI software can enhance human judgment, but a physicians must always make the final call when it comes to diagnosing dementia
AI holds tremendous promise in the early detection of dementia, offering tools that can analyse complex data and identify subtle signs of disruptions to cognition.
To fully realise this potential, continued research and investment in AI technologies and high-quality data collection are essential.
About the Author – Mike Battista, Director, Science and Research, Creyos
Mike Battista is the Director of Science and Research at Creyos.
His interests and science communication focus on brain health, cognition, and neuropsychological testing.
He received his PhD in personality and measurement psychology at Western University in 2010 and has been exploring the intersection of science and technology ever since.
For more information about Creyos Health visit www.creyos.com
Gut-friendly foods such as kimchi and kombucha may carry hidden risks for heart health when eaten in excess, the British Heart Foundation (BHF) has warned.
The charity said foods marketed as prebiotic, probiotic or otherwise good for the gut can support the microbiome, but some may also be high in salt or sugar, which can raise the risk of cardiovascular disease.
Products highlighted by the British Heart Foundation included kimchi, kombucha, fruit yoghurts, smoothies and sauerkraut. It said there is no harm in including them as part of a healthy diet, but advised people to check labels for added salt and sugar and eat them in moderation.
Tracy Parker, the charity’s nutrition lead, said: “We encourage everyone to choose foods that can keep their gut microbiome healthy. The benefits are clear, and we are continuing to improve our understanding of how a gut-friendly diet may help our hearts.
“A lot of these products can contain high levels of salt or sugar though, so it is important to be aware of the potential drawbacks.
“By ensuring you check package labels for added salt and sugars, and eat each in moderation, you can make sure the risks do not outweigh the benefits for your heart health.”
Fermented foods such as kimchi and sauerkraut are rich in probiotics, the healthy bacteria produced during fermentation that can help support a diverse and healthy gut microbiome.
However, both are traditionally made using a lot of salt, which can raise blood pressure if eaten frequently or in large quantities. High blood pressure is known to increase the risk of heart attack and stroke.
Kombucha, a fermented tea, also contains probiotics and can be a healthier alternative to fizzy drinks, but many commercial and shop-bought versions contain added sugar.
Eating too much sugar can lead to weight gain, which can increase the risk of heart attack, stroke and other cardiovascular disease.
Fruit yoghurts can contain probiotic live bacteria cultures, but may also be high in sugar and have fewer live cultures than plain versions.
The charity said plain yoghurt with live and active cultures on the label can be a lower-sugar option, with whole fruit added at home for sweetness.
Smoothies made with whole fruits provide prebiotic fibre, which feeds beneficial gut bacteria and supports digestive health.
They can also provide vitamins and antioxidants, especially when made with a variety of plant-based ingredients.
But blending breaks down the structure of fruit, releasing free sugars that behave like added sugars in the body and can cause faster rises in blood sugar levels.
Regularly consuming too much sugar can lead to weight gain, which can increase the risk of developing type 2 diabetes, heart disease and kidney disease.
The charity said only one 150ml serving of any smoothie counts towards five-a-day, and suggested adding nuts or seeds for extra protein and fibre to help keep blood sugar levels more stable.
The BHF also noted that some shop-bought sauerkraut is pasteurised, which removes most of the live bacteria.
It advised checking the label, eating small portions and choosing unpasteurised products for those seeking the probiotic benefits.
The charity said beneficial gut bacteria produce short-chain fatty acids during digestion, which are linked to reduced inflammation, better metabolism and better heart and circulatory health.
These good bacteria also help digest polyphenols, natural plant chemicals thought to have antioxidant properties and which may help lower blood pressure.
By contrast, harmful gut bacteria, which thrive on diets high in fat and red meat, produce chemicals that can cause problems in the heart and blood vessels by increasing inflammation and altering how cholesterol is processed in the body.
Beneficial bacteria thrive on varied diets high in prebiotics, non-digestible fibres found in foods such as wholegrains, oats, beans, lentils, bananas and onions.
People with diabetes may have undiagnosed heart failure that could be detected by a simple screening blood test, research suggests.
The TARTAN-HF trial found that one in four patients with diabetes who had at least one other risk factor for heart failure had undiagnosed heart failure detected through screening with a blood test and ultrasound scanning of the heart.
Experts said the findings show the extent of unrecognised heart failure in people with diabetes, and how the condition can be detected using a widely available blood test called NT-proBNP, which measures how much strain the heart is under.
They suggest a heart failure screening programme for diabetics could improve diagnosis rates, lead to earlier treatment and potentially reduce the risk of hospitalisation and death.
The study, involving 700 patients, was led by the University of Glasgow in collaboration with AstraZeneca, Roche Diagnostics, Us2.ai, NHS Greater Glasgow and Clyde and NHS Lanarkshire.
Dr Kieran Docherty, clinical senior lecturer at the University of Glasgow’s School of Cardiovascular and Metabolic Health, said: “Our results from the landmark TARTAN-HF trial identified heart failure in a large proportion of people living with diabetes, emphasising the need for a heart failure screening strategy in this group of patients.
“We know that many of the symptoms and signs of heart failure are non-specific, and may go unrecognised as potentially being due to heart failure for a long time.
“The strategy used in our trial is simple and easy to implement in clinical practice, and will aid in the early identification of heart failure in people with diabetes, and facilitate the initiation of medications that we know improve outcomes in patients with heart failure.”
The study, which began more than three years ago, involved more than 700 people with diabetes from the two health board areas who had at least one other risk factor for heart failure.
They were randomly assigned either to receive heart failure screening or to continue with their usual care.
Researchers found screening uncovered a large number of previously unrecognised cases of heart failure. Around one in four, or 24.9 per cent, of those screened were found to have the condition within six months, compared with 1 per cent in the group continuing their usual care.
The study, involving patients with type 1 and type 2 diabetes, found almost all of the participants found to have heart failure had preserved ejection fraction, which can be difficult to detect without dedicated testing.
The findings of the TARTAN-HF trial were presented at the American College of Cardiology conference taking place from 28 to 30 March in New Orleans in the US.
Dr Edward Piper, medical director at AstraZeneca UK, said: “Delayed diagnosis and treatment of heart failure in people with type 2 diabetes contributes to poor long-term outcomes. TARTAN-HF demonstrates that targeted, risk-based screening can identify previously undiagnosed heart failure in approximately one in four high-risk patients with diabetes, enabling earlier intervention with guideline-directed therapy.”
Dr Christian Simon, head of global medical affairs at Roche Diagnostics, said: “We are proud to have supported the landmark TARTAN-HF trial. These findings demonstrate the transformative power of early, accessible diagnostics like the NT-proBNP blood test.
“By identifying unrecognised heart failure in people with diabetes, we enable clinicians to initiate appropriate treatments sooner, ultimately improving patient outcomes and lives.”
The UK has launched a £6.3m men’s health fund to back local projects aimed at helping men and boys live longer, healthier lives.
The Men’s Health Community Fund is a partnership between the Department of Health and Social Care, Movember and People’s Health Trust.
The government is contributing £3m, while the two charities are more than doubling that to take the total to £6.3m.
Grants will support community projects reaching underserved men and boys aged 16 and over, particularly in the most disadvantaged areas and at key points in their lives such as becoming a father, losing a job or retiring.
Projects could include support for new fathers, activities for men facing loneliness and social isolation, services to help young men engage with the health system, and support for men in work, out of work and moving into retirement.
The programme will bring together voluntary, community and social enterprise organisations to test new ways of reaching men who are least likely to use traditional health services.
An evaluation funded through the National Institute for Health and Care Research will assess what works and help inform future policy and delivery.
Health and social care secretary Wes Streeting said: “Too many men across the country are living shorter, less healthy lives, particularly those in our most disadvantaged communities.
“This new partnership will help men get the support they need in the places they feel most comfortable, their communities, among people they trust.
“By working with expert charities and local organisations, we can reach the men who are too often missed by traditional services and help them take better care of their mental and physical health.”
“It is a key step in delivering our first ever Men’s Health Strategy and driving forward our ambition to halve the gap in healthy life expectancy between the richest and poorest areas.”
The Men’s Health Strategy sets out plans to tackle the physical and mental health challenges men and boys face.
Men can be less likely to seek help and more likely to suffer in silence, while higher rates of smoking, drinking, gambling and drug use are damaging men’s health and affecting families, workplaces and communities.
The government is also investing £3.6m over the next three years in suicide prevention projects for middle-aged men in local communities across areas of England where men are most at risk, many of which are also among the most deprived. Suicide is one of the biggest killers of men under 50, and three-quarters of all suicides are men.
The projects will aim to break down barriers middle-aged men face in seeking support, including stigma around asking for help and a lack of awareness of what is available and how to access it.
They will be co-designed with experts and men with lived experience of mental health crises and suicidal thoughts.
Gut-friendly foods may damage heart, charity warns
Diabetes patients face increased risk of undiagnosed heart failure
UK government announces £6.3m fund to boost men’s health
Brain health collaboratory launches in Gulf South
