1. SHORT-TERM MEMORY LOSS
AND SMARTPHONE APPS
GIANLUCA DE LEO PhD MBA
COLLEGE OF HEALTH SCIENCES
VIRGINIA MODELING ANALYSIS AND SIMULATION CENTER
OLD DOMINION UNIVERSITY
NORFOLK VA, USA
GDELEO@ODU.EDU
+1 757 683 6733

2. Outline
Smartphone: a
Brief overview of
Who am I? disruptive
Alzheimer's disease
technology
Smartphone
Case study research
solution to capture Results
project
daily life moments
Vision Q&A

3. Who am I?
In Genova, Italy:
• BS, Electronic Engineering (1997)
• MS, Electronic Engineering (1999)
In St. Louis, MO:
• PhD, Biomedical Engineering (2003)
• Post Doctorate, Public Health Informatics (2005)
• MBA (2005)

4. Who am I?

5. Question
How many of you have heard about:
disruptive technology?

6. Disruptive technology
A disruptive technology or disruptive
innovation is an innovation that helps create a
new market and value network, and eventually goes
on to disrupt an existing market and value network
(over a few years or decades), displacing an earlier
technology there. [1]

7. Disruptive technology
Do you think that "early cars" should be considered
disruptive technology?
Horse-drawn vehicles Early cars

8. Disruptive technology
FORD Model T was a disruptive technology!
Horse-drawn vehicles FORD Model T

9. Disruptive technology
The hydraulic excavator was a disruptive technology!
Cable-operated Hydraulic excavator
excavator

10. Smartphones (1999)
• NOT yet a disruptive
technology
• NOT affordable
• NOT easy to use

11. Smartphones: Disruptive technology (2011)
Smartphones:
• disruptive technology
• affordable
• easy to use
• changing how we:
• Communicate
• Interact
• Play/access music
• Take pictures
• Access information

12. My experience with smartphones
I Click I Talk:
The research driven AAC
system for iPhone, iPad
and Windows.
Perfect for all ages, all
communication
disabilities
and all languages.

13. Background on Alzheimer's
• Currently, 5.4 million Americans are affected with
Significance
Alzheimer's Dementia [2]
• Alzheimer's is a neurodegenerative disease causing
progressive decline in memory.
Science • The disease’s most frequent and recognizable
symptom is memory loss associated with recent
events [2]
• Three main stages: Mild, Moderate and Severe.
• Patients suffer from increasing confusion,
disorganized thinking, impaired judgment, trouble
Stages and
in expressing themselves, and disorientation.
Effects
• Dependence on caregivers increases steadily to the
point of becoming burden, affecting the quality of
life of patients and caregivers [2]
• No permanent solution, but cuing patients about the
Treatment past events can reduce the rate of decline in memory
[2]

14. Background on Alzheimer's
 The capacity to remember recent events is linked to
autobiographical memory, human memory responsible
for archiving and recollection of specific personal
experiences [3]
 Autobiographical memory allows people to have a
coherent tale of their personal experiences [4], a sense of
self [5], and a ‘‘life history’’ to talk about with other people
[6]
 Loss of autobiographical memory causes confusion and
frustration in patients with AD, and their caregivers have
to step in to assist in the memory recall process

15. SenseCam
 The SenseCam is a wearable digital
camera that is designed to take
photographs while it is being worn,
without any user interaction
 This specialized camera captures a picture
every 30 seconds. These pictures are
uploaded to a computer by a nurse and
combined into a movie. The movie is then
shown to the subject. The movie serves as
a recap of the subject’s day
Now a product by
Vicon Motion Systems Inc http://research.microsoft.com/en-
http://viconrevue.com us/umcambridge/projects/sensecam/introduction.htm
$500

16. My personal experience with Alzheimer's
My grandmother
(on my mother’s side)
1917 – 2008
• Healthy individual
• Her memory (recent events)
started declining in 1990
• Degenerated to no
communication in 2006
• Increase burden on caregivers
(her 3 daughters)

17. Smartphone
• Samsung Blackjack
Flat surface  less blurred images
Windows based
• iPhone does not allow taking picture
automatically
Test idea: the smartphone was
programmed to capture an image
every 5 minutes by using the in-built
camera

18. Daily life moments

19. Daily life moments

20. Research opportunity (2008)

21. Smartphone solution to capture daily life moments
The subject carries the smartphone during the day, by way of the supplied lanyard, for 4 weeks
The smart phone automatically takes pictures every 5 minutes during the day (8:00 a.m. to
8:00 p.m.) and uploads them to a secure server during the night (at 2:00 a.m.)
The images are automatically retrieved, date-stamped, combined into a slideshow, and burned
onto a DVD
DVDs containing the final slideshows are mailed to the patient every week along with a
satisfaction survey and a memory recall test
The subject/caregiver uses a pre-stamped envelope to return the completed test and survey to
the investigator

22. Subject
80-year-old, His caregiver
right-handed, Holds a was his wife,
married male master’s age 73, also a
Familiar with
in stage 4 of degree and is college
the use of cell
the FAST a retired graduate.
phones
scale (Mild military They had
Alzheimer’s) officer been married
[7] for 54 years
Patient at the
Hampton Roads Neurophysiology Clinic,
located in Virginia Beach, Virginia

23. Measurements
Repeatable Battery for the Assessment
of Neuropsychological Status (RBANS)
(before and after the interventions)
[8]
Subject Satisfaction Survey
(once a week)
Recent events memory recall test
(once a week)

24. Methods
Subject Satisfaction Survey (once a week, Likert scale 1 to 5)
 I feel comfortable wearing the smart phone around my neck
 The smart phone is invasive
 Seeing images from the slideshow brings back the memories of recent events
 I feel less anxious knowing that the smart phone is recording what I am doing
 I feel more relaxed in social situations because the slideshow will show me who
I meet
 Sharing past experiences through the slideshow with my family is a pleasure
 Watching the slideshow helps me deal with daily tasks better
 Recalling events with the help of the slideshow agitates me
 Watching the slideshow with my family is boring
 The slideshow has been a useful tool for my family
 The slideshow has been a useful memory aid for me
 The smart phone is easy to use

25. Methods
Recent events memory recall test (once a week, yes or no)

26. Results

27. Results
Subject Satisfaction Survey
 The subject did not have any problem wearing the
device
 The subject considered the slideshow a useful tool
for helping to live with persistent memory loss.

28. Results
 It is possible to capture one's real life experiences
without any involvement of the subjects.
 Pictures collected do represent an ensemble of the
important events occurred in the past.
 Pictures from smart phones may indeed be used as
an assistive device in the recall of recent events.

29. Limitations/problems
 Case study with only one subject
 Battery did not last the entire day
 Subject forgot to wear the device (one day)
 Smartcard was accidently disconnected (no
pictures for a week)
 Caregivers involvement is needed

30. Vision
 No more DVD. Images will be made available on
the web and subjects will look at them using tablets
 Surveys available on-line
 GPS capability
 The smart phone (camera, data connection, and
operating system) will be miniaturized and made
available in the form of jewelry or a tie pin

31. Vision
EMERGENCY HOSPITAL PRIMARY PREVENTIVE WELLNESS
CARE CARE CARE CARE
ACUTE
PATIENTS TRADITIONAL
BIOMEDICAL
CHRONIC MARKET SEGMENTS
PATIENTS
CITIZEN EMERGING MARKET SEGMENTS
CONSUMER NEXT GENERATION MARKET SEGMENTS

32. Research partners
 Eleonora Brivio, MS
Old Dominion University
 Scott W. Sautter, PhD, FACPN
Hampton Roads Neuropsychology
Virginia Beach VA
Project funded by:
The Virginia Center on Aging, Virginia
Commonwealth University, Richmond, VA (2008)

33. References
[1] Bower, Joseph L. & Christensen, Clayton M. (1995). "Disruptive Technologies: Catching
the Wave" Harvard Business Review, January–February 1995
[2] Alzheimer’s Association. (2011). 2011 Alzheimer’s disease facts and figures. Retrieved
from http://www.alz.org/downloads/Facts_Figures_2011.pdf
[3] Lee, M. L., & Dey, A. K. (2007). Providing good memory cues for people with episodic
memory impairment. In Proceedings of the 9th International ACM SIG ACCESS Conference
on Computers and Accessibility (pp. 131–138). New York, NY: ACM.
[4] Barclay, C. R. (1986). Schematization of autobiographical memory. In D. C. Rubin (Ed.),
Autobiographical memory (pp. 82–89). Cambridge, England: Cambridge University Press.
[5] Brewer, W. F. (1986). What is autobiographical memory? In D. C. Rubin (Ed.),
Autobiographical memory (pp. 25–49). Cambridge, England: Cambridge University Press.
[6] Harley, K., & Reese, E. (1999). Origins of autobiographical memory. Developmental
Psychology, 35, 1338–1348
[7] Sclan, S. G., & Reisberg, B. (1992). Functional Assessment Staging (FAST) in Alzheimer’s
disease: Reliability, validity, and ordinality. International Psychogeriatrics, 4(3), 55–69
[8] Randolph, C. (1998). Repeatable Battery for the Assessment of Neuro- psychological
Status (RBANS). San Antonio, TX: The Psychologi- cal Corporation.

34. References (who am I?)
[1] De Leo G, Ponder M, Molet T, Fato M, Thalmann D, Thalmann N, Bermano F,
Beltrame F. A Virtual Reality System for the Training of Volunteers Involved in
Health Emergency Situations. CyberPsycology & Behaviour, 2003; 6(3): 267-274.
[2] De Leo G, Krishna S, Boren S, Fato M, Porro I, Balas E A. Web and Computer
Telephone-Based Diabetes Education: Lessons Learnt from the Development and
Use of a Call Center. J Med Syst , 2005; 29(4):343-355.
[3] Boren SA, De Leo G, Chanetsa FF, Donaldson JF, Krishna S, Balas EA.
Evaluation of a Diabetes Education Call Center Intervention. Telemedicine
Journal and E-Health. 2006; 12(4):457-465.
[4] Kott K, Lesher K, De Leo G. Combining a Virtual Reality System with
Treadmill Training for Children with Cerebral Palsy. Journal of CyberTherapy &
Rehabilitation. 2009; 2(1): 35-42.
[5] De Leo G, Gonzales C, Battagiri P, Leroy G. A Smart-Phone Application and a
Companion Website for the Improvement of the Communication Skills of Children
with Autism: Clinical Rationale, Technical Development and Preliminary Results,
J Med Syst. 2011; 35:703-711.

35. Any questions?
Thank you
for your attention