Magdalena Kolanko

Nan Fletcher-Lloyd, Alina-Irina Serban, Magdalena Kolanko et al.

Malnutrition and dehydration are strongly associated with increased cognitive and functional decline in people living with dementia (PLWD), as well as an increased rate of hospitalisations in comparison to their healthy counterparts. Extreme changes in eating and drinking behaviours can often lead to malnutrition and dehydration, accelerating the progression of cognitive and functional decline and resulting in a marked reduction in quality of life. Unfortunately, there are currently no established methods by which to objectively detect such changes. Here, we present the findings of an extensive quantitative analysis conducted on in-home monitoring data collected from 73 households of PLWD using Internet of Things technologies. The Coronavirus 2019 (COVID-19) pandemic has previously been shown to have dramatically altered the behavioural habits, particularly the eating and drinking habits, of PLWD. Using the COVID-19 pandemic as a natural experiment, we conducted linear mixed-effects modelling to examine changes in mean kitchen activity within a subset of 21 households of PLWD that were continuously monitored for 499 days. We report an observable increase in day-time kitchen activity and a significant decrease in night-time kitchen activity (t(147) = -2.90, p < 0.001). We further propose a novel analytical approach to detecting changes in behaviours of PLWD using Markov modelling applied to remote monitoring data as a proxy for behaviours that cannot be directly measured. Together, these results pave the way to introduce improvements into the monitoring of PLWD in naturalistic settings and for shifting from reactive to proactive care.

Honglin Li, Roonak Rezvani, Magdalena Anita Kolanko et al.

Behavioural symptoms and urinary tract infections (UTI) are among the most common problems faced by people with dementia. One of the key challenges in the management of these conditions is early detection and timely intervention in order to reduce distress and avoid unplanned hospital admissions. Using in-home sensing technologies and machine learning models for sensor data integration and analysis provides opportunities to detect and predict clinically significant events and changes in health status. We have developed an integrated platform to collect in-home sensor data and performed an observational study to apply machine learning models for agitation and UTI risk analysis. We collected a large dataset from 88 participants with a mean age of 82 and a standard deviation of 6.5 (47 females and 41 males) to evaluate a new deep learning model that utilises attention and rational mechanism. The proposed solution can process a large volume of data over a period of time and extract significant patterns in a time-series data (i.e. attention) and use the extracted features and patterns to train risk analysis models (i.e. rational). The proposed model can explain the predictions by indicating which time-steps and features are used in a long series of time-series data. The model provides a recall of 91\% and precision of 83\% in detecting the risk of agitation and UTIs. This model can be used for early detection of conditions such as UTIs and managing of neuropsychiatric symptoms such as agitation in association with initial treatment and early intervention approaches. In our study we have developed a set of clinical pathways for early interventions using the alerts generated by the proposed model and a clinical monitoring team has been set up to use the platform and respond to the alerts according to the created intervention plans.

Honglin Li, Magdalena Anita Kolanko, Shirin Enshaeifar et al.

Machine learning techniques combined with in-home monitoring technologies provide a unique opportunity to automate diagnosis and early detection of adverse health conditions in long-term conditions such as dementia. However, accessing sufficient labelled training samples and integrating high-quality, routinely collected data from heterogeneous in-home monitoring technologies are main obstacles hindered utilising these technologies in real-world medicine. This work presents a semi-supervised model that can continuously learn from routinely collected in-home observation and measurement data. We show how our model can process highly imbalanced and dynamic data to make robust predictions in analysing the risk of Urinary Tract Infections (UTIs) in dementia. UTIs are common in older adults and constitute one of the main causes of avoidable hospital admissions in people with dementia (PwD). Health-related conditions, such as UTI, have a lower prevalence in individuals, which classifies them as sporadic cases (i.e. rare or scattered, yet important events). This limits the access to sufficient training data, without which the supervised learning models risk becoming overfitted or biased. We introduce a probabilistic semi-supervised learning framework to address these issues. The proposed method produces a risk analysis score for UTIs using routinely collected data by in-home sensing technologies.