Nic Fleming 

How wearable cameras can help those with Alzheimer’s

The wearable camera is being touted as the latest must-have accessory for social-media obsessives, but is a real boon for helping people with serious medical conditions recall important events in their lives, writes Nic Fleming
  
  

The Microsoft Research SenseCam automatic wearable camera
The Microsoft Research SenseCam has spawned a new generation of technology aimed at tech-savvy twentysomethings. Photograph: PR

Some people hang out with their friends on yachts or play pool with pretty girls. Others like to go on treetop zip-wire adventures and holiday on wooded Thai islands. These examples of images on the websites of Autographer and Narrative Clip, two leading wearable cameras, reveal the kind of things their makers imagine we might do with their devices.

These gadgets automatically snap hundreds of photos per day from their user's perspective. The much-awaited Google Glass, expected to go on general sale within months, will be able to do the same thing. Some believe future historians will peg 2014 as the dawn of the "life-logging" era, in which many or even most of us will carry devices that record images or video of our daily lives.

Beyond the huge privacy implications, the big question is: can this technology improve our lives? For the current market leaders, it is about providing tech-savvy twenty- and thirtysomethings with a way to generate automatically digital photo albums of unprecedented detail and supercharging their social media-sharing capabilities. Some "self-quantifiers" are already using continuous image-gathering as part of personal improvement projects such as losing weight or boosting their productivity.

But such applications are far removed from those envisaged by the technology's early developers, who set out to create visual aids for people with failing memories. And those pioneers may yet be vindicated. Early research suggests that these devices can not only help those with amnesia and dementia recall important events, but may also be able to improve their memory abilities.

One of those innovators was Lyndsay Williams, who probably has the best claim to have been the first to come up with a device capable of taking large numbers of still images automatically. In 1999, shortly after having joined Microsoft Research Cambridge, she attached a digital camera linked to an accelerometer to her bicycle's basket. Her "SenseCam" was designed to take pictures when she was forced to brake hard, in order to capture the details of careless drivers. Williams had temporarily lost six months of memories as a result of being the victim of a hit-and-run road accident aged 17, and she hoped her invention could help others in the same boat. "After that bang on the head I couldn't remember whether I'd been to a concert I had a ticket for or whether I'd done my exams, so I was keenly aware of the frustration of memory difficulties," says Williams, now an independent design consultant. "I also wanted to help a friend who was always losing their keys and their spectacles."

In March 2004, Microsoft filed a patent application for a "recall device" that could help "a victim of Alzheimer's disease and his/her care-giver to reconstruct a portion of the individual's daily activity". Researchers at Addenbrooke's hospital's memory clinic began a collaboration with nearby Microsoft Research in Cambridge to investigate the technology's potential for its patients.

In a case study published in 2007, they revealed that a 63-year-old librarian known as Mrs B, who had amnesia caused by a brain infection, could recall more than 80% of key facts about significant events after a fortnight of reviewing SenseCam images every couple of days and that a similar level of recall persisted for months after she stopped looking at the pictures. This compared with being able to recall just under half of the details using a written diary and no recall at all without either intervention after five days.

Two years later, they published a study in which Mrs B showed increased activity in the parts of the brain linked to experiences associated with time and place, known as episodic memories. They concluded that the device could provide cues that help bring back stored but inaccessible memories, including thoughts, feelings and occurrences not in the images themselves.

This finding was reinforced by work with Jonathan Eason, a politics student who suffered amnesia, anxiety and depression after being assaulted by two strangers. In the same year, the Addenbrooke's-Microsoft Research group reported that a Mrs W, who had memory problems, was able to recall twice as much detail about events six months old when she viewed streams of SenseCam images over two weeks compared with discussing a written diary for the same amount of time.

The first study involving a number of Alzheimer's patients was published earlier this year by an Addenbrooke's team led by neuropsychologist Dr Emma Woodberry. Six patients with mild to moderate Alzheimer's were able to recall an average of 85% of key factual details about events after a fortnight of viewing SenseCam images every other day. When this was replaced by discussion of a written diary, this fell to 56% and with no intervention it was 33%. Three months later, without any image-viewing, they could still recall an average of just under half of key details, more than three times better than when using a diary.

"Sharing experiences with loved ones is really important to our sense of wellbeing, identity and closeness with the people we love," says Woodberry. "Losing that is debilitating and has a profound effect on your relationships. It's too early to say whether it can slow progression of Alzheimer's, but I think it can improve quality of life in the here and now."

Dr Doug Brown of the Alzheimer's Society believes larger studies are needed. "These findings are interesting but the study is too small to draw any firm conclusions about whether this particular technology is something that we should make widely available to people with dementia, but it's an area that warrants further investigation." His wish could soon be granted: two larger trials are being conducted in France and Portugal.

Others are not only more bullish about the technology's ability to help patients cope day to day, but believe it can have more profound, longer-term effects. A decade ago, Claire, a nurse who lives in Cambridgeshire, awoke from a coma brought on by viral encephalitis, an infection that affects the brain. Then aged 43, she no longer recognised the five people around her bedside as her husband, Ed, and their four children and remembered nothing except some vague childhood memories.

She began using a SenseCam several years ago as part of research led by Dr Catherine Loveday, a cognitive psychologist at the University of Westminster. She uses it most days and views sequences of the images to help her in various situations, such as when she is about to meet a friend. "It can be the oddest little thing in the corner of a picture or somebody's expression that triggers a memory," she says.

"In my friendships, I often feel inadequate because the other person knows about me and the parts of our lives we've shared and I can't remember a single thing about them, their families, or things they might have told me about yesterday. Looking over the images gives me a feeling that I can feel part of our friendship and a tremendous sense of security." Claire is now able to retain recent memories of events as a result of repeated viewings of SenseCam images of them.

Loveday believes pictures from the device help cue recall because they are similar to the snapshots of moments we store and stitch together into narratives to form our natural autobiographical memories. "We think viewing the images in sequence triggers activity in the same brain circuits that were triggered when you first experienced the events and that by doing so repeatedly you can prod the memory into consciousness. I think anyone who has a problem with memory could get a good degree of day-to-day support from using this technology, and, although the evidence is too limited to say for sure at the moment, I think that for some people there is also the possibility that it could lead to recovery of some function."

These encouraging early findings led UK company Vicon Motion to license the technology from Microsoft and launch it in 2010 as the Vicon Revue, a £500 device aimed mainly at people needing memory aids. However, sales were disappointing and it stopped selling the device in 2012. The newer Autographer, marketed more as a visual diary gathering tool, is also based on SenseCam, using sensors to identify action and trigger picture-taking.

Steve Hodges, who leads Microsoft Research Cambridge's sensors and devices group, believes it won't be long before the use of wearable cameras by those with memory loss becomes commonplace.

"Sometimes, an inventor comes up with the perfect solution but the world isn't quite ready for it," he says. "This technology has great deal of potential for those with memory problems and as the devices become more acceptable and commonplace, and they get cheaper and storage and access technologies become more mature, I think we'll see larger trials and more patients using it."

 

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