A monitoring device to objectively assess functional/ psychosocial impairment in older-age adults with major depression

Depression is one of the most common psychiatric disorders, being the fourth highest cause of disability worldwide. In later-life, depression can have a huge negative impact on quality of life and can affect many different aspects of day to day living and social relationships. As well as suffering from low mood, many individuals with depression show a reduced ability to think, plan and concentrate and it is thought that these problems may link directly to the problems with day to day living. This is an important link to study and understand, however there are problems in how accurately measurements of daily activity and social interactions can be obtained. This research project intends to develop a device that can be worn by an individual and will measure very accurately the amount of activity and interactions with others (but to protect the privacy of people, the device will not record actual conversations). This, for the first time, will allow researchers to precisely examine how different aspects of depression, such as low mood and reduced thinking ability, relate to day to day living and social interactions. Because of particular problems in these areas, the present project will focus on older age people but this device will have potential applications in many other areas in the future.

Depression is one of the most common psychiatric disorders, with at least one in six adults meeting the criteria for a major depressive episode at some time in their life. In later-life depression has a huge negative impact on quality of life and is directly associated with functional impairment. Although the illness is defined by the occurrence of low mood, over recent years there has been an increasing understanding of the profile and magnitude of neuropsychological impairments in mood disorders. These have been shown to be of greater magnitude in older age individuals. One of the most important consequences of neuropsychological and emotional processing deficits is their impact on social and everyday functioning and disability. To date, most studies in older age individuals have utilised questionnaire-based measures of everyday function which have major problems with accuracy and validity as they either rely on informant accounts or are self-report. Technological advances such as the actigraph have enabled more precise assessment of locomotor activity and circadian rhythms in normal, everyday living, while within the pervasive computing community, social informatics technologies based on auditory signal processing have been developed that can measure aspects of social interaction using situated measures of spoken communication. The aims of this pilot study are to develop a truly novel, sensitive worn monitoring device that integrates direct measures both physical activity and social interaction, to use these measures to examine daily activity and social interaction in older age individuals. The instrument will be piloted in older healthy individuals and then depressed patients and the relationship between the device output and illness features, clinical characteristics and neuropsychological performance explored. These results will be compared to those achieved using current measures of social function and activity.