SAMS - Software Architecture for Mental health Self management

Lead Research Organisation: University of Manchester
Department Name: Computer Science

Abstract

SAMS is a proposed 3-year project to that will investigate the potential for novel data and text mining techniques for detecting subtle signs of Cognitive Dysfunction that may indicate the early stages of Alzheimer's disease. Promoting self-awareness of change in cognitive function is will investigate the potential for novel data and text mining techniques for detecting subtle signs of change in cognition that may indicate the early stages of Alzheimer's disease. Promoting self-awareness of change in cognitive function is a key step in encouraging people to self-refer for clinical evaluation. A key motivation for SAMS, therefore, is to provide a non-invasive tool that helps develop such self-awareness.
An increasing number of older people, the group most at risk of cognitive dysfunction and dementia, regularly use the Internet to keep in touch with their families, particularly grandchildren. This Internet activity presents an opportunity to harness rich, routinely available information that may contain indications of changes in the linguistic, executive and motor speed abilities in older people.
Development work is needed to develop the software to harness this opportunity, to establish the optimal thresholds for flagging up important changes in cognition and the optimal methods for feeding this information back to individuals. SAMS will validate thresholds by examining changes in performance in people with established cognitive dysfunction and mild Alzheimer's disease and begin to explore the potential for technology-enhanced detection of early cognitive dysfunction. Patterns of computer use and content analysis of e-mails, such as forgetting topics, expressions of concern, emotion, etc., will be analysed and coupled to feedback mechanisms to enhance users' cognitive self awareness, empowering them self administer follow up tests and decide when to self refer themselves for expert medical advice.
Tackling cognitive change detection requires the novel pooling of knowledge and integration of techniques from different sub-disciplines within a Computer Science. In addition to developing techniques for MCI detection and supporting self-referral, an explicit goal of the research is to develop a generic sense making and user-centred feedback architecture. This could be applied to a wide range of problems where interpreting computer use may be appropriate, e.g. mental health, social loneliness, privacy and social exploitation.
 
Description To date, we have undertaken a requirements elicitation exercise that has helped us understand the features that are essential of the SAMS software is to be accepted and used by its target user group. As a side-effect, we have had to develop a novel mix-mode requirements elicitation technique for home healthcare-monitoring systems for senior users. As of the end of 2015, the SAMS software has been installed on 32 consenting older adults' home computers and is logging encrypted and anonymised data collected from computer use to a server running in Lancaster University (with planned mirror at Manchester). The SAMS software has been engineered to work across a range of operating systems, applications and web browsers. A great deal of effort was devoted to making it robust and resilient and benign with respect to its affect on users and their use of their computers. Analysis of this data is being informed by the results of an earlier (also in 2015) cross-sectional study in which cohorts of healthy adults and people with Mild Cognitive Impairment or early Alzheimer's Disease performed a set series of tasks on a computer. Early analysis of the results suggests marked differences in performance between the two cohorts in terms of (e.g.) speed of completing tasks. The data from the longitudinal study is still in progress. There is a large volume of data to analyse. The text analysis too completed near the end of the project (SNOWCAT - see Software) has now been validated on two previous studies in the literature; one on novels and one on press conferences. This has broadly confirmed the findings of these earlier studies but also revealed that propositional density is not a reliable indicator of language decline in dementia, as was suggested in a third earlier study.
Exploitation Route The requirements elicitation method is likely to have applications to other discretionary use software systems, particularly those that are in affect-laden domains such as mental health monitoring. The SAMS monitoring software and the overall systems architecture of which it forms a part could serve as a reusable resource for other projects. Indeed it is planned to use it for logging eye-movement data in EP/M006255/1.
Sectors Digital/Communication/Information Technologies (including Software),Healthcare

 
Title The SAMS system 
Description SAMS monitors computer interaction to identify early signs of the onset of cognitive decline that may signal the development of dementia. At the end of the SAMS project, the SAMS monitoring system (See under Software) had been deployed to over 30 older adult users's Windows computers, and data collected over a c. 8-month period. This data is still being analysed, but the data itself forms a potentially valuable resource for other researchers. 
Type Diagnostic Tool - Non-Imaging
Current Stage Of Development Initial development
Year Development Stage Completed 2016
Development Status On hold
Impact The impacts to date relate to the development of monitoring software, interns of: - software architecture - privacy and security - software reliability - user requirements The understanding that has been developed is likely to be of benefit to developers of ambient healthcare monitoring systems. 
 
Title SAMS monitoring system 
Description The SAMS monitoring system runs as a background application on Windows 8 and Windows 10 machines, collecting a variety of data on user interactions with the operating system and with a range of Windows applications. Any users on whose computer the SAMS software runs are assigned a unique identifier by a designated member of the SAMS clinical research team. The collected data is tagged with this user ID and stripped of all other information that could be used to identify the user. It is then encrypted and periodically uploaded to a server. The server stores the data securely for use by the SAMS research team. Only the designated members of the clinical research team is able to associate the user IDs with which the data is tagged with the actual user identity. 
Type Of Technology Software 
Year Produced 2016 
Impact To date impact is listed to research publications as the software is tailored to the goals of the SAMS project. There have been discussions about using it for new mental and brain health research projects but these are still at an early stage. 
 
Title SNOWCAT 
Description SNOWCAT is a tailored integration of several text analysis techniques to detect signs of decline in language consistent with dementia. Given a set of documents (e.g. diary entries over a period of months), a range of metrics is produced that summarise the author's use of language. 
Type Of Technology Software 
Year Produced 2016 
Impact To date, replication of published analyses of novels and press conferences. 
 
Description 'From Click to Cognition: Using daily computer use data to detect cognitive change in elderly people', 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Health professionals
Results and Impact Talk sparked questions and discussion afterwards

None as yet
Year(s) Of Engagement Activity 2014
URL http://www.globaleventslist.elsevier.com/events/2014/02/dementias-2014-16th-national-dementias-confe...
 
Description Institute of Brain Behaviour and Mental Health Postgraduate Summer Showcase, The University of Manchester (2016). 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact Poster presentation; Institute of Brain Behaviour and Mental Health (IBBMH), Postgraduate Summer Showcase, The University of Manchester (2016).

Stringer. G., Brown, L., Montaldi, D., and Leroi, I. Can you detect Alzheimer's from an email? Measuring computer use behaviours to detect functional impairment in early dementia.

Dissemination to PG students and academics.

AWARDS:
1st place for best oral presentation in the IBBMH postgraduate showcase (June, 2016).
3rd place for best poster in IBBMH as part of the Postgraduate Summer Showcase, The University of Manchester (2016).
Year(s) Of Engagement Activity 2016
URL https://www.researchgate.net/publication/305264513_Can_you_detect_Alzheimer%27s_from_an_email_Measur...
 
Description Oral presentation (Couth) - International Psychogeriatrics Association International Congress 2016. San Francisco, USA. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Oral presentation - International Psychogeriatrics Association International Congress 2016. San Francisco, USA.

Couth, S., Stringer, G., Gledson, A., Mellor, J. and Leroi, I. (2016) Detecting changes in computer-use behaviours as an indicator of early cognitive decline: a feasibility study. International Psychogeriatrics Association International Congress 2016. San Francisco, USA.

Dissemination to peer community - IPA's fundamental role is to connect geriatric mental health care professionals with one another so they can share information, exchange ideas, and collaborate to provide better mental health for older people.
Year(s) Of Engagement Activity 2016
 
Description Oral presentation (Couth) - The British Society of Gerontology 45th Annual Conference, University of Stirling, UK. (2106) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Oral presentation - The British Society of Gerontology 45th Annual Conference, University of Stirling, UK.

Couth, S., Stringer, G., Leroi, I., Sutcliffe, A., Montaldi, D., Poliakoff, E., McDonald, K., Rust, J., Thompson, J., Bruno, D. and Brown, L. (2016) Identifying computer-use behaviours that could indicate cognitive decline: insights from an expert reference group. Oral presentation (by Brown, L.).

Dissemination to specialist peer community - Conference is a key event in aiming to enhance knowledge about ageing and later life.
Year(s) Of Engagement Activity 2016
 
Description Oral presentation (Stringer) - International Psychogeriatrics Association International Congress 2016. San Francisco, USA. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Oral prsentation - International Psychogeriatrics Association International Congress 2016. San Francisco, USA.

Stringer, G., Couth, S., Brown, L., Gledson, A., Mellor, J., Sutcliffe, A., Sawyer, P., Keane, J., Bull, C., and Leroi, I. (2016). Can you detect Alzheimer's from an email? Measuring computer use behaviours to detect functional impairment in early dementia.

Dissemination to peer community - IPA's fundamental role is to connect geriatric mental health care professionals with one another so they can share information, exchange ideas, and collaborate to provide better mental health for older people.
Year(s) Of Engagement Activity 2016
 
Description Oral presentation (Stringer) - The British Society of Gerontology 45th Annual Conference, University of Stirling, UK. (2016) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Oral presentation - The British Society of Gerontology 45th Annual Conference, University of Stirling, UK (2016)

Stringer, G., Brown, L., Leroi, L. and Sikkes, S. Capturing declining daily activity performance in a technologically-advancing older population: UK cultural validation of the Amsterdam IADL Questionnaire.

Dissemination to specialist peer community - Conference is a key event in aiming to enhance knowledge about ageing and later life.
Year(s) Of Engagement Activity 2016
 
Description Poster presentation - ARUK conference, Manchester, UK (2016). 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Alzheimer's Research UK Conference, 2016 - poster presentation

Stringer, G. and Couth, S. on behalf of the SAMS study team. The SAMS Project: A protocol to capture early changes in cognitive and functional ability detected by daily computer use.

Dissemination to specialist peer community at the UK's largest dementia research conference.
Year(s) Of Engagement Activity 2016
URL https://www.researchgate.net/publication/298318348_The_SAMS_Project_A_protocol_to_capture_early_chan...
 
Description Using technology in the detection and management of cognitive impairment: the Manchester experience (Nice, France; Nov 2014) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Talks sparked questions and discussion afterwards

None as yet
Year(s) Of Engagement Activity 2014
URL http://www.innovation-alzheimer.fr/ia-workshop-2014-november-6-2014-institut-claude-pompidou/