Skin Health and Alzheimer’s – Huh?

Wow, check this out: an app for something other than Millennials’ games or pictures, which will actually work to improve Alzheimer’s care. The new app – the “Itch Tracker” – is an innovation from Nestle Skin Health to help detect and diagnose deteriorated skin among older adults, which can be the source of sores and infections exacerbated by scratching. This is especially problematic in cognitively impaired patients, including those with Alzheimer’s – making the Itch Tracker a potentially critical tool for Alzheimer’s and elder care.

Yes, older adults’ skin health is much more serious than you might have thought. This was the starting hypothesis for the Itch Tracker, which uses the Apple Watch to help elder caregivers understand how aging, dry, older skin can cause serious conditions like atopic dermatitis, xerosis, pruritus, and severe skin sores. In fact, such irritating, painful conditions may exacerbate the agitation and behavioral changes common among Alzheimer’s patients. A recent study found that more than 70% of dementia patients had dry skin, and that those in later disease stages often could not communicate about their discomfort. Then, perhaps, even a simple solution like better skin hydration, especially pre-hospitalization, could be the answer to that agitated state that can be so challenging for caregivers and healthcare providers.

Not surprisingly, the idea for the innovation was hatched in Japan, where the birth rate has plummeted to a stunning 1.2 births per woman, creating one of the oldest populations on the planet. This is the nation, after all, where there will be more adult diapers than baby diapers by 2020. In response, Japan is fast becoming the home for innovative technology solutions for the perils of aging, including tech like apps, robotics, and artificial intelligence.

Alzheimer’s is one of the most devastating of these problems, for both individuals and society. As a consequence of Japan’s longevity, the country faces an immense Alzheimer’s challenge. The risk of Alzheimer’s is roughly 8-1 for those over 65 and escalates to about 2-1 for those over 85, which is the fastest growing demographic both in Japan and the U.S. Due to Japan’s longevity and aging population, Alzheimer’s has already become a public health crisis and fiscal nightmare for the nation. So why wouldn’t Japan create incentives and encouragement to apply innovation across the spectrum, including skin health, for that 40% of their population over 60? Japan is also an important example and pioneer for the whole planet, as all countries with aging populations will have to tackle similar challenges in the near future.

The Itch Tracker project began late last year through Nestle Skin Health’s innovative SHIELD Center in Japan to determine if this innovation in support of elder caregivers could be used to test their hypothesis about skin health and Alzheimer’s. So far, it’s proving true: Alzheimer’s patients using the Itch Tracker application, particularly during sleep, reveal a closer correlation between care management and skin health. Moreover, through the project and the unique SHIELD approach to education and investigation, enough data is emerging to warrant further study. The results will be presented at the Alzheimer’s Disease International Global Annual Meeting in Kyoto at the end of the month and then further explored at the end of July at the International Association of Geriatrics and Gerontology (IAGG) four-year Conference in San Francisco.

The innovation is a good example of an idea that connects dots not normally connected – one of the hallmarks of the Nestle Skin Health SHIELD Center. Experts and leaders in Alzheimer’s care management were immediately interested, seeing the idea as a potential breakthrough for the mysteries surrounding patients’ agitation. Similar innovations include the proven link between oral health and Alzheimer’s, where it was found that the presumed “normal Alzheimer’s agitation” was really gum and teeth problems the patients could not explain. The Itch Tracker applies a similar idea to the skin.

The Itch Tracker is on track to soon come to market to enable family members, elder caregivers, geriatricians, and nurses to begin to more clearly separate “Alzheimer’s agitation” from the problems of aging skin – and then channel solutions. As one of the leading researchers on the project, Dr. Toshiya Ebata, Director of Chitofuna Dermatology Clinic, Tokyo and Secretary of the International Forum for the Study of Itch, said, “Until now, it has been difficult to evaluate itch objectively…the Itch Tracker is a new and exciting tool for its potential to provide a scratch measurement for everyone, as well as provide important data to researchers.” Dr. Ebata and others on the project contemplate using this new technology application to detect, identify and then stop the vicious cycles of “itch-scratch” that not only impairs quality of life, but often leads to skin deterioration in frail elderly adults. This can cause dangerous infections, and it also explodes costs due to increased hospitalization, physician visits, and care management.

So, if we can learn anything from the Nestle Skin Health SHIELD project utilizing the Apple Watch, it’s that we are only at the beginning of leveraging existing technology to address the huge health and social challenges of demographic aging and longevity. Surely, the app that my daughter uses for fun and games is bringing happiness to her life; equally, if these apps can bring peace of mind through healthier aging, we will have passed a threshold where Silicon Valley and aging Japan can learn together. And, in the process, encourage even more invention and collaboration to realize the potential of 21st century longevity.

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