Award Title: Healthy cognitive ageing: Empowering older adults through self-testing
Funder: Economic and Social Research Council

Abstract: Older adults experience cognitive deterioration from 50 years on, affecting work, daily activity, and quality of life. With 12.3 million (19%) in the UK aged 65+, rising to 25% by 2050, we need sustainable, effective ways to identify cognitive changes and keep older adults active, social, and productive. This is impeded by inadequate NHS resources and flawed methods. We will solve this by developing an online cognitive test for older adults to use at home with a standard computer / laptop and webcam, providing instant results and guidance to manage cognitive changes. By 12 months, we will develop a functioning prototype.

We know which tests pick up cognitive changes in older adults in lab conditions. Here, we will be using this knowledge to develop an accessible online test for older adults. This will empower them to self-monitor their cognition and take steps to maintain quality of life and independence, much as self-testing blood sugar levels empowers people with diabetes. 

Accordingly, we have three key aims:

1) Iteratively develop a combination of tasks for the test which minimises burden and duration for the end-user, while maximising effectiveness and accuracy of outcomes.

2) In parallel, collaborate with the steering committee to maximise test accessibility, acceptability, desirability, and useability.

3) Work with the steering committee to develop guidance and reports for test users, to ensuring these are meaningful for older adult users and services they use for support.

Completing these aims will enable us to produce a functioning online cognitive test prototype. For a sustainable product, during the Award we will explore routes to market using expertise from Zinc, input from our Innovation / Commercial teams, and exploring connections with industry specialists. This may also involve founding a spin-out company and seeking third-sector adoption, possibly by selling test licences to appropriate third-sector bodies for clients / members. A second option is self-pay, which enables further user testing. A third, longer-term possible goal is exploring NHS partnership via organisations like NHS Providers and Public Digital. Due to the nature of the Healthy Ageing Catalyst award, these later objectives are not yet concretely defined and will be clarified as the project progresses with the help of the Zinc support programme.

Lay Abstract: From around age 50, people experience increasing problems with thinking ("cognition"), and 1 in 5 go on to develop diagnosed cognitive impairment. In our ageing population, rising numbers of older people are experiencing worsening problems with memory, concentration, and multitasking. Without support, this increasingly affects day-to-day life. As average retirement age rises, it also prevents older adults from maintaining skilled work. This affects individuals' activity and wellbeing, and employers lose critical skills and experience from their workforce. 

Accordingly, identifying these cognitive problems in older adults is crucial to helping them access support, continue working, and fully enjoy life. However, NHS resources cannot assess all older adults for potential cognitive changes. Here, we outline a new approach to identifying cognitive problems, while minimising reliance on stretched healthcare resources.

We will develop an online-access cognitive test for older adults, which can be self-administered at home to test and track cognitive changes. The test will use simple computer-based tasks which are already individually proven to detect changes in memory, concentration, and multi-tasking. This will allow older adults to independently self-test their cognition, as people with diabetes check their blood sugar, without attending specialist clinics.

The test will produce results meaningful to the older person, healthcare professionals, and workplace support systems like occupational health. It will provide results-based recommendations, such as signposting to support services, or using practical, brain-training and social strategies to help manage cognitive changes. We aim to empower older adults to monitor their own cognitive wellbeing, and to identify those needing support to reduce avoidable impact on their wellbeing and work.

Research Activity Codes: 7.1 INDIVIDUAL CARE NEEDS
Health Categories: MENTAL HEALTH