segunda-feira, 24 de julho de 2017

6- Smart Systems to support elderly

Lonely elderly – depression – apps – smartphones – embedded systems

How these words are connected and how we can develop smart systems to help elderly don’t fall in depression?

Here you can find a brief discussion and some insights about this relevant topic.


We are experiencing an important demographic change around the world, with the increase of elderly people in our society[1]. In the United States, the elderly population has grown 10-fold within the last century. According to projections by the US Census Bureau, about 1 in 5 Americans would be considered elder by the year 2030.
Depression is a mental health disease which is characterised by having a depressed mood or a loss of interest and pleasure in daily activities[2]. Most importantly, it disrupts the normal functioning of a person. There are multiple proposed underlying mechanisms which cause depression. One of them is Beck’s classic cognitive triad theory[3]. Beck believes depression is the result of a downward spiral of negative views about oneself, the world and the future. The subjective and often faulty perception of the individual plays a key role in maintaining a depression.
Another classic theory is the hopelessness theory proposed by Abramson, Seligman and Teasdale[4]. This theory assumes that depression-prone individuals often see themselves as the cause for negative events. Whenever positive events occur, they are often seen as caused by others or external events. This attributional style causes individuals to take the blame for all negative events and leads to feelings of hopelessness about the future which in turn promotes depression.     
This phenomenon brings many economic impacts and also the increasing sensibility of society to provide a happy and healthy life for elderly. There are organisations and companies that offer very useful teleassistance services in many communities around the world. For the most part, these services are based on the demand by the user by simply pushing a button on a small device that he/she carries on him/her[5].

What are symptoms of depression in elderly?

What are the reasons behind depression among elderly?

What is being done at this moment in order to prevent depression?

Smart Systems to support elderly

Many smart systems are being developing to support people, few to support elderly don’t fall in depression. Here you find some start hints that could help to develop such systems. The design attends to specific conditions: Elderly, Living alone and be aware of his vulnerability condition, what means that he is engaged in a help group because of his historic prognostic of depression. The stakeholders are: the person, the family, the help group and the automatic house system. Figure 5 shows the workflow of system and the link among stakeholders.

Figure 5: System workflow.
In Figure 5, the yellow tones represent stakeholders, while blue blocks are aspects of the system. The model is presented in blocks highlighted in red. The system monitors elderly, evaluating the level of depression according to with his activities and contact with other stakeholders. The model decides by continue monitoring his behaviour or if is necessary act directly in elderly or activating the other stakeholders.

How to evaluate depression and translate to code and actions.

Based on the previously described symptoms, it is possible to define some strategies in order to estimate the depression level of people. This requires using sensors that are installed in home and forms to evaluate the current mood of people. Combining the method established by American Psychiatric[6] mixed with input values collected from the system, some thresholds are established to infer the risk of the beginning of a depression process. The risk is based on quantity of events by period of time. An event is the detection of one of symptoms described in Table 1. While external factors are related to weather, economy, particular situations that could mask or push a depression situation.
   (2 events or less + (external factors)) in 2 weeks: pre-depression - stage 0.
   (3 events + (external factors)) in 2 weeks: starting pre-depression process - stage 1.
   (4 events + (external factors)) in 2 weeks: pre-depression - stage 2.
(5 events + (external factors)) in 2 weeks: eminence of depression - stage 3.

If you want know more about the actions and the backend system, visit:

[1] United Nations, "World population ageing 2013", Department of Economic and Social Affairs 2013.
[2]  DSM-IV
[3] Beck, A.T. (1970). The core problem in depression: The cognitive triad. In J.H. Masserman (Ed.), Depression: Theories and therapies (pp. 47-55). New York: Grune & Stratton
[4] Dykman, B., & Abramson, L. (1990). Contributions of Basic Research to the Cognitive Theories of Depression. Personality and Social Psychology Bulletin,16(1), 42.
[5] Aguilera, S., Colas, J., Campos, E., "Multi Functional Call Center for Disabled and Elderly
People. Assistive Technology Shaping the future", In AAAT 2003.
[6] American Psychiatric Association, “Diagnostic and Statistical Manual of Mental Disorders”, Fifth Edition, 2013.

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