[top] - [introduction] - [what is dementia] - [discomfort] - [main goal] - [progress]

Introduction

Epidemiological research shows that 5% up to 10% of the population older than 65 years is suffering from dementia. With the increased live-expectation, the chance of obtaining dementia, are increasing too. Based on the results of the Belgian National Institute for Statistics the prevalence (the ratio of number of diseased to the number of healthy subject within a certain age group) is increasing exponentially starting with the age of 65 years and it doubles each 5 years from than on. So with ageing of the population there is a strong increasing of patients with dementia.

[top] - [introduction] - [what is dementia] - [discomfort] - [main goal] - [progress]

What is dementia?

Dementia is a syndrome which implies a smoothly decline of the intellectual power. It's not some kind of disease but a clinical syndrome or a complete set of symptoms which can be affected by several disease.
Sometimes, the ageing will be fastened by different kinds of brain damage, which mostly starts at one typical place in the brain.

The current identification guidelines for psychiatric disorders, the DSM (Diagnostic and Statistical Manual of Mental Disorders), describes the criteria to classifies different levels of dementia. The different levels are: mild dementia, moderate dementia and serious dementia.

mild dementia

Dementia will be diagnosed from the moment on that the professional activities of the person/patient are disturbed with cognitive distortions. In this case, the activities of the patient  are disturbed, but he/she can still live independently. In this stage, the demented patient still can do the daily care handlings by themselves.

moderate dementia

It will become tougher to live independently for the patient with moderate dementia. Some daily activities are hard to perform and the cognitive distortion will become more visible. The memory problems are getting more severe and speaking is difficult to perform. This stage of dementia requires supervision of care givers.

serious dementia

In this stage the patient are completely dependent of the caregivers/nursing staff. They are bedridden and not able to verbally communicate with their environment. These patients become incontinent and have multiple medical problems.

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Discomfort

One important and underestimated aspect is discomfort (pain) in this group of patients. Several studies prove that about 70% of the people living in nursing homes struggle with pain. Almost half of them have chronically pain (Hall-Lord et al. 2003). Recognition of pain is therefore an important issue for the care-givers.
By patients with normal communication possibilities a pain scale, based on an list of questions, can be used to indicate their pain level. Therefore there is a need for an additional non-verbal method to detect discomfort (pain) by serious demented patients. The only way they communicate is by facial expressions. It has been shown that facial expressions are even more correlated with physiological indicators of pain than e.g.: heartbeat and blood pressure (Hadjistavropoulos et al., 2002).

[top] - [introduction] - [what is dementia] - [discomfort] - [main goal] - [progress]

Main goal

In the current situation discomfort is monitored by the caregivers by inspecting the body language, especially the facial expression. The disadvantage of this approach is that it is subjective and discontinuous in time. Therefore there is a need to automatically quantify discomfort on a continuous and objective bases.

The purpose of this project is to monitor the non-verbal expressions of patients with server dementia by means of a vision system (cheap and compact video camera’s) and to identify discomfort in real time by means of pattern recognition techniques.

An on-line monitoring tool must enables care givers to intervene immediatly when discomfort occurs.

[top] - [introduction] - [what is dementia] - [discomfort] - [main goal] - [progress]

Progress

The first step is to set up a vision system which monitors the patients and stores the images (video). These images are then marked, by pain experts to quantify the pain (discomfort). This gold standard data-set, is used to develop pattern recognition algorithms which identify discomfort and which run in real-time.

[top] - [introduction] - [what is dementia] - [discomfort] - [main goal] - [progress]