SMART: Self-Monitoring, Ability-Reactive Technology for Age-Related Macular Degeneration

EAS Article
Figure 1: Example of how a subway map might be viewed through an eye affected by AMD [generated using www.inclusivedesigntoolkit.com].

In the UK, over the past 25 years, there has been a sharp increase in the percentage of the population aged 65 and over - a trend expected to continue . Physical and sensory impairments that accompany ageing have significant impact on older adults’ independence and quality of life. Amongst those are also individuals with degenerative disabilities whose needs and capabilities change over time. Several studies have identified the main barriers for the use of technology by older adults to be the lack of understanding/consideration of the needs of those users with different levels of physical and sensory impairments. In an attempt to meet the needs of users with degenerative impairments, we aim to develop a tool whereby mobile assistive technologies are developed and then automatically adapted based on observed use by people with degenerative disabilities.

In order to achieve this objective we aim to develop a proof-of-concept diet diary application for people with Age-Related Macular Degeneration (AMD). AMD is the UK’s leading cause of severe visual impairment amongst the elderly. It accounts for 16,000 blind/partial sight registrations per year and is the leading cause of blindness among people aged 55 years and older in western countries . Loss of central vision with AMD is a major limit on independence of elderly patients. Strategies to combat AMD are now focusing on prevention of AMD progression rather than expensive pharmaceutical treatments which are not universally effective. Further, evidence suggests that there is link between dietary factors, AMD risk, and AMD progression.

Thus, our ultimate goal is to develop an assistive mobile application (SMART) to support accurate and convenient diet data collection on which basis to then provide customised dietary advice and recommendations in order to help support individuals with AMD to mitigate their on-going risk and retard the progression of the disease.  As highlighted by Figure 1, AMD presents a significant challenge in terms of user interface (UI) design (i.e., the design, sensory modality, and placement of UI elements) – a challenge which is further complicated by the degenerative nature of the disease.  In recognition of this challenge, we are adopting a multidisciplinary research approach, incorporating the expertise of computer science, HCI, ophthalmology, and psychology.  Central to our approach is a user-centred, participatory design philosophy, whereby target users and stakeholders (e.g. persons with AMD, clinicians, carers, etc.) are involved throughout all stages from the design to deployment of the SMART application. Only by combining the expertise across the four disciplines and that of target users, will it be possible to promote healthy, independent ageing underpinned by sophisticated technology with emphasis on psychological factors for acceptance.  

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