Get Lost – Spatial Disorientation in Dementia

 

Prof Michael Hornberger sheds light on the link between spatial disorientation and dementia, highlighting the significance and impact of this in the real world. Michael is Professor of Applied Dementia Research at Norwich Medical School, UK. This article was first published in the July/August 2023 Navigation News.

Getting lost in an unfamiliar environment is a common occurrence for the vast majority of people. For example, we can easily get lost and have difficulty finding our bearings when on holiday in a new town. This can be amusing, in particular when we pass the same place for the third time, but it can be also quite unsettling and distressing when we get completely lost. Such ‘getting lost’ scenarios are very common for people with dementia, who often have difficulties finding their bearings even in highly familiar locations. It might come as a surprise to many people that such spatial disorientation is a key symptom in dementia, since we would assume that memory problems are the key early symptom. Spatial disorientation is actually as common as memory problems, but is under-recognised since it is often not noticed by family members, and is rarely inquired about as a symptom by clinicians and healthcare professionals. To better understand why spatial disorientation occurs in dementia, we need to understand how the brain is affected by the dementia disease processes. 

Dementia is an umbrella term for different dementias, with Alzheimer’s disease accounting for 60-70% of cases with dementia. It is thought that Alzheimer’s disease is caused by the build-up of two proteins (amyloid and tau) in the brain. The exact reason why these proteins accumulate and cause the disease is not yet fully established. However, once the two proteins accumulate, they start becoming toxic to the nerve cells and subsequently nerve cells start dying. It is this dying of nerve cells which causes the symptoms in Alzheimer’s disease, since the brain cannot conduct its functions properly anymore once the nerve cells are gone. 

For dementia diagnosis, spatial orientation changes can potentially complement the reported memory problems, which helps to confirm the diagnosis. This is particularly useful, since many people report changes to their memory as they age, while healthy people would rarely report having problems with orientation.

Read the full article here

Learn more about the symptoms and warning signs of dementia on the Alzheimer Research UK website 

Author

Prof Michael Hornberger

Professor of Applied Dementia Research, Norwich Medical School

Michael's book ‘Tangled Up – The science and history of Alzheimer’s disease’ is available here.

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RIN Cog Nav Special Interest Group

https://cognavrin.org.uk/

 

 

New technologies present new challenges to PNT - the RIN PNT Advisory Group Executive Committee meeting had a lot to cover at its 23rd May meeting.  

UK PNT Advisory Group (PAG) Chair Andy Proctor and PAG Secretary Guy Buesnel report on the committees wide-ranging discussions.

The PNT Advisory Group Executive Committee met last month online; the topics discussed include:
• Advances in Quantum technologies for PNT
• The rise of Artificial Intelligence
• PNT in Automation/autonomous systems 
• The role of PNT Standards or Guidance in improving systems or equipment resilience 
• Developing a communications strategy for the committee
• Improving committee participation and International Reach 
• Forthcoming RIN Defence Seminar at Aerospace Bristol
• Following up the recent LEO event
• A review of PNT Advisory Group Activities

Defence PNT

An area focussed on was the forthcoming RIN Defence Seminar at Aerospace Bristol on 03 July.  The MoD wants to reconnect with companies and individuals in the Defence Sector on PNT matters. RIN and the Advisory Group has developed a one-day programme of talks and discussion to enable discussions and networking. The event is especially important given the recent news stories detailing how an inertial navigation sensor has undergone trials on a Royal Navy warship.

The Seminar’s focus will be on 
• What is meant by "resilient PNT" and "assured PNT"?
• How should threats and hazards be considered?
• Development of requirements for defence PNT systems
• Approaches to assessing risks at different levels from modules to integrated systems
• Mitigation approaches and their relative/absolute effectiveness
• Research and development challenges
• Latest developments in PNT for defence applications

The programme will have presentations from MoD and DSTL personnel in the morning and two panel discussions in the afternoon session. The event moderator is the RIN PNT Advisory Group Chair, Andy Proctor

The talks will include: -
• Keynote: Wing Cdr Mark Brammer, MOD
• Briefing from Strategic Command, Space Capability Planning (SATCOM & PNT) - Al Harris, PNT Desk Officer
• Briefing from DSTL on their activities - Rob Handley, Acting Chief PNT Scientist
• Briefing from DE&S - Jonathan Wilson
• Briefing from DSC on their activity - Stuart Snedden, Space Team, UK Defence Solutions Centre

The afternoon panel discussions will concentrate on “Threats and Disruptions” and “Systems Thinking/Infrastructure protection”.

The last few places for this event are available here:  https://rin.org.uk/events/EventDetails.aspx?id=1748439

Low Earth Orbit (LEO) PNT

The Advisory Group discussed how best to follow up the recent RIN LEO PNT Seminar. RIN hosted the event in March 2023 to encourage a discussion and debate, under “Chatham House rules”, to discuss the technical, value chain, resilience, and business model challenges of providing PNT services from large satellite constellations. The event centred around open discussion, independence, and the objective of bringing the challenges forward for debate. 
These challenges include frequency selection, orbit determination and prediction accuracy (noted by a few attendees as “hard for LEO”); concept of operation (doppler or time-of-arrival), and the integration with other, linked services (independence and interoperability). 
Of greater concern in the room was the lack of clear business models from most of the LEO PNT providers. That is understandable as companies are reluctant to expose their models in front of their competitors. But there was less clarity in the room about why someone would pay for additional PNT services from space.

Approximately 100 people attended in person from over 40 organisations, UK and beyond, spanning users, service providers, equipment manufacturers and government officials.

The Advisory Group noted that a follow up by RIN is needed as the one-day seminar attracted some very lively debate and argument and succeeded in highlighting several key areas where significant challenges remain.

“Standards damn Standards”

The role of standards or guidance in increasing the resilience of systems or equipment is being discussed with the PAG preparing a white paper in this area. Its author Ramsey Farragher had opened the paper up to contributions from the rest of the executive committee. 

RIN PAG Chair Andy Proctor outlined the evolving US IEEE P1952 standard and its focus on resilience levels.  He speculated as to whether this approach would succeed in adding value to the PNT community but also stated that there was a need for intervention, be it a standard, guidance or even a code of conduct.  An analysis of the US Resilience Conformance Framework would be part of developing the correct intervention.

The meeting noted it is necessary to help users assess their current levels of resilience – there is nothing available to support presently.  This links to the other PAG activity on if there is a need for a UK PNT test bed, which is being consulted upon. The “standards” report is nearly completed and the executive committee discussed whether an RIN event on standards to coincide with the release of the document, would be worth considering. 

This blog invites recipients to feedback to the RIN on if a seminar on PNT standards/guidance/best practice would be welcomed. Please contact RIN Communications and Events Manager Clare Stead at comms@rin.org.uk with any feedback

Ensuring better communications

The group Secretary Guy Buesnel also presented plans to develop a coherent communications strategy for the RIN PAG which could be widely used to achieve consistency and greater reach for the group, including keeping members on the mailing list up to date.

The Committee also unanimously decided to issue approve the admission of Mitch Narins FRIN to the PNT Advisory Committee Exec team.  Mitch has been a prolific contributor to the work of the RIN and to developing Systems thinking for achieving PNT resilience and in developing usable standards to improve PNT Resilience. Mitch was employed with the FAA for more than 26 years, becoming Chief Systems Engineer for Navigation Services. He is also an Adjunct Professor at George Washington University, a member of the editorial advisory board for GPS World, magazine, a member of the Corporate Faculty at Harrisburg University of Science and Technology, is a Fellow of the RIN and is now the Principal Consultant and owner of Strategic Synergies, LLC.  Mitch will bring a wealth of industrial and academic expertise to the committee as well as a US perspective on Resilient PNT affairs.
The PNT Advisory Group always welcomes suggestions and inputs on PNT matters, large or small. Feel free to get in touch. 

Andy and Guy. 

The Little Ship Club hosted the Small Craft Group’s evening presentation by Bob Bradfield at its London Headquarters on 17th. January. Bob specialises in producing charts of areas in the West Coast of Scotland that are not recently surveyed by UKHO or inadequately detailed for yachtsmen seeking out of the way anchorages.

Bob explained that the West Coast of Scotland is a wonderful area to sail and explore, especially if you can choose your weather. He had been sailing in high latitudes but then realised that he did not need to go so far to find excellent anchorages and scenery.

But why the West Coast of Scotland? Firstly, it is a huge area, some 125 nm x 300 nm, with most of it sheltered from ocean swells. There are sandy beaches and rocky coves surrounded by magnificent hill scenery. Add to this the number of small channels and anchorages and, of course, there is an abundance of wildlife. However, there were no charts suitable for yachtsmen of these inshore areas. So, he decided to make his own.

The UKHO standard charts of the area, Bob explained, were fine for passage making from island to island, but they lacked the detail for more adventurous sailing and accessing small, isolated coves. Even Pilot Books, although better than standard charts, gave only sparse information. The Clyde Cruising Club pilots and Imray charts were fine for a sunny day with good visibility but could let you down in rain or on a foggy day, with recommended transits between a building and the background hills being hidden.

UKHO charts of these inshore areas were often drawn from very old surveys, often from the 19th. century done by lead line. When these were made the positioning technique was far from the accuracy expected today and there were occasional omissions or misrepresentations. We were show a UKHO chart from1985 (not so old as some) and a comparison with its correction – a 0.7 metre sounding lurking in a 5.2 metre area!

To make a chart Bob starts with Ordnance Survey details of the shore and HW line as a background. He then surveys this basic outline with a single beam echo sounder using DGPS for accurate positioning. Extra detail is added to the chart as it is found. A final check is made with side scan sonar. At the same time a tide gauge is set up on a prominent solid location so that accurate tidal heights can be determined. Once tidal heights have been reduced to soundings all the data can then be incorporated into the new chart.

The Antares charts, which only cover the inshore areas explored by yachtsmen, can be run on a computer (PC or Mac), on tablets, a chart plotter or even a mobile phone. Even those without internal GPS can be used if connected via Bluetooth to a separate GPS receiver. Bob recommends the use of the Memory Map app to run his charts, although other apps can be used.

Things to be aware of:

He issues a warning that the charts have been produced by unqualified yachtsmen and suggests there will be errors – beware, use carefully, he says.

When using the charts, things can happen too quickly and GPS can lag or even stop updating. Proceed slowly when in confined waters close to shallows or rocks. He suggests that large scale charts in chart plotters plus strong tides can quickly produce a dangerous situation.  In other words, use carefully and proceed with caution!

Bob concluded by showing a UKHO chart of the area around Dunstaffnage which was alongside his own chart. He indicated five significant differences between the two, differences that could be a problem to a yacht.

A full list of the electronic charts in the package which is available for sale (and updated annually), and much more information, can be found on the web site: 

http://www.antarescharts.co.uk

The talk was greatly appreciated by the audience, which then went to dinner in the Little Ship Club. You can watch the recording of the presentation on the Little Ship Club's YouTube Channel here.