Isaac John’s father was first recognized with Parkinson’s illness in 2016. On the time, Issac was on a quick sabbatical from his company life in Bengaluru whereas his father was working in Vapi, Gujarat. Witnessing his father battle with this neurodegenerative situation wasn’t simple.

Chatting with The Higher India, Issac recollects, “It started with involuntary shaking of his arms with out anybody paying attention to it. We waited for months earlier than searching for medical enter. He was placed on a medication referred to as Syndopa that continued all through the remainder of his life together with sure vitamin dietary supplements. Whereas he labored for one more yr after his first analysis, driving a automobile was one of many first issues he had to surrender, and subsequently, his job as nicely.”

After a while, Issac’s father was compelled to maneuver to a small city in Kerala and reside with their joint household. Since then, they needed to have interaction in ‘regular administration’ of his situation.

“We acquired little steerage on what weight loss plan or way of life would assist him cope higher. Residing in a small city in Kerala, entry to high-quality neurological specialists was additionally restricted. Our household and I accepted the established order and slowly he withdrew from different social actions. He wished to renew work in a roundabout way, however the shaking of the arms transferred to the legs as nicely in a few years, and he needed to have somebody round for mobility round the home,” he recollects.

Past a degree, the remedy did little to enhance his father’s high quality of life; seeing it deteriorate like that regardless of the remedy had a profound affect on Isaac. Tragically, he handed away in 2020 amid the COVID-19 pandemic.

In the meantime, Rahul Krishnan, who comes from a big joint household in Ernakulam, Kerala, additionally witnessed firsthand the struggles of loneliness and isolation amongst his older family members, significantly these coping with neurodegenerative circumstances. With the added pressure of the pandemic, there was information day-after-day of somebody’s cognitive well being within the household deteriorating.

Chatting with The Higher India, Rahul notes, “I come from a big joint household in Kerala. Like me, a lot of my cousins and mates ventured away from dwelling in pursuit of higher instructional and profession prospects. With the rise of nuclear households, assembly elders grew to become a yearly affair at greatest. However witnessing the fast ageing and forgetfulness of our family members has at all times made me marvel why there are not any instruments for early detection of reminiscence decline.”

“Whereas I inspired my father to play sudoku and remedy puzzle books to maintain his thoughts sharp and lively, I recognised a latent concern in nearly each household like mine. The realisation that there’s a important hole in consciousness and entry to sources geared toward understanding and arresting cognitive decline served as a key driving drive behind the inception of ‘Ivory’,” he provides.

After assembly one another for the primary time in July 2022 throughout a residency programme for aspiring entrepreneurs run by Antler, an early-stage enterprise capitalist (VC) agency, Issac and Rahul would come collectively to ascertain ‘Ivory’.

Based in October 2022, this Mumbai-based ‘age-tech’ startup is working in the direction of redefining “the ageing expertise” by specializing in “higher mind well being by means of neuroscience-backed assessments, interactive video games, and personalised options.”

Discovering frequent floor

Rahul and Issac hail from totally different small cities in Kerala. Their shared expertise of being away in metropolitan cities for his or her careers whereas their dad and mom stayed again in Kerala grew to become a key purpose for them to bond over the issues of the aged that led to Ivory’s founding.

“Our place to begin was to construct one thing that might assist dad and mom really feel much less remoted and lonely as they stayed away from their kids. In the course of the course of our analysis, we understood that loneliness and isolation improve dangers of neurodegeneration by over 50%, particularly in collectivist societies like in India,” says Issac.

“This made us look into this area extra carefully. The extra we spoke to individuals, we realised dropping reminiscence was a widespread concern that many individuals vocalised however had little route on what to do about it. That’s how we zeroed in on the ache level of cognitive decline, which when not arrested early can rapidly result in dementia,” he provides.

“Similar to how pure ivory embodies resilience, sturdiness, and timeless magnificence, our startup empowers seniors to guide fulfilling lives of their later years. It is also a homage to Kerala, our dwelling state, the place majestic elephants are treasured as a part of our wealthy heritage,” says Rahul.

The size of the issue

In response to a September 2023 report in The Hindu, “Estimates primarily based on a latest multi-centric research reveal a dementia prevalence price of seven.4% amongst these aged 60 years and above, translating to almost 9 lakh Indians at the moment dwelling with dementia.”

The report goes on so as to add, “From an estimated 88 lakh in 2016, the prevalence of dementia is projected to extend to 1.7 crore by 2036. The research titled ‘Prevalence of dementia in India: Nationwide and State estimates from a nationwide research’ was revealed in July this yr [2023] in Alzheimer’s and Dementia, the journal of the Alzheimer’s Affiliation.”

In response to specialists at Ivory, “Newest analysis estimates present that one individual in India faces the danger of dementia each 20 seconds. Contributing elements comparable to loneliness, elevated nuclear households and sedentary existence have added to the issue.”

As per their analysis, “Newest studies present that circumstances have elevated from an estimated 5.3 million in 2020 to eight.8 million in 2023. Moreover, adults aged 50 to 70, even with gentle cognitive impairment, face a 1 in 3 probability of progressing to dementia inside 5 years, underscoring the pressing want for heightened dialogue and motion in neuro well being.”

Talking on the topic, Issac, co-founder and CEO at Ivory, stated, “Traditionally, there was inadequate consideration and understanding of dementia, particularly in India. The dearth of symptom identification instruments mixed with scant entry to high-quality neurological recommendation on the proper time makes this a urgent downside for each Indian family with an ageing father or mother. City seniors, significantly these dwelling alone, face challenges in monitoring their cognitive well being, exacerbated by [COVID-19] pandemic-induced isolation.”

Rahul, co-founder and chief product officer, Ivory, goes on so as to add, “At Ivory, we’re creating a pioneering platform devoted to the cognitive wellness of seniors and cultivating wholesome mind habits. We provide a various vary of interactive content material, social video games, neuroscience-backed assessments, and complete wellness programmes geared toward enhancing cognitive well-being and mitigating the danger of brain-related illnesses comparable to dementia.”

Getting up to now, nonetheless, hasn’t been simple. As Issac recollects, “After we first met, there have been few prepared reckoners and analysis accessible for corporations who’re constructing in age-tech, significantly in India, so it was not doable to take any present learnings and apply them to the wants of seniors. That meant that we needed to experiment with a number of product ideas parallelly earlier than zeroing down on what would discover mass pain-point resonance.”

Entrepreneurship within the area of mind well being remains to be at a nascent stage. “As we constructed these learnings, we additionally realised that the VC ecosystem was nonetheless warming as much as this sector,” he says.

“Whereas within the final six months, many funds have stepped ahead to assist AgeTech corporations, 18 months in the past, we needed to construct conviction concerning the alternative of the AgeTech area within the enterprise ecosystem,” he provides. Suffice it to say that Ivory efficiently raised $500,000 (Rs 4.13 crore) in a funding spherical led by Capital A, an early-stage VC fund, in February 2024.

“With this fundraiser, we intention to bridge these gaps by providing a tech-driven platform that makes medical instruments and experience for higher mind well being accessible to tens of millions,” says Issac.

Serving to seniors navigate mind well being

Dr Sumiti Saharan, a neuroscientist with over 15 years of expertise in neurodegenerative problems and dementia analysis, says, “By 2050, one in 5 people might be aged in India. The urgency for progressive options for dementia detection and administration has turn out to be simple. Proof-based options like Ivory supply a scalable and accessible mechanism for redefining the dementia care journey and empowering the aged to reside a wholesome life.”

So, how does Ivory assist senior residents navigate their mind well being?

In response to Rahul, “For the involved customers and their households who wish to perceive if their reminiscence lapses are stress associated or one thing which warrants extra consideration, Ivory gives the equal of your annual well being checkup on your mind. This checkup is completed by means of cognitive assessments and neuro-psychological evaluations, which make it easier to profile your mind well being standing and potential cognitive impairment or dementia danger.”

“In the direction of this finish, we’ve partnered with Cognifit — a scientifically validated and main mind coaching and cognitive assessments firm — to offer a place to begin for checks. Their battery of checks have been developed with greater than 20 years of inputs and analysis,” he provides.

However, as Issac goes on to elucidate, “A cognitive take a look at is simply one of many many inputs which go into assessing somebody’s cognitive decline, as each person is exclusive by way of their cultural and sociological background. These assessments present a cognitive report throughout numerous expertise, and put up that, extra focussed assessments are carried out. Therefore, each report that goes to the person is mixed with a human interplay with a neuro counsellor to present a holistic danger evaluation. Neuropsychologists then use these studies in consonance with their subjective examination of the affected person to suggest various lifestyle-based interventions.”

“Each neuropsychologist does make use of a third-party evaluation mechanism like a Mini-Psychological State Examination (MMSE), or a Montreal Cognitive Evaluation (MoCA), or an ICMR (Indian Council of Medical Analysis)-NCTB (Neuro Cognitive Device Field), or Addenbrooke’s Cognitive Examination (ACE)-III take a look at. It’s the mixture of the take a look at used together with a subjective interpretation and steady monitoring that makes for a extra definitive evaluation,” he provides.

Following these cognitive and neuro-psychological assessments, counsellors employed by the startup recommend the subsequent plan of action which may embody additional medical assessments.

As Rahul notes, “For proactive customers, who would simply wish to guarantee they’re protecting themselves mentally lively and take a preventive strategy in the direction of mind well being, we’ve got our app which gives every day quizzes, mind video games, and every day suggestions for an lively way of life resulting in diminished impairment danger. We now have additionally developed a personalised mind exercise every day, calibrated to enhance the talents they lag in. The every day exercise at the moment consists of two video games and a mini-assessment to measure progress. Going forward we might be creating our proprietary exercises as we perceive extra about these customers.”

“Relying on how the person performs, both the issue stage or the video games are then modified on an ongoing foundation. The person can even get charts of progress that they will see throughout the talents he’s being examined for,” he provides. An excellent place to begin for that is the present cognitive age take a look at that they’ve reside that may be accessed right here on cellular. In the meantime, the every day suggestions they provide are reside on their social media pages, which might be accessed right here.

“There are near 50 totally different video games with totally different ranges of problem that can even be reside on our app. These take a look at totally different expertise, comparable to auditory expertise, hand-eye coordination, visible reasoning, focus, planning, and short-term reminiscence, amongst 23 totally different expertise. The app is at the moment in its beta model slated for additional testing however comprises numerous video games ” notes Rahul.

“For instance, we’ve got a recreation which checks processing pace, estimation, and spatial notion. Aside from these cognitive video games, Ivory additionally has a gamified quizzing expertise in model 1 throughout matters of curiosity for our goal group (TG) other than ongoing brain-teasers that we’ll quickly drop on the app,” he provides.

As Jwala Narayanan, a consulting neuropsychologist at Annaswamy Mudaliar Hospital and Manipal Hospital, notes, “At present, we perceive that dementia dangers are numerous, making prevention a vital technique within the battle in opposition to it. Given the appreciable challenges of behaviour change, Ivory’s position within the healthcare ecosystem turns into important, harnessing know-how’s benefits to encourage a optimistic shift in individuals’s habits”.

Wanting forward

As Issac notes, “We see Ivory with a deep-rooted basis in making higher mind well being accessible for almost all of Indians. One of many recurring themes coming from each neurologist or neuropsychologist who treats dementia sufferers is ‘We’re 10-15 years late’, and Ivory seeks to bridge that hole. The brand new applied sciences in detection, and restoration and rehab of Dementia sufferers that may come within the subsequent few years is what’s going to outline Ivory’s journey.”

Within the medium time period, nonetheless, Rahul says that Ivory intends to deliver collectively “the ability of high-quality cognitive assessments” and make them accessible for Indians to take higher care of their mind well being. As he goes on so as to add, “Well timed response to cognitive decline can enhance the standard of life as individuals age. Our goal is to make this a actuality for each Indian family with an ageing father or mother.”

(Ivory’s beta model of the app is out there on the Google Play Retailer.)

(Edited by Pranita Bhat; Pictures courtesy Ivory, Shutterstock/WESTOCK PRODUCTIONS and Shutterstock/Raushan_Films)

Extra Supply:

‘India must gear up for the rising dementia epidemic, say specialists’ by Afshan Yasmeen for The Hindu, Revealed on 8 September 2023