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Palmirotta C, Aresta S, Battista P, Tagliente S, Lagravinese G, Mongelli D, Gelao C, Fiore P, Castiglioni I, Minafra B, Salvatore C. Unveiling the Diagnostic Potential of Linguistic Markers in Identifying Individuals with Parkinson's Disease through Artificial Intelligence: A Systematic Review. Brain Sci 2024; 14:137. [PMID: 38391712 PMCID: PMC10886733 DOI: 10.3390/brainsci14020137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
While extensive research has documented the cognitive changes associated with Parkinson's disease (PD), a relatively small portion of the empirical literature investigated the language abilities of individuals with PD. Recently, artificial intelligence applied to linguistic data has shown promising results in predicting the clinical diagnosis of neurodegenerative disorders, but a deeper investigation of the current literature available on PD is lacking. This systematic review investigates the nature of language disorders in PD by assessing the contribution of machine learning (ML) to the classification of patients with PD. A total of 10 studies published between 2016 and 2023 were included in this review. Tasks used to elicit language were mainly structured or unstructured narrative discourse. Transcriptions were mostly analyzed using Natural Language Processing (NLP) techniques. The classification accuracy (%) ranged from 43 to 94, sensitivity (%) ranged from 8 to 95, specificity (%) ranged from 3 to 100, AUC (%) ranged from 32 to 97. The most frequent optimal linguistic measures were lexico-semantic (40%), followed by NLP-extracted features (26%) and morphological consistency features (20%). Artificial intelligence applied to linguistic markers provides valuable insights into PD. However, analyzing measures derived from narrative discourse can be time-consuming, and utilizing ML requires specialized expertise. Moving forward, it is important to focus on facilitating the integration of both narrative discourse analysis and artificial intelligence into clinical practice.
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Affiliation(s)
- Cinzia Palmirotta
- Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Bari Institute, 70124 Bari, Italy
| | - Simona Aresta
- Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Bari Institute, 70124 Bari, Italy
| | - Petronilla Battista
- Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Bari Institute, 70124 Bari, Italy
| | - Serena Tagliente
- Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Bari Institute, 70124 Bari, Italy
| | - Gianvito Lagravinese
- Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Bari Institute, 70124 Bari, Italy
| | - Davide Mongelli
- Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology, Bari Institute, 70124 Bari, Italy
| | - Christian Gelao
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Unit of Bari Institute, 70124 Bari, Italy
| | - Pietro Fiore
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Unit of Bari Institute, 70124 Bari, Italy
- Department of Physical and Rehabilitation Medicine, University of Foggia, 71122 Foggia, Italy
| | - Isabella Castiglioni
- Department of Physics G. Occhialini, University of Milan-Bicocca, 20133 Milan, Italy
| | - Brigida Minafra
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Unit of Bari Institute, 70124 Bari, Italy
| | - Christian Salvatore
- Department of Science, Technology and Society, University School for Advanced Studies IUSS Pavia, 27100 Pavia, Italy
- DeepTrace Technologies S.R.L., 20122 Milan, Italy
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Giaquinto F, Battista P, Angelelli P. Touchscreen Cognitive Tools for Mild Cognitive Impairment and Dementia Used in Primary Care Across Diverse Cultural and Literacy Populations: A Systematic Review. J Alzheimers Dis 2022; 90:1359-1380. [PMID: 36245376 DOI: 10.3233/jad-220547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Touchscreen cognitive tools opened new promising opportunities for the early detection of cognitive impairment; however, most research studies are conducted in English-speaking populations and high-income countries, with a gap in knowledge about their use in populations with cultural, linguistic, and educational diversity. OBJECTIVE To review the touchscreen tools used in primary care settings for the cognitive assessment of mild cognitive impairment (MCI) and dementia, with a focus on populations of different cultures, languages, and literacy. METHODS This systematic review was conducted following the PRISMA guidelines. Studies were identified by searching across MEDLINE, EMBASE, EBSCO, OVID, SCOPUS, SCIELO, LILACS, and by cross-referencing. All studies that provide a first-level cognitive assessment for MCI and dementia with any touchscreen tools suitable to be used in the context of primary care were included. RESULTS Forty-two studies reporting on 30 tools and batteries were identified. Substantial differences among the tools emerged, in terms of theoretical framework, clinical validity, and features related to the application in clinical practice. A small proportion of the tools are available in multiple languages. Only 7 out of the 30 tools have a multiple languages validation. Only two tools are validated in low-educated samples, e.g., IDEA and mSTS-MCI. CONCLUSION General practitioners can benefit from touchscreen cognitive tools. However, easy requirements of the device, low dependence on the examiner, fast administration, and adaptation to different cultures and languages are some of the main features that we need to take into consideration when implementing touchscreen cognitive tools in the culture and language of underrepresented populations.
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Affiliation(s)
- Francesco Giaquinto
- Department of History, Laboratory of Applied Psychology and Intervention, Society and Human Studies, University of Salento, Lecce, Italy
| | - Petronilla Battista
- Clinical and Scientific Institutes Maugeri Pavia, Scientific Institute of Bari, IRCCS, Italy
| | - Paola Angelelli
- Department of History, Laboratory of Applied Psychology and Intervention, Society and Human Studies, University of Salento, Lecce, Italy
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Marques-Costa C, Simões MR, Almiro PA, Prieto G, Salomé Pinho M. Integrating Technology in Neuropsychological Assessment. EUROPEAN PSYCHOLOGIST 2022. [DOI: 10.1027/1016-9040/a000484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Although neuropsychological assessments include some measures that are administered, scored, or interpreted using new technologies, most researchers in this area advocate that more technology should be integrated. The current situation in neuropsychological assessment may be conceptualized as triggering a crisis leading to a paradigm shift, as there is some resistance to adopting more technology. In this paper, the context of the present crisis in neuropsychological assessment, the main obstacles, and new developments will be discussed. An example of a new computerized assessment tool, the NIH Toolbox, is highlighted. Also addressed are potential issues: in the assessment with tablets illustrating it with the older adult population and how to ensure the compatibility of data collected through these devices within the framework of the European General Data Protection Regulation (GDPR). Recommendations for research, test development, and clinical practice are also provided.
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Affiliation(s)
- Catarina Marques-Costa
- Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Portugal
- Psychological Assessment and Psychometrics Laboratory (PsyAssessmentLab), University of Coimbra, Portugal
| | - Mário R. Simões
- Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Portugal
- Psychological Assessment and Psychometrics Laboratory (PsyAssessmentLab), University of Coimbra, Portugal
| | - Pedro A. Almiro
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Portugal
- Psychological Assessment and Psychometrics Laboratory (PsyAssessmentLab), University of Coimbra, Portugal
- Research Centre for Psychology (CIP), Autonomous University Lisbon, Portugal
| | - Gerardo Prieto
- Psychological Assessment and Psychometrics Laboratory (PsyAssessmentLab), University of Coimbra, Portugal
- Faculty of Psychology, University of Salamanca, Spain
| | - Maria Salomé Pinho
- Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Portugal
- Memory, Language, and Executive Functions Laboratory, University of Coimbra, Portugal
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Leese MI, Mattek N, Bernstein JPK, Dorociak KE, Gothard S, Kaye J, Hughes AM. The survey for memory, attention, and reaction time (SMART): Preliminary normative online panel data and user attitudes for a brief web-based cognitive performance measure. Clin Neuropsychol 2022:1-19. [PMID: 35930438 PMCID: PMC9899293 DOI: 10.1080/13854046.2022.2103033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
ObjectiveThe Survey for Memory, Attention, and Reaction Time (SMART) was recently introduced as a brief (<5 min), self-administered, web-based measure of cognitive performance in older adults. The purpose of this study was threefold: (1) to develop preliminary norms on the SMART; (2) to examine the relationship between demographic variables (i.e. age, sex, education), device type used, and SMART performance; and (3) to assess user attitudes of the SMART. Method A sample of 1,050 community-dwelling adults (M age =59.5 (15.2), M education = 16.5 (2.1), 67.1% female, 96% white) was recruited from an ongoing web-based research cohort. Participants completed the SMART, which consists of four face-valid cognitive tasks assessing visual memory, attention/processing speed, and executive functioning. SMART performance outcome metrics were subtest completion time (CT), click count, and total CT. Participants provided demographic information and completed a survey of user attitudes toward the SMART (i.e. usability, acceptability). Results Older age was the only demographic variable associated with slower SMART total CT (r = .60, p <.001). Education was not associated with SMART CT or click counts overall (p > .05). Male sex was generally associated with longer SMART CT (p < .001, partial eta squared = .14) on all sub-tests. Regarding acceptability, 97.3% indicated willingness to take the SMART again, with more than half willing to complete it on a weekly basis. Conclusion The preliminary normative data on the SMART indicates that it is a feasible and well-accepted web-based cognitive assessment tool that can be administered on multiple device platforms.
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Affiliation(s)
- Mira I. Leese
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Nora Mattek
- Oregon Center for Aging & Technology, Portland, OR, USA,Oregon Health & Science University, Portland, OR, USA
| | | | | | - Sarah Gothard
- Oregon Center for Aging & Technology, Portland, OR, USA,Oregon Health & Science University, Portland, OR, USA
| | - Jeffrey Kaye
- Oregon Center for Aging & Technology, Portland, OR, USA,Oregon Health & Science University, Portland, OR, USA
| | - Adriana M. Hughes
- Oregon Center for Aging & Technology, Portland, OR, USA,Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA,Minneapolis VA Health Care System, Minneapolis, MN, USA
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Xiao Y, Jia Z, Dong M, Song K, Li X, Bian D, Li Y, Jiang N, Shi C, Li G. Development and validity of computerized neuropsychological assessment devices for screening mild cognitive impairment: Ensemble of models with feature space heterogeneity and retrieval practice effect. J Biomed Inform 2022; 131:104108. [PMID: 35660522 DOI: 10.1016/j.jbi.2022.104108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 05/26/2022] [Accepted: 05/28/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to develop and validate computerized neuropsychological assessment devices for screening patients with mild cognitive impairment (MCI). METHODS We conducted this study in three phases. Phase I involved the development of a conceptual framework of Memory Guard (MG) based on the principles of the cognitive design system (CDS). Phase II involved three steps of feature engineering: item development, filter, and wrapper. Based on the initial items, the number of items in each dimension was determined through analytic hierarchy process. We constructed an initial set with a total of 198 items with three levels of difficulty. Next, we performed feature selection through comprehensive reliability and validity tests, which resulted in the best item bank of 38 test items. The features for modeling were obtained from the best item bank (option scores, reading time scores and total time scores), demographic variables and their MoCA groups. Regarding the heterogeneity of the feature space, we combined the AdaBoost with the Naive Bayes classification algorithm as the decision model of MG. For the screening tool to be used repeatedly, the retrieval practice effect was considered in the design. Phase III involved the validation of measuring instruments. The features incorporated into the modeling process were optimized based on the classification accuracy and area under curve. We also verified the classification effect of the other three classification models with MG. RESULTS After three steps of feature engineering, a total of 6 dimensions of cognitive areas were included in MG: orientation, memory, attention, calculation, recall, and language & executive function. 38 features were included in the model (17 features of option score, 20 features of time score, and 1 demographic feature). A total of 333 individuals from two communities in Shanghai and Henan province were included in the measuring instrument verification process. Women accounted for 68.2% of the sample. The median age was 63. 15.3% of the participants had bachelor's degrees or above and 111 participants lived in urban areas (33.3%). The results showed that MG had an accuracy of 93.75% and AUC of 0.923, with a sensitivity of 91.67% and a specificity of 95.45%. Compared to the other three classification models, MG that combined the AdaBoost with the Naive Bayes classification algorithm was the most accurate classifier. CONCLUSIONS MG was proved to be reliable and valid in early screening for patients with MCI. MG that integrated heterogeneous features such as demography, option scores, and time scores had a better predictive performance for screening MCI.
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Affiliation(s)
- Yuyin Xiao
- School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China; Center for HTA, China Hospital Development Institute, Shanghai JiaoTong University, Shanghai, China
| | - Zhiying Jia
- School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China; Center for HTA, China Hospital Development Institute, Shanghai JiaoTong University, Shanghai, China
| | - Minye Dong
- School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China; Center for HTA, China Hospital Development Institute, Shanghai JiaoTong University, Shanghai, China
| | - Keyu Song
- School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China; Center for HTA, China Hospital Development Institute, Shanghai JiaoTong University, Shanghai, China
| | - Xiyang Li
- School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China; Center for HTA, China Hospital Development Institute, Shanghai JiaoTong University, Shanghai, China
| | - Dongsheng Bian
- School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China; School of Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, USA; Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Nan Jiang
- Department of Social Work, Faculty of Arts and Social Sciences, National University of Singapore, Singapore; School of Healthcare Management, Tsinghua Medicine, Tsinghua University, Beijing, China
| | - Chenshu Shi
- Center for HTA, China Hospital Development Institute, Shanghai JiaoTong University, Shanghai, China.
| | - Guohong Li
- School of Public Health, Shanghai JiaoTong University School of Medicine, Shanghai, China; Center for HTA, China Hospital Development Institute, Shanghai JiaoTong University, Shanghai, China.
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Augusto-Oliveira M, Arrifano GDP, Lopes-Araújo A, Santos-Sacramento L, Lima RR, Lamers ML, Le Blond J, Crespo-Lopez ME. Salivary biomarkers and neuropsychological outcomes: A non-invasive approach to investigate pollutants-associated neurotoxicity and its effects on cognition in vulnerable populations. ENVIRONMENTAL RESEARCH 2021; 200:111432. [PMID: 34062204 DOI: 10.1016/j.envres.2021.111432] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/17/2021] [Accepted: 05/26/2021] [Indexed: 06/12/2023]
Abstract
The occurrence of neurotoxicity caused by xenobiotics such as pesticides (dichlorodiphenyltrichloroethane, organophosphates, pyrethroids, etc.) or metals (mercury, lead, aluminum, arsenic, etc.) is a growing concern around the world, particularly in vulnerable populations with difficulties on both detection and symptoms treatment, due to low economic status, remote access, poor infrastructure, and low educational level, among others features. Despite the numerous molecular markers and questionnaires/clinical evaluations, studying neurotoxicity and its effects on cognition in these populations faces problems with samples collection and processing, and information accuracy. Assessing cognitive changes caused by neurotoxicity, especially those that are subtle in the initial stages, is fundamentally challenging. Finding accurate, non-invasive, and low-cost strategies to detect the first signals of brain injury has the potential to support an accelerated development of the research with these populations. Saliva emerges as an ideal pool of biomarkers (with interleukins and neural damage-related proteins, among others) and potential alternative diagnostic fluid to molecularly investigate neurotoxicity. As a source of numerous neurological biomarkers, saliva has several advantages compared to blood, such as easier storage, requires less manipulation, and the procedure is cheaper, safer and well accepted by patients compared with drawing blood. Regarding cognitive dysfunction, neuropsychological batteries represent, with their friendly interface, a feasible and accurate method to evaluate the eventual cognitive deficits associated with neurotoxicity in people from diverse cultural and educational backgrounds. The association of these two tools, saliva and neuropsychological batteries, to cover the molecular and cognitive aspects of neurotoxicity in vulnerable populations, could potentially increase the prevalence of early intervention and successful treatment.
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Affiliation(s)
- Marcus Augusto-Oliveira
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, 66075-110, Brazil.
| | - Gabriela de Paula Arrifano
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, 66075-110, Brazil.
| | - Amanda Lopes-Araújo
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, 66075-110, Brazil.
| | - Letícia Santos-Sacramento
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, 66075-110, Brazil.
| | - Rafael Rodrigues Lima
- Laboratório de Biologia Estrutural e Funcional, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, 66075-110, Brazil.
| | - Marcelo Lazzaron Lamers
- Department of Morphological Sciences, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil.
| | | | - Maria Elena Crespo-Lopez
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, 66075-110, Brazil.
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Physical Training In-Game Metrics for Cognitive Assessment: Evidence from Extended Trials with the Fitforall Exergaming Platform. SENSORS 2021; 21:s21175756. [PMID: 34502647 PMCID: PMC8434168 DOI: 10.3390/s21175756] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/13/2021] [Accepted: 08/23/2021] [Indexed: 11/24/2022]
Abstract
Conventional clinical cognitive assessment has its limitations, as evidenced by the environmental shortcomings of various neuropsychological tests conducted away from an older person’s everyday environment. Recent research activities have focused on transferring screening tests to computerized forms, as well as on developing short screening tests for screening large populations for cognitive impairment. The purpose of this study was to present an exergaming platform, which was widely trialed (116 participants) to collect in-game metrics (built-in game performance measures). The potential correlation between in-game metrics and cognition was investigated in-depth by scrutinizing different in-game metrics. The predictive value of high-resolution monitoring games was assessed by correlating it with classical neuropsychological tests; the area under the curve (AUC) in the receiver operating characteristic (ROC) analysis was calculated to determine the sensitivity and specificity of the method for detecting mild cognitive impairment (MCI). Classification accuracy was calculated to be 73.53% when distinguishing between MCI and normal subjects, and 70.69% when subjects with mild dementia were also involved. The results revealed evidence that careful design of serious games, with respect to in-game metrics, could potentially contribute to the early and unobtrusive detection of cognitive decline.
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Tsoy E, Zygouris S, Possin KL. Current State of Self-Administered Brief Computerized Cognitive Assessments for Detection of Cognitive Disorders in Older Adults: A Systematic Review. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2021; 8:267-276. [PMID: 34101783 PMCID: PMC7987552 DOI: 10.14283/jpad.2021.11] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Early diagnosis of cognitive disorders in older adults is a major healthcare priority with benefits to patients, families, and health systems. Rapid advances in digital technology offer potential for developing innovative diagnostic pathways to support early diagnosis. Brief self-administered computerized cognitive tools in particular hold promise for clinical implementation by minimizing demands on staff time. In this study, we conducted a systematic review of self-administered computerized cognitive assessment measures designed for the detection of cognitive impairment in older adults. Studies were identified via a systematic search of published peer-reviewed literature across major scientific databases. All studies reporting on psychometric validation of brief (≤30 minutes) self-administered computerized measures for detection of MCI and all-cause dementia in older adults were included. Seventeen studies reporting on 10 cognitive tools met inclusion criteria and were subjected to systematic review. There was substantial variability in characteristics of validation samples and reliability and validity estimates. Only 2 measures evaluated feasibility and usability in the intended clinical settings. Similar to past reviews, we found variability across measures with regard to psychometric rigor and potential for widescale applicability in clinical settings. Despite the promise that self-administered cognitive tests hold for clinical implementation, important gaps in scientific rigor in development, validation, and feasibility studies of these measures remain. Developments in technology and biomarker studies provide potential avenues for future directions on the use of digital technology in clinical care.
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Affiliation(s)
- E Tsoy
- Katherine L. Possin, PhD, Associate Professor in Residence, Department of Neurology, University of California San Francisco, Memory and Aging Center, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, Tel: 415-476-1889, E-mail:
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Ferreira-Brito F, Alves S, Santos O, Guerreiro T, Caneiras C, Carriço L, Verdelho A. Photo-Realistic Interactive Virtual Environments for Neurorehabilitation in Mild Cognitive Impairment (NeuroVRehab.PT): A Participatory Design and Proof-of-Concept Study. J Clin Med 2020; 9:jcm9123821. [PMID: 33255869 PMCID: PMC7760013 DOI: 10.3390/jcm9123821] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/22/2020] [Accepted: 11/23/2020] [Indexed: 11/24/2022] Open
Abstract
Mild cognitive impairment (MCI) is characterized by cognitive, psychological, and functional impairments. Digital interventions typically focus on cognitive deficits, neglecting the difficulties that patients experience in instrumental activities of daily living (IADL). The global conjecture created by COVID-19 has highlighted the seminal importance of digital interventions for the provision of healthcare services. Here, we investigated the feasibility and rehabilitation potential of a new design approach for creating highly realistic interactive virtual environments for MCI patients’ neurorehabilitation. Through a participatory design protocol, a neurorehabilitation digital platform was developed using images captured from a Portuguese supermarket (NeuroVRehab.PT). NeuroVRehab.PT’s main features (e.g., medium-sized supermarket, the use of shopping lists) were established according to a shopping behavior questionnaire filled in by 110 older adults. Seven health professionals used the platform and assessed its rehabilitation potential, clinical applicability, and user experience. Interviews were conducted using the think-aloud method and semi-structured scripts, and four main themes were derived from an inductive semantic thematic analysis. Our findings support NeuroVRehab.PT as an ecologically valid instrument with clinical applicability in MCI neurorehabilitation. Our design approach, together with a comprehensive analysis of the patients’ past experiences with IADL, is a promising technique to develop effective digital interventions to promote real-world functioning.
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Affiliation(s)
- Filipa Ferreira-Brito
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (O.S.); (A.V.)
- Correspondence:
| | - Sérgio Alves
- LASIGE, Faculdade de Ciências Universidade de Lisboa, 1749-016 Lisboa, Portugal; (S.A.); (T.G.); (L.C.)
| | - Osvaldo Santos
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (O.S.); (A.V.)
- Unbreakable Idea Research, Lda, 2550-426 Painho, Portugal
| | - Tiago Guerreiro
- LASIGE, Faculdade de Ciências Universidade de Lisboa, 1749-016 Lisboa, Portugal; (S.A.); (T.G.); (L.C.)
| | - Cátia Caneiras
- Laboratório de Investigação em Microbiologia na Saúde Ambiental (EnviHealthMicro Lab), Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal;
- Healthcare Department, Nippon Gases Portugal, 2600-242 Vila Franca de Xira, Portugal
| | - Luís Carriço
- LASIGE, Faculdade de Ciências Universidade de Lisboa, 1749-016 Lisboa, Portugal; (S.A.); (T.G.); (L.C.)
| | - Ana Verdelho
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (O.S.); (A.V.)
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Neurology Service, Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
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Staffaroni AM, Tsoy E, Taylor J, Boxer AL, Possin KL. Digital Cognitive Assessments for Dementia: Digital assessments may enhance the efficiency of evaluations in neurology and other clinics. PRACTICAL NEUROLOGY (FORT WASHINGTON, PA.) 2020; 2020:24-45. [PMID: 33927583 PMCID: PMC8078574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Elena Tsoy
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Jack Taylor
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Katherine L Possin
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, Global Brain Health Institute, University of California, San Francisco, San Francisco, CA
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Lunardini F, Luperto M, Romeo M, Basilico N, Daniele K, Azzolino D, Damanti S, Abbate C, Mari D, Cesari M, Borghese NA, Ferrante S. Supervised Digital Neuropsychological Tests for Cognitive Decline in Older Adults: Usability and Clinical Validity Study. JMIR Mhealth Uhealth 2020; 8:e17963. [PMID: 32955442 PMCID: PMC7536607 DOI: 10.2196/17963] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/12/2020] [Accepted: 06/03/2020] [Indexed: 12/02/2022] Open
Abstract
Background Dementia is a major and growing health problem, and early diagnosis is key to its management. Objective With the ultimate goal of providing a monitoring tool that could be used to support the screening for cognitive decline, this study aims to develop a supervised, digitized version of 2 neuropsychological tests: Trail Making Test and Bells Test. The system consists of a web app that implements a tablet-based version of the tests and consists of an innovative vocal assistant that acts as the virtual supervisor for the execution of the test. A replay functionality is added to allow inspection of the user’s performance after test completion. Methods To deploy the system in a nonsupervised environment, extensive functional testing of the platform was conducted, together with a validation of the tablet-based tests. Such validation had the two-fold aim of evaluating system usability and acceptance and investigating the concurrent validity of computerized assessment compared with the corresponding paper-and-pencil counterparts. Results The results obtained from 83 older adults showed high system acceptance, despite the patients’ low familiarity with technology. The system software was successfully validated. A concurrent validation of the system reported good ability of the digitized tests to retain the same predictive power of the corresponding paper-based tests. Conclusions Altogether, the positive results pave the way for the deployment of the system to a nonsupervised environment, thus representing a potential efficacious and ecological solution to support clinicians in the identification of early signs of cognitive decline.
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Affiliation(s)
- Francesca Lunardini
- Nearlab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Matteo Luperto
- AISLab, Department of Computer Science, University of Milano, Milano, Italy
| | - Marta Romeo
- School of Computer Science, The University of Manchester, Manchester, United Kingdom
| | - Nicola Basilico
- AISLab, Department of Computer Science, University of Milano, Milano, Italy
| | - Katia Daniele
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Domenico Azzolino
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Nutritional Sciences, University of Milano, Milano, Italy
| | - Sarah Damanti
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Nutritional Sciences, University of Milano, Milano, Italy
| | - Carlo Abbate
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Daniela Mari
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Clinical and Community Sciences, University of Milano, Milano, Italy
| | | | - Simona Ferrante
- Nearlab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
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Spreij LA, Gosselt IK, Visser-Meily JMA, Nijboer TCW. Digital neuropsychological assessment: Feasibility and applicability in patients with acquired brain injury. J Clin Exp Neuropsychol 2020; 42:781-793. [PMID: 32878561 DOI: 10.1080/13803395.2020.1808595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Digital neuropsychological assessment (d-NPA) has several advantages over paper-and-pencil tests in neuropsychological assessment, such as a more standardized stimulus presentation and response acquisition. We investigated (1) the feasibility and user-experience of a d-NPA in patients with acquired brain injury (ABI) and healthy controls; (2) the applicability of conventional paper-and-pencil norms on digital tests; and (3) whether familiarity with a tablet would affect test performance on a tablet. METHOD We administered a d-NPA in stroke patients (n = 59), traumatic brain injury patients (n = 61) and healthy controls (n = 159). The neuropsychological tests were presented on a tablet and participants used a pencil stylus to respond. We examined the completion rate to assess the feasibility, and a semi-structured interview was conducted to examine the user-experience. The applicability of conventional norms was examined by the number of healthy controls performing <10th percentile, which was expected to be no more than 10%. The effect of tablet familiarity on test performance was examined with a regression-based model. RESULTS Overall, 94% of patients completed the d-NPA. The d-NPA was considered pleasant by patients and healthy controls. Conventional norms that exist for paper-and-pencil tests were not applicable on the digital version of the tests, as up to 34% of healthy controls showed an abnormal performance on half of the tests. Tablet familiarity did not affect test performance on a tablet, indicating that participants who were more experienced with working with a tablet did not perform better on digital tests. CONCLUSIONS The administration of a d-NPA is feasible in patients with ABI. Familiarity with a tablet did not impact test performance, which is particularly important in neuropsychological assessment. Future research should focus on developing norms in order to implement a d-NPA in clinical practice.
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Affiliation(s)
- Lauriane A Spreij
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and de Hoogstraat Rehabilitation , Utrecht, The Netherlands
| | - Isabel K Gosselt
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and de Hoogstraat Rehabilitation , Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and de Hoogstraat Rehabilitation , Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht , Utrecht, The Netherlands
| | - Tanja C W Nijboer
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and de Hoogstraat Rehabilitation , Utrecht, The Netherlands.,Department of Experimental Psychology, Helmholtz Institute, Utrecht University , Utrecht, The Netherlands
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Schulz-Heik RJ, Fahimi A, Durazzo TC, Friedman M, Bayley PJ. Evaluation of adding the CANTAB computerized neuropsychological assessment battery to a traditional battery in a tertiary care center for veterans. APPLIED NEUROPSYCHOLOGY. ADULT 2020; 27:256-266. [PMID: 30633552 DOI: 10.1080/23279095.2018.1534735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Numerous advantages of and concerns about computerized neuropsychological assessment systems have been noted. Here we report a program evaluation of incorporating a computerized system, the Cambridge Neuropsychological Test Automated Battery (CANTAB), in our tertiary assessment center for Veterans. Patients were 23 consecutive referrals to the Western War Related Illness and Injury Study Center, an interdisciplinary assessment center within the Veterans Affairs Healthcare System for Veterans with complex medical presentations. Patients were administered both the CANTAB and a brief traditional neuropsychological battery. The correlation between global composite scores from each method was .71 (p < .05), indicating "good" concordance. Concordance was "fair" to "good" for scores on specific cognitive domains. However, concordance was lower when classifying patients' cognition as "impaired" or "not-impaired" based on a cutoff score. Despite the CANTAB's primarily visuospatial interface, discrepancy between the two methods' scores was not associated with patients' visuospatial abilities. The two methods were similarly sensitive to deficits associated with posttraumatic stress disorder, which is prevalent among the Center's patients. The CANTAB was judged to be a valid and useful complement to, but not an acceptable alternative to a traditional neuropsychologist-administered cognitive assessment battery for the Center's specific patients and needs.
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Affiliation(s)
- R Jay Schulz-Heik
- War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, San Jose, California, USA
| | - Atoossa Fahimi
- War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, San Jose, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Timothy C Durazzo
- War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, San Jose, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Marcelle Friedman
- War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, San Jose, California, USA.,PGSP-Stanford Psy.D. Consortium, Palo Alto University, Palo Alto, California, USA
| | - Peter J Bayley
- War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, San Jose, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
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Tsoy E, Possin KL, Thompson N, Patel K, Garrigues SK, Maravilla I, Erlhoff SJ, Ritchie CS. Self-Administered Cognitive Testing by Older Adults At-Risk for Cognitive Decline. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2020; 7:283-287. [PMID: 32920631 DOI: 10.14283/jpad.2020.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Self-administered computerized cognitive testing could effectively monitor older individuals at-risk for cognitive decline at home. In this study, we tested the feasibility and reliability of 3 tablet-based executive functioning measures and an executive composite score in a sample of 30 older adults (age 80±6) with high multimorbidity. The tests were examiner-administered at baseline and then self-administered by the participants at home across 2 subsequent days. Eight of the participants reported no prior experience with touchscreen technology. Twenty-seven participants completed both self-administered assessments, and 28 completed at least one. Cronbach's alpha (individual tests: .87-.89, composite: .93) and correlations between examiner-administered and self-administered performances (individual tests: .72-.91, composite: .93) were high. The participants who had never used a smartphone or a tablet computer showed comparable consistency. Remote self-administered tablet-based testing in older adults at-risk for cognitive decline is feasible and reliable, even among participants without prior technology experience.
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Affiliation(s)
- E Tsoy
- Elena Tsoy, PhD, Memory and Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, California, USA, 94158, Tel: 415-514-7477, E-mail:
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Rodriguez FS, Spilski J, Schneider A, Hekele F, Lachmann T, Ebert A, Rupprecht FA. Relevance of the assessment mode in the digital assessment of processing speed. J Clin Exp Neuropsychol 2019; 41:730-739. [DOI: 10.1080/13803395.2019.1616079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Francisca S. Rodriguez
- Center for Cognitive Science, University of Kaiserslautern, Kaiserslautern, Germany
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Jan Spilski
- Center for Cognitive Science, University of Kaiserslautern, Kaiserslautern, Germany
| | - Andreas Schneider
- Computer graphics & HCI, Department of Computer Science, University of Kaiserslautern, Kaiserslautern, Germany
| | - Felix Hekele
- Center for Cognitive Science, University of Kaiserslautern, Kaiserslautern, Germany
| | - Thomas Lachmann
- Center for Cognitive Science, University of Kaiserslautern, Kaiserslautern, Germany
- Facultad de Lenguas y Educación, Universidad Nebrija, Madrid, Spain
| | - Achim Ebert
- Center for Cognitive Science, University of Kaiserslautern, Kaiserslautern, Germany
- Computer graphics & HCI, Department of Computer Science, University of Kaiserslautern, Kaiserslautern, Germany
| | - Franca Alexandra Rupprecht
- Computer graphics & HCI, Department of Computer Science, University of Kaiserslautern, Kaiserslautern, Germany
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Morrison RL, Pei H, Novak G, Kaufer DI, Welsh-Bohmer KA, Ruhmel S, Narayan VA. A computerized, self-administered test of verbal episodic memory in elderly patients with mild cognitive impairment and healthy participants: A randomized, crossover, validation study. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2018; 10:647-656. [PMID: 30456291 PMCID: PMC6234960 DOI: 10.1016/j.dadm.2018.08.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction Performance of “Revere”, a novel iPad-administered word-list recall (WLR) test, in quantifying deficits in verbal episodic memory, was evaluated versus examiner-administered Rey Auditory Verbal Learning Test (RAVLT) in patients with mild cognitive impairment and cognitively normal participants. Methods Elderly patients with clinically diagnosed mild cognitive impairment (Montreal Cognitive Assessment score 24–27) and cognitively normal (Montreal Cognitive Assessment score ≥28) were administered RAVLT or Revere in a randomized crossover design. Results A total of 153/161 participants (Revere/RAVLT n = 75; RAVLT/Revere n = 78) were randomized; 148 (97%) completed study; 121 patients (mean [standard deviation] age: 70.4 [7.84] years) were included for analysis. Word-list recall scores (8 trials) were comparable between Revere and RAVLT (Pearson's correlation coefficients: 0.12–0.70; least square mean difference [Revere-RAVLT]: −0.84 [90% CI, −1.15; −0.54]). Model factor estimates indicated trial (P < .001), period (P < .001) and evaluation sequence (P = .038) as significant factors. Learning over trials index and serial position effects were comparable. Discussion Participants' verbal recall performance on Revere and RAVLT were equivalent.
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Affiliation(s)
- Randall L. Morrison
- Janssen Research and Development, LLC, Titusville, NJ, USA
- Corresponding author. Tel.: +1 609 730-3620; Fax: +1 215 273-4263.
| | - Huiling Pei
- Janssen Research and Development, LLC, Pennington, NJ, USA
| | - Gerald Novak
- Janssen Research and Development, LLC, Titusville, NJ, USA
| | - Daniel I. Kaufer
- Department of Neurology and Psychiatry, University of North Carolina, Chapel Hill, NC, USA
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ELECTRONIC DEVICES FOR COGNITIVE IMPAIRMENT SCREENING: A SYSTEMATIC LITERATURE REVIEW. Int J Technol Assess Health Care 2017; 33:654-673. [PMID: 28920567 DOI: 10.1017/s0266462317000800] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The reduction in cognitive decline depends on timely diagnosis. The aim of this systematic review was to analyze the current available information and communication technologies-based instruments for cognitive decline early screening and detection in terms of usability, validity, and reliability. METHODS Electronic searches identified 1,785 articles of which thirty-four met the inclusion criteria and were grouped according to their main purpose into test batteries, measures of isolated tasks, behavioral measures, and diagnostic tools. RESULTS Thirty one instruments were analyzed. Fifty-two percent were personal computer based, 26 percent tablet, 13 percent laptop, and 1 was mobile phone based. The most common input method was touchscreen (48 percent). The instruments were validated with a total of 4,307 participants: 2,146 were healthy older adults (M = 73.59; SD = 5.12), 1,104 had dementia (M = 74.65; SD = 3.98) and 1,057 mild cognitive impairment (M = 74.84; SD = 4.46). Only 6 percent were administered at home, 19 percent reported outcomes about usability, and 22 percent about understandability. The methodological quality of the studies was good, the weakest methodological area being usability. Most of the instruments obtained acceptable values of specificity and sensitivity. CONCLUSIONS It is necessary to create home delivered instruments and to include usability studies in their design. Involvement of people with cognitive decline in all phases of the development process is of great importance to obtain valuable and user-friendly products. It would be advisable for researchers to make an effort to provide cutoff points for their instruments.
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Klimova B, Valis M, Kuca K. Potential of mobile technologies and applications in the detection of mild cognitive impairment among older generation groups. SOCIAL WORK IN HEALTH CARE 2017; 56:588-599. [PMID: 28463071 DOI: 10.1080/00981389.2017.1316339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
At present, demographic changes result in the growing number of older people. This trend inevitably brings about serious social and economic issues, as well as occurrence of aging diseases. The purpose of this study is to discuss the potential of using mobile technologies and applications in the detection of aging disorders such as mild cognitive impairment. The methods used for this review study include a literature search in the world's acknowledged databases. The findings of this study indicate that mobile applications can serve as appropriate diagnostic tools for aging disorders such as mild cognitive impairment because they seem to provide better, faster, and less costly care for older people.
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Affiliation(s)
- Blanka Klimova
- a Department of Neurology , University Hospital Hradec Kralove , Hradec Kralove , Czech Republic
- b Department of Applied Linguistics , University of Hradec Kralove , Hradec Kralove , Czech Republic
| | - Martin Valis
- a Department of Neurology , University Hospital Hradec Kralove , Hradec Kralove , Czech Republic
| | - Kamil Kuca
- c Biomedical Research Centre , University Hospital Hradec Kralove , Hradec Kralove , Czech Republic
- d Department of Chemistry, Faculty of Science , University of Hradec Kralove , Hradec Kralove , Czech Republic
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Cerrato A, Ponticorvo M. Enhancing Neuropsychological Testing with Gamification and Tangible Interfaces: The Baking Tray Task. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/978-3-319-59773-7_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
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Meiland F, Innes A, Mountain G, Robinson L, van der Roest H, García-Casal JA, Gove D, Thyrian JR, Evans S, Dröes RM, Kelly F, Kurz A, Casey D, Szcześniak D, Dening T, Craven MP, Span M, Felzmann H, Tsolaki M, Franco-Martin M. Technologies to Support Community-Dwelling Persons With Dementia: A Position Paper on Issues Regarding Development, Usability, Effectiveness and Cost-Effectiveness, Deployment, and Ethics. JMIR Rehabil Assist Technol 2017; 4:e1. [PMID: 28582262 PMCID: PMC5454557 DOI: 10.2196/rehab.6376] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/16/2016] [Accepted: 10/24/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND With the expected increase in the numbers of persons with dementia, providing timely, adequate, and affordable care and support is challenging. Assistive and health technologies may be a valuable contribution in dementia care, but new challenges may emerge. OBJECTIVE The aim of our study was to review the state of the art of technologies for persons with dementia regarding issues on development, usability, effectiveness and cost-effectiveness, deployment, and ethics in 3 fields of application of technologies: (1) support with managing everyday life, (2) support with participating in pleasurable and meaningful activities, and (3) support with dementia health and social care provision. The study also aimed to identify gaps in the evidence and challenges for future research. METHODS Reviews of literature and expert opinions were used in our study. Literature searches were conducted on usability, effectiveness and cost-effectiveness, and ethics using PubMed, Embase, CINAHL, and PsycINFO databases with no time limit. Selection criteria in our selected technology fields were reviews in English for community-dwelling persons with dementia. Regarding deployment issues, searches were done in Health Technology Assessment databases. RESULTS According to our results, persons with dementia want to be included in the development of technologies; there is little research on the usability of assistive technologies; various benefits are reported but are mainly based on low-quality studies; barriers to deployment of technologies in dementia care were identified, and ethical issues were raised by researchers but often not studied. Many challenges remain such as including the target group more often in development, performing more high-quality studies on usability and effectiveness and cost-effectiveness, creating and having access to high-quality datasets on existing technologies to enable adequate deployment of technologies in dementia care, and ensuring that ethical issues are considered an important topic for researchers to include in their evaluation of assistive technologies. CONCLUSIONS Based on these findings, various actions are recommended for development, usability, effectiveness and cost-effectiveness, deployment, and ethics of assistive and health technologies across Europe. These include avoiding replication of technology development that is unhelpful or ineffective and focusing on how technologies succeed in addressing individual needs of persons with dementia. Furthermore, it is suggested to include these recommendations in national and international calls for funding and assistive technology research programs. Finally, practitioners, policy makers, care insurers, and care providers should work together with technology enterprises and researchers to prepare strategies for the implementation of assistive technologies in different care settings. This may help future generations of persons with dementia to utilize available and affordable technologies and, ultimately, to benefit from them.
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Affiliation(s)
- Franka Meiland
- Department of Psychiatry, VU University medical centre, Amsterdam, Netherlands
| | - Anthea Innes
- Universities of Salford and Stirling UK, Manchester, Stirling, United Kingdom
| | - Gail Mountain
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Louise Robinson
- Institute for Ageing, Newcastle University, Newcastle, United Kingdom
| | - Henriëtte van der Roest
- Department of General Practice and Elderly Care Medicine, VU university medical centre, Amsterdam, Netherlands
| | - J Antonio García-Casal
- Iberian Research Psychosciences Institute, Psychosocial Rehabilitation Centre, Intras Foundation, Zamora, Spain
| | | | - Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock, Greifswald, Germany
| | - Shirley Evans
- Association for Dementia Studies, University of Worcester, Worcester, United Kingdom
| | - Rose-Marie Dröes
- Department of Psychiatry, VU University medical centre, Amsterdam, Netherlands
| | - Fiona Kelly
- Centre for Person-centred Practice Research, Queen Margaret University, Edinburgh, United Kingdom
| | | | - Dympna Casey
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Tom Dening
- Division of Psychiatry & Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Michael P Craven
- NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, United Kingdom
- Bioengineering Research Group, Faculty of Engineering, University of Nottingham, Nottingham, United Kingdom
| | - Marijke Span
- Windesheim University of Applied Sciences, Zwolle, Netherlands
| | | | - Magda Tsolaki
- Memory and dementia outpatient clinic, 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Manuel Franco-Martin
- Iberian Research Psychosciences Institute, Psychiatric Department in Zamora Hospital, Salamanca University, Zamora, Spain
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Gros A, Bensamoun D, Manera V, Fabre R, Zacconi-Cauvin AM, Thummler S, Benoit M, Robert P, David R. Recommendations for the Use of ICT in Elderly Populations with Affective Disorders. Front Aging Neurosci 2016; 8:269. [PMID: 27877126 PMCID: PMC5099137 DOI: 10.3389/fnagi.2016.00269] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/24/2016] [Indexed: 12/27/2022] Open
Abstract
Objective: Affective disorders are frequently encountered among elderly populations, and the use of information and communication technologies (ICT) could provide an added value for their recognition and assessment in addition to current clinical methods. The diversity and lack of consensus in the emerging field of ICTs is however a strong limitation for their global use in daily practice. The aim of the present article is to provide recommendations for the use of ICTs for the assessment and management of affective disorders among elderly populations with or without dementia. Methods: A Delphi panel was organized to gather recommendations from experts in the domain. A set of initial general questions for the use of ICT in affective disorders was used to guide the discussion of the expert panel and to analyze the Strengths, Weaknesses, Opportunities, and Threats (SWOT) of employing ICT in elderly populations with affective disorders. Based on the results collected from this first round, a web survey was sent to local general practitioners (GPs) and to all interns in psychiatry in France. Results: The results of the first round revealed that ICT may offer very useful tools for practitioners involved in the diagnosis and management of affective disorders. However, the results of the web survey showed the interest to explain better to current and upcoming practitioners the utility of ICT especially for people living with dementia.
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Affiliation(s)
- Auriane Gros
- Département de Neurologie, Centre Mémoire de Ressources et de Recherche, Centre Hospitalier Universitaire de DijonDijon, France; CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia AntipolisNice, France; Centre Edmond et Lily Safra pour la Recherche sur la Maladie d'Alzheimer, Centre Mémoire de Ressources et de Recherche, Institut Claude Pompidou, Centre Hospitalier Universitaire de NiceNice, France
| | - David Bensamoun
- CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia AntipolisNice, France; Département de Psychiatrie, Hôpital Pasteur, Centre Hospitalier Universitaire de NiceNice, France
| | - Valeria Manera
- CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia Antipolis Nice, France
| | - Roxane Fabre
- Centre Edmond et Lily Safra pour la Recherche sur la Maladie d'Alzheimer, Centre Mémoire de Ressources et de Recherche, Institut Claude Pompidou, Centre Hospitalier Universitaire de NiceNice, France; Département de Santé Publique, Hôpital L'Archet, Centre Hospitalier Universitaire de NiceNice, France
| | | | - Susanne Thummler
- CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia Antipolis Nice, France
| | - Michel Benoit
- CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia AntipolisNice, France; Département de Psychiatrie, Hôpital Pasteur, Centre Hospitalier Universitaire de NiceNice, France
| | - Philippe Robert
- CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia AntipolisNice, France; Centre Edmond et Lily Safra pour la Recherche sur la Maladie d'Alzheimer, Centre Mémoire de Ressources et de Recherche, Institut Claude Pompidou, Centre Hospitalier Universitaire de NiceNice, France
| | - Renaud David
- CoBTek (Cognition-Behaviour-Technology), University of Nice Sophia AntipolisNice, France; Centre Edmond et Lily Safra pour la Recherche sur la Maladie d'Alzheimer, Centre Mémoire de Ressources et de Recherche, Institut Claude Pompidou, Centre Hospitalier Universitaire de NiceNice, France
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Zannat R, Uddin MMN, Rahman MA, Aklima J, Al Amin MM. Antihistamines considerably modulate the cognitive and psychomotor performance of human volunteers. COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1216242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Rawshan Zannat
- Department of Psychology, University of Chittagong, Chittaagong 4334, Bangladesh
| | | | - Md. Atiar Rahman
- Department of Biochemistry and Molecular Biology, University of Chittagong, Chittagong 4331, Bangladesh
| | - Jannatul Aklima
- Department of Biochemistry and Molecular Biology, University of Chittagong, Chittagong 4331, Bangladesh
| | - Md. Mamun Al Amin
- Queensland Brain Institute, University of Queensland, Queensland, Australia
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Pietto M, Parra MA, Trujillo N, Flores F, García AM, Bustin J, Richly P, Manes F, Lopera F, Ibáñez A, Baez S. Behavioral and Electrophysiological Correlates of Memory Binding Deficits in Patients at Different Risk Levels for Alzheimer’s Disease. J Alzheimers Dis 2016; 53:1325-40. [DOI: 10.3233/jad-160056] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Marcos Pietto
- Instituto de Neurociencia Cognitiva y Traslacional (INCyT), Laboratorio de Psicología Experimental y Neurociencias (LPEN), Fundación INECO, Universidad de Favaloro, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Unidad de Neurobiología Aplicada, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Consejo Nacional de Investigaciones Científicas y Técnicas CONICET, Buenos Aires, Argentina
| | - Mario A. Parra
- School of Life Sciences, Psychology, Heriot-Watt University, UK
- Human Cognitive Neuroscience and Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, UK
- Alzheimer Scotland Dementia Research Centre and Scottish Dementia Clinical Research Network, UK
- Universidad Autónoma del Caribe, Barranquilla, Colombia
| | - Natalia Trujillo
- School of Public Health, University of Antioquia (UDEA), Medellin, Colombia
- Neuroscience Group, Faculty of Medicine, University of Antioquia (UDEA), Medellin
| | - Facundo Flores
- Instituto de Neurociencia Cognitiva y Traslacional (INCyT), Laboratorio de Psicología Experimental y Neurociencias (LPEN), Fundación INECO, Universidad de Favaloro, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Adolfo M. García
- Instituto de Neurociencia Cognitiva y Traslacional (INCyT), Laboratorio de Psicología Experimental y Neurociencias (LPEN), Fundación INECO, Universidad de Favaloro, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- ACR Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia
| | - Julian Bustin
- Instituto de Neurociencia Cognitiva y Traslacional (INCyT), Laboratorio de Psicología Experimental y Neurociencias (LPEN), Fundación INECO, Universidad de Favaloro, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Pablo Richly
- Instituto de Neurociencia Cognitiva y Traslacional (INCyT), Laboratorio de Psicología Experimental y Neurociencias (LPEN), Fundación INECO, Universidad de Favaloro, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Facundo Manes
- Instituto de Neurociencia Cognitiva y Traslacional (INCyT), Laboratorio de Psicología Experimental y Neurociencias (LPEN), Fundación INECO, Universidad de Favaloro, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Faculty of Elementary and Special Education (FEEyE), National University of Cuyo (UNCuyo), Sobremonte 74, C5500, Mendoza, Argentina
| | - Francisco Lopera
- Neuroscience Group, Faculty of Medicine, University of Antioquia (UDEA), Medellin
| | - Agustín Ibáñez
- Instituto de Neurociencia Cognitiva y Traslacional (INCyT), Laboratorio de Psicología Experimental y Neurociencias (LPEN), Fundación INECO, Universidad de Favaloro, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Universidad Autónoma del Caribe, Barranquilla, Colombia
- Faculty of Elementary and Special Education (FEEyE), National University of Cuyo (UNCuyo), Sobremonte 74, C5500, Mendoza, Argentina
| | - Sandra Baez
- Instituto de Neurociencia Cognitiva y Traslacional (INCyT), Laboratorio de Psicología Experimental y Neurociencias (LPEN), Fundación INECO, Universidad de Favaloro, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Grupo de Investigación Cerebro y Cognición Social, Bogotá, Colombia
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Sullivan EV, Brumback T, Tapert SF, Fama R, Prouty D, Brown SA, Cummins K, Thompson WK, Colrain IM, Baker FC, De Bellis MD, Hooper SR, Clark DB, Chung T, Nagel BJ, Nichols BN, Rohlfing T, Chu W, Pohl KM, Pfefferbaum A. Cognitive, emotion control, and motor performance of adolescents in the NCANDA study: Contributions from alcohol consumption, age, sex, ethnicity, and family history of addiction. Neuropsychology 2016; 30:449-73. [PMID: 26752122 DOI: 10.1037/neu0000259] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To investigate development of cognitive and motor functions in healthy adolescents and to explore whether hazardous drinking affects the normal developmental course of those functions. METHOD Participants were 831 adolescents recruited across 5 United States sites of the National Consortium on Alcohol and NeuroDevelopment in Adolescence 692 met criteria for no/low alcohol exposure, and 139 exceeded drinking thresholds. Cross-sectional, baseline data were collected with computerized and traditional neuropsychological tests assessing 8 functional domains expressed as composite scores. General additive modeling evaluated factors potentially modulating performance (age, sex, ethnicity, socioeconomic status, and pubertal developmental stage). RESULTS Older no/low-drinking participants achieved better scores than younger ones on 5 accuracy composites (general ability, abstraction, attention, emotion, and balance). Speeded responses for attention, motor speed, and general ability were sensitive to age and pubertal development. The exceeds-threshold group (accounting for age, sex, and other demographic factors) performed significantly below the no/low-drinking group on balance accuracy and on general ability, attention, episodic memory, emotion, and motor speed scores and showed evidence for faster speed at the expense of accuracy. Delay Discounting performance was consistent with poor impulse control in the younger no/low drinkers and in exceeds-threshold drinkers regardless of age. CONCLUSIONS Higher achievement with older age and pubertal stage in general ability, abstraction, attention, emotion, and balance suggests continued functional development through adolescence, possibly supported by concurrently maturing frontal, limbic, and cerebellar brain systems. Determination of whether low scores by the exceeds-threshold group resulted from drinking or from other preexisting factors requires longitudinal study. (PsycINFO Database Record
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Affiliation(s)
- Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | - Ty Brumback
- Department of Psychiatry, University of California, San Diego
| | - Susan F Tapert
- Psychology Service, Veterans Affairs San Diego Healthcare System
| | - Rosemary Fama
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | | | - Sandra A Brown
- Department of Psychiatry, University of California, San Diego
| | - Kevin Cummins
- Department of Psychiatry, University of California, San Diego
| | | | | | | | - Michael D De Bellis
- Healthy Childhood Brain Development Research Program, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine
| | - Stephen R Hooper
- Department of Allied Health Sciences, University of North Carolina School of Medicine
| | | | - Tammy Chung
- Department of Psychiatry, University of Pittsburgh
| | - Bonnie J Nagel
- Departments of Psychiatry and Behavioral Neuroscience, Oregon Health and Sciences University
| | - B Nolan Nichols
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | | | | | - Kilian M Pohl
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | - Adolf Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
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