Technical Challenges for Smooth Interaction With Seniors With Dementia: Lessons From Humanitude™

The Impact of Training in Multimodal Communication Skills on Psychotropic Medication Use in Dementia Care

Aim This study aimed to assess the trends in psychotropic drug prescriptions among elderly residents with dementia following the continuous implementation of multimodal comprehensive care communication skills training for staff in a long-term care facility. Methods This retrospective single-center cross-sectional study utilized the database of an urban public hospital that included a long-term care facility. The data were collected from 2016 to 2020. All 130 staff members at the hospital (52 nurses, 48 professional caregivers, seven rehabilitation staff members, three physicians, and three pharmacists) initiated multimodal comprehensive care communication skills basic training from October 2014 to December 2015, which was followed by continuous monthly training until the end of 2020. Antipsychotic prescription rates for residents aged over 65 years with dementia were measured throughout the study period. Results A total of 506 eligible residents were identified, the median age was 86.0 years (IQR: 81.0-90.0), and 283 (55.9%) residents were females. The prescription rates for psychotropic drugs among residents with dementia decreased significantly (43.5% in 2016, 27.0% in 2020; p=0.01). Notably, the percentage of patients prescribed anxiolytics decreased significantly (from 4.7% to 0.0%), while the percentage of patients receiving antipsychotic drugs, hypnotics, antidepressants, or antiepileptic drugs remained unchanged over time. The prescription rates for antidementia drugs significantly decreased from 15.3% to 4.0%. Conclusion The prescription rates of psychotropic drugs were significantly reduced following multimodal comprehensive care communication skills training for staff at a long-term care facility. The improvement in communication skills among staff at long-term care facilities has a tangible impact on reducing drug use among elderly residents with dementia.

Delivery of pleasant stroke touch via robot in older adults

Touch care has clinically positive effects on older adults. Touch can be delivered using robots, addressing the lack of caregivers. A recent study of younger participants showed that stroke touch delivered via robot produced subjective and physiologically positive emotional responses similar to those evoked by human touch. However, whether robotic touch can elicit similar responses in older adults remains unknown. We investigated this topic by assessing subjective rating (valence and arousal) and physiological signals [corrugator and zygomatic electromyography (EMG) and skin conductance response (SCR)] to gentle stroking motions delivered to the backs of older participants by robot and human agents at two different speeds: 2.6 and 8.5 cm/s. Following the recent study, the participants were informed that only the robot strokes them. We compared the difference between the younger (their data from the previous study) and the older participants in their responses when the two agents (a robot and a human) stroked them. Subjectively, data from both younger and older participants showed that 8.5 cm/s stroking was more positive and arousing than 2.6 cm/s stroking for both human and robot agents. Physiologically, data from both younger and older participants showed that 8.5 cm/s stroking induced weaker corrugator EMG activity and stronger SCR activity than the 2.6 cm/s stroking for both agents. These results demonstrate that the overall patterns of the older groups responses were similar to those of the younger group, and suggest that robot-delivered stroke touch can elicit pleasant emotional responses in older adults.

Behavioral and neural underpinnings of empathic characteristics in a Humanitude-care expert

Background

Humanitude approaches have shown positive effects in elderly care. However, the behavioral and neural underpinnings of empathic characteristics in Humanitude-care experts remain unknown.

Methods

We investigated the empathic characteristics of a Humanitude-care expert (YG) and those of age-, sex-, and race-matched controls (n = 13). In a behavioral study, we measured subjective valence and arousal ratings and facial electromyography (EMG) of the corrugator supercilii and zygomatic major muscles while participants passively observed dynamic facial expressions associated with anger and happiness and their randomized mosaic patterns. In a functional magnetic resonance imaging (MRI) study, we measured brain activity while participants passively observed the same dynamic facial expressions and mosaics. In a structural MRI study, we acquired structural MRI data and analyzed gray matter volume.

Results

Our behavioral data showed that YG experienced higher subjective arousal and showed stronger facial EMG activity congruent with stimulus facial expressions compared with controls. The functional MRI data demonstrated that YG showed stronger activity in the ventral premotor cortex (PMv; covering the precentral gyrus and inferior frontal gyrus) and posterior middle temporal gyrus in the right hemisphere in response to dynamic facial expressions versus dynamic mosaics compared with controls. The structural MRI data revealed higher regional gray matter volume in the right PMv in YG than in controls.

Conclusion

These results suggest that Humanitude-care experts have behavioral and neural characteristics associated with empathic social interactions.

Effect of multimodal comprehensive communication skills training with video analysis by artificial intelligence for physicians on acute geriatric care: a mixed-methods study

OBJECTIVES

To quantitatively analyse by artificial intelligence (AI) the communication skills of physicians in an acute care hospital for geriatric care following a multimodal comprehensive care communication skills training programme and to qualitatively explore the educational benefits of this training programme.

DESIGN

A convergent mixed-methods study, including an intervention trial with a quasi-experimental design, was conducted to quantitatively analyse the communication skills of physicians. Qualitative data were collected via physicians' responses to an open-ended questionnaire administered after the training.

SETTING

An acute care hospital.

PARTICIPANTS

A total of 23 physicians.

INTERVENTIONS

In a 4-week multimodal comprehensive care communication skills training programme, including video lectures and bedside instruction, from May to October 2021, all the participants examined a simulated patient in the same scenario before and after their training. These examinations were video recorded by an eye-tracking camera and two fixed cameras. Then, the videos were analysed for communication skills by AI.

MAIN OUTCOME MEASURES

The primary outcomes were the physicians' eye contact, verbal expression, physical touch and multimodal communication skills with a simulated patient. The secondary outcomes were the physicians' empathy and burnout scores.

RESULTS

The proportion of the duration of the participants' single and multimodal types of communication significantly increased (p<0.001). The mean empathy scores and the personal accomplishment burnout scores also significantly increased after training. We developed a learning cycle model based on the six categories that changed after training from the physicians' perspective: multimodal comprehensive care communication skills training; increasing awareness of and sensitivity to changes to geriatric patients' condition; changes in clinical management; professionalism; team building and personal accomplishments.

CONCLUSIONS

Our study showed that multimodal comprehensive care communication skills training for physicians increased the proportions of time spent performing single and multimodal communication skills by video analysis through AI.

TRIAL REGISTRATION NUMBER

UMIN Clinical Trials Registry (UMIN000044288; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000050586).

Pleasant Stroke Touch on Human Back by a Human and a Robot

Pleasant touching is an important aspect of social interactions that is widely used as a caregiving technique. To address the problems resulting from a lack of available human caregivers, previous research has attempted to develop robots that can perform this kind of pleasant touch. However, it remains unclear whether robots can provide such a pleasant touch in a manner similar to humans. To investigate this issue, we compared the effect of the speed of gentle strokes on the back between human and robot agents on the emotional responses of human participants (n = 28). A robot or a human stroked on the participants' back at two different speeds (i.e., 2.6 and 8.5 cm/s). The participants' subjective (valence and arousal ratings) and physiological (facial electromyography (EMG) recorded from the corrugator supercilii and zygomatic major muscles and skin conductance response) emotional reactions were measured. The subjective ratings demonstrated that the speed of 8.5 cm/s was more pleasant and arousing than the speed of 2.6 cm/s for both human and robot strokes. The corrugator supercilii EMG showed that the speed of 8.5 cm/s resulted in reduced activity in response to both human and robot strokes. These results demonstrate similar speed-dependent modulations of stroke on subjective and physiological positive emotional responses across human and robot agents and suggest that robots can provide a pleasant touch similar to that of humans.

Enzyme inhibition, molecular docking, and density functional theory studies of new thiosemicarbazones incorporating the 4-hydroxy-3,5-dimethoxy benzaldehyde motif

New Schiff base-bearing thiosemicarbazones (1-13) were obtained from 4-hydroxy-3,5-dimethoxy benzaldehyde and various isocyanates. The structures of the synthesized molecules were elucidated in detail. Density functional theory calculations were also performed to determine the spectroscopic properties of the compounds. Moreover, the enzyme inhibition activities of these compounds were investigated. They showed highly potent inhibition effects on acetylcholinesterase (AChE) and human carbonic anhydrases (hCAs) (K_I values are in the range of 51.11 ± 6.01 to 278.10 ± 40.55 nM, 60.32 ± 9.78 to 300.00 ± 77.41 nM, and 64.21 ± 9.99 to 307.70 ± 61.35 nM for AChE, hCA I, and hCA II, respectively). In addition, molecular docking studies were performed, confirmed by binding affinities studies of the most potent derivatives.

Extraction and Evaluation of Greeting Speech-Timing and Characteristic Upper Body Motion for Robots to Gain Attention of Older Adults

Greeting is important for socially assistive robot to smoothly initiate conversations with older adults. Because of their decreased cognitive function, older adults may occasionally be unaware of the presence of a robot. The purpose of this study was to investigate and evaluate the characteristic motion and utterance time for greeting older adults in comparison with those for greeting non-older adults. The motion and utterance for greeting a seated target imitating an older adult and greeting a non-older adult were measured. The utterance times of the greeting and motion parameters such as the maximum joint angles were calculated from the measured data. The parameters were compared using statistical methods. According to the results, the hip bending angle in older adults was 36.6° greater than in the non-older adults. The utterance lag for greeting the older adults was 0.7 s longer than that for greeting the non-older adults at this time. The impressions of the robot that greeted the participants based on the extracted motion parameters were compared to verify these parameter differences. Although the greeting styles did not differ significantly, it was verified that the robot’s greeting was more impressive than that of a computer-graphics robot.

Humanoid Robot Use in Cognitive Rehabilitation of Patients with Severe Brain Injury: A Pilot Study

Severe acquired brain injury (SABI) is a major global public health problem and a source of disability. A major contributor to disability after SABI is limited access to multidisciplinary rehabilitation, despite evidence of sustained functional gains, improved quality of life, increased return to work, and reduced need for long-term care. Twelve patients with a diagnosis of SABI were enrolled and equally divided into two groups: experimental and control. Patients in both groups underwent intensive neurorehabilitation according to the severity of their disabilities (motor, psycho-cognitive, and sensory deficits). However, in the experimental group, the treatment was performed by using a humanoid robot. At baseline, the two groups differed significantly only in Severe Impairment Battery (SIB) scores. Results showed that the experimental treatment had a higher effect than the traditional one on quality of life and mood. In conclusion, this pilot study provides evidence of the possible effects of relational and cognitive stimulation in more severely brain-injured patients.