Emotional indifference in Alzheimer's disease

Modeling and mobile home monitoring of behavioral and psychological symptoms of dementia (BPSD)

With the increasing global aging population, dementia care has rapidly become a major social problem. Current diagnosis of Behavior and Psychological Symptoms of Dementia (BPSD) relies on clinical interviews, and behavioral rating scales based on a period of behavior observation, but these methods are not suitable for identification of occurrence of BPSD in the daily living, which is necessary for providing appropriate interventions for dementia, though, has been studied by few research groups in the literature. To address these issues, in this study developed a BPSD monitoring system consisting of a Psycho-Cognitive (PsyCo) BPSD model, a Behavior-Physio-Environment (BePhyEn) BPSD model, and an implementation platform. The PsyCo BPSD model provides BPSD assessment support to caregivers and care providers, while the BePhyEn BPSD model provides instantaneous alerts for BPSD enabled by a 24-hour home monitoring platform for early intervention, and thereby alleviation of burden to patients and caregivers. Data for acquiring the models were generated through extensive literature review and regularity determined. A mobile robot was utilized as the implementation platform for improving sensitivity of sensors for home monitoring, and elderly individual following algorithms were investigated. Experiments in a virtual home environment showed that, a virtual BPSD elderly individual can be followed safely by the robot, and BPSD occurrence could be identified accurately, demonstrating the possibility of modeling and identification of BPSD in home environment.

Critical Influences on Responsible Tourism Behavior and the Mediating Role of Ambivalent Emotions

This research employed a behavioral model to confirm and elucidate the critical influence of place attachment, destination involvement, and ambivalent emotion on responsible tourism behaviors. A total of 415 questionnaires were collected from tourists visiting Penghu Island in Taiwan. Following data analysis using structural equation modeling, the results suggested that place attachment, destination involvement, and ambivalent emotion critically impact responsible tourism behaviors, and that place attachment is negatively related to ambivalent emotion. In addition, ambivalent emotion was found to mediate the relationship between place attachment and responsible tourism behaviors. Finally, implications for the promotion of sustainable tourism development were thoughtfully provided based on these findings.

NLRP3 Inflammasome Blocking as a Potential Treatment of Central Insulin Resistance in Early-Stage Alzheimer's Disease

BACKGROUND

Alzheimer's disease (AD) is a devastating neurodegenerative disorder. In recent years, attention of researchers has increasingly been focused on studying the role of brain insulin resistance (BIR) in the AD pathogenesis. Neuroinflammation makes a significant contribution to the BIR due to the activation of NLRP3 inflammasome. This study was devoted to the understanding of the potential therapeutic roles of the NLRP3 inflammasome in neurodegeneration occurring concomitant with BIR and its contribution to the progression of emotional disorders.

METHODS

To test the impact of innate immune signaling on the changes induced by Aβ1-42 injection, we analyzed animals carrying a genetic deletion of the Nlrp3 gene. Thus, we studied the role of NLRP3 inflammasomes in health and neurodegeneration in maintaining brain insulin signaling using behavioral, electrophysiological approaches, immunohistochemistry, ELISA and real-time PCR.

RESULTS

We revealed that NLRP3 inflammasomes are required for insulin-dependent glucose transport in the brain and memory consolidation. Conclusions NLRP3 knockout protects mice against the development of BIR: Taken together, our data reveal the protective role of Nlrp3 deletion in the regulation of fear memory and the development of Aβ-induced insulin resistance, providing a novel target for the clinical treatment of this disorder.

The thermodynamic brain and the evolution of intellect: the role of mental energy

The living state is low entropy, highly complex organization, yet it is part of the energy cycle of the environment. Due to the recurring presence of the resting state, stimulus and its response form a thermodynamic cycle of perception that can be modeled by the Carnot engine. The endothermic reversed Carnot engine relies on energy from the environment to increase entropy (i.e., the synaptic complexity of the resting state). High entropy relies on mental energy, which represents intrinsic motivation and focuses on the future. It increases freedom of action. The Carnot engine can model exothermic, negative emotional states, which direct the focus on the past. The organism dumps entropy and energy to its environment, in the form of aggravation, anxiety, criticism, and physical violence. The loss of mental energy curtails freedom of action, forming apathy, depression, mental diseases, and immune problems. Our improving intuition about the brain's intelligent computations will allow the development of new treatments for mental disease and novel find applications in robotics and artificial intelligence.

Designing Socially Assistive Robots for Alzheimer's Disease and Related Dementia Patients and Their Caregivers: Where We are and Where We are Headed

Over the past few years there has been a large rise in the field of robotics. Robots are being in used in many industries, but there has not been a large surge of robots in the medical field, especially the robots for healthcare use. However, as the aging population keeps growing, current medical staff and healthcare providers are increasingly burdened by caring for the ever-growing number of senior patients, especially those with cognitive impairment of Alzheimer's disease (AD) and Alzheimer's disease-related dementia (ADRD) patients. As a result, we can expect to see a large increase in the field of medical robotics, especially in forms of socially assistive robots (SARs) for senior patients and healthcare providers. In fact, SARs can alleviate AD and ADRD patients and their caregivers' unmet medical needs. Herein, we propose a design outline for such a SAR, based on a review of the current literature. We believe the next generation of SARs will enhance health and well-being, reduce illness and disability, and improve quality of life for AD and ADRD patients and their caregivers.

Impaired Empathy Versus General Hypoemotionality in Frontotemporal Dementia

OBJECTIVE

Impaired empathy is a diagnostic feature of behavioral variant frontotemporal dementia (bvFTD), but it is not clear whether it is caused by a primary impairment in empathy or by general emotional blunting.

METHODS

Patients with bvFTD who met criteria for loss of empathy (N=10) and patients with Alzheimer's disease (N=15) were assessed with a measure for empathy (Socioemotional Dysfunction Scale [SDS]) and a measure for general emotion (Scale for Emotional Blunting [SEB]). All patients underwent neuroimaging. Both patient groups and a healthy control group (N=18) were evaluated by using autonomic responses (skin conductance responses [SCR]) to pictures from the Internal Affective Picture System (IAPS) (presence or absence of empathy stimuli and high versus low emotion).

RESULTS

All participants reported understanding the content and others' perspectives on the empathy pictures; however, only patients with bvFTD showed impaired empathic behavior on the SDS, which persisted after adjusting for measures from the emotion scale (SEB). Patients with bvFTD had significantly lower SCR for all the IAPS stimuli, including for empathy pictures, which also persisted after adjusting for emotional content. On MRI analysis, SCR across groups significantly correlated with the volume of the dorsal anterior cingulate gyrus (dACC).

CONCLUSIONS

These results indicate that patients with bvFTD have decreased empathic behavior with or without emotional blunting, and they exhibit decreased psychophysiological responses to empathy stimuli, independent of general emotion. These preliminary findings suggest a specific impairment in emotional empathy, possibly related to impairment of the emotional appraisal role of the dACC.

Understanding the world of dementia. How do people with dementia experience the world?

BACKGROUND

There is growing awareness that the subjective experience of people with dementia is important for understanding behavior and improving quality of life. This paper reviews and reflects on the currently available theories on subjective experience in dementia and it explores the possibility of a knowledge gap on the influence of neurological deficits on experience in late stage dementia.

METHODS

A literature review on current commonly used theories on experience in dementia was supplemented with a systematic review in PubMed and Psychinfo. For the systematic review, the terms used were Perception and Dementia and Behavior; and Awareness and Dementia and Long term care.

RESULTS

Current models emphasize the psychosocial factors that influence subjective experience, but the consequences of neurological deficits are not elaborated upon. The systematic literature search on the neuropsychological functioning in dementia resulted in 631 papers, of which 94 were selected for review. The current knowledge is limited to the early stages of Alzheimer's disease. Next to memory impairments, perception of the direct environment, interpretation of the environment, and inhibition of own responses to the environment seem to be altered in people with dementia.

CONCLUSIONS

Without knowledge on how perception, interpretation and the ability for response control are altered, the behavior of people with dementia can easily be misinterpreted. Research into neuropsychological functioning of people in more severe stages and different forms of dementia is needed to be able to develop a model that is truly biopsychosocial. The proposed model can be used in such research as a starting point for developing tests and theories.