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Janssen Daalen JM, van den Bergh R, Prins EM, Moghadam MSC, van den Heuvel R, Veen J, Mathur S, Meijerink H, Mirelman A, Darweesh SKL, Evers LJW, Bloem BR. Digital biomarkers for non-motor symptoms in Parkinson's disease: the state of the art. NPJ Digit Med 2024; 7:186. [PMID: 38992186 PMCID: PMC11239921 DOI: 10.1038/s41746-024-01144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/22/2024] [Indexed: 07/13/2024] Open
Abstract
Digital biomarkers that remotely monitor symptoms have the potential to revolutionize outcome assessments in future disease-modifying trials in Parkinson's disease (PD), by allowing objective and recurrent measurement of symptoms and signs collected in the participant's own living environment. This biomarker field is developing rapidly for assessing the motor features of PD, but the non-motor domain lags behind. Here, we systematically review and assess digital biomarkers under development for measuring non-motor symptoms of PD. We also consider relevant developments outside the PD field. We focus on technological readiness level and evaluate whether the identified digital non-motor biomarkers have potential for measuring disease progression, covering the spectrum from prodromal to advanced disease stages. Furthermore, we provide perspectives for future deployment of these biomarkers in trials. We found that various wearables show high promise for measuring autonomic function, constipation and sleep characteristics, including REM sleep behavior disorder. Biomarkers for neuropsychiatric symptoms are less well-developed, but show increasing accuracy in non-PD populations. Most biomarkers have not been validated for specific use in PD, and their sensitivity to capture disease progression remains untested for prodromal PD where the need for digital progression biomarkers is greatest. External validation in real-world environments and large longitudinal cohorts remains necessary for integrating non-motor biomarkers into research, and ultimately also into daily clinical practice.
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Affiliation(s)
- Jules M Janssen Daalen
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands.
| | - Robin van den Bergh
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands
| | - Eva M Prins
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands
| | - Mahshid Sadat Chenarani Moghadam
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands
| | - Rudie van den Heuvel
- HAN University of Applied Sciences, School of Engineering and Automotive, Health Concept Lab, Arnhem, The Netherlands
| | - Jeroen Veen
- HAN University of Applied Sciences, School of Engineering and Automotive, Health Concept Lab, Arnhem, The Netherlands
| | | | - Hannie Meijerink
- ParkinsonNL, Parkinson Patient Association, Bunnik, The Netherlands
| | - Anat Mirelman
- Tel Aviv University, Sagol School of Neuroscience, Department of Neurology, Faculty of Medicine, Laboratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility (CMCM), Tel Aviv, Israel
| | - Sirwan K L Darweesh
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands
| | - Luc J W Evers
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands
- Radboud University, Institute for Computing and Information Sciences, Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands.
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Facchinetti G, Petrucci G, Albanesi B, De Marinis MG, Piredda M. Can Smart Home Technologies Help Older Adults Manage Their Chronic Condition? A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1205. [PMID: 36673957 PMCID: PMC9859495 DOI: 10.3390/ijerph20021205] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/23/2022] [Accepted: 01/01/2023] [Indexed: 05/26/2023]
Abstract
The management of chronic diseases requires personalized healthcare that allows older adults to manage their diseases at home. This systematic review aimed to describe the smart home technologies used in the management of chronic diseases in older people. A systematic literature review was conducted on four databases and was reported following the PRISMA statement. Nineteen articles were included. The intervention technologies were classified into three groups: smart home, characterized by environmental sensors detecting motion, contact, light, temperature, and humidity; external memory aids, characterized by a partnership between mobile apps and smart home-based activity learning; and hybrid technology, with the integration of multiple technologies, such as devices installed at patients' homes and telemedicine. The health outcomes evaluated are vital signs, medication management, ADL-IADL, mobility, falls, and quality of life. Smart homes show great potential in the management of chronic diseases by favouring the control of exacerbations and increasing patients' safety by providing support in disease management, including support for cognitively impaired older people. The use of smart homes in the community could bring numerous benefits in terms of continuity of care, allowing the constant monitoring of older people by local and hospital health services.
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Affiliation(s)
- Gabriella Facchinetti
- Research Unit of Nursing Science, Department of Medicine and Surgery, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 00128 Rome, Italy
| | - Giorgia Petrucci
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 00128 Rome, Italy
| | - Beatrice Albanesi
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5 bis, 10126 Turin, Italy
| | - Maria Grazia De Marinis
- Research Unit of Nursing Science, Department of Medicine and Surgery, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 00128 Rome, Italy
- Campus Bio-Medico University Hospital Foundation, Via Alvaro del Portillo, 00128 Rome, Italy
| | - Michela Piredda
- Research Unit of Nursing Science, Department of Medicine and Surgery, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 00128 Rome, Italy
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Sohn M, Yang J, Sohn J, Lee JH. Digital healthcare for dementia and cognitive impairment: A scoping review. Int J Nurs Stud 2022; 140:104413. [PMID: 36821951 DOI: 10.1016/j.ijnurstu.2022.104413] [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: 04/29/2022] [Revised: 11/11/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cognitive disorders, such as Alzheimer's disease, are a global health problem. Digital healthcare technology is an innovative management tool for delaying the progression of dementia and mild cognitive impairment. Thanks to digital technology, the possibility of safe and effective care for patients at home and in the community is increasing, even in situations that threaten the continuity of care, such as the COVID-19 pandemic. However, it is difficult to select appropriate technology and alternatives due to the lack of comprehensive reviews on the types and characteristics of digital technology for cognitive impairment, including their effects and limitations. OBJECTIVE This study aims to identify the types of digital healthcare technology for dementia and mild cognitive impairment and comprehensively examine how its outcome measures were constructed in line with each technology's purpose. METHODS According to the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines, a literature search was conducted in August 2021 using Medline (Ovid), EMBASE, and Cochrane library. The search terms were constructed based on Population-Concept-Context mnemonic: 'dementia', 'cognitive impairment', and 'cognitive decline'; digital healthcare technology, such as big data, artificial intelligence, virtual reality, robots, applications, and so on; and the outcomes of digital technology, such as accuracy of diagnosis and physical, mental, and social health. After grasping overall research trends, the literature was classified and analysed in terms of the type of service users and technology. RESULTS In total, 135 articles were selected. Since 2015, an increase in literature has been observed, and various digital healthcare technologies were identified. For people with mild cognitive impairment, technology for predicting and diagnosing the onset of dementia was studied, and for people with dementia, intervention technology to prevent the deterioration of health and induce significant improvement was considered. Regarding caregivers, many studies were conducted on monitoring and daily living assistive technologies that reduce the burden of care. However, problems such as data collection, storage, safety, and the digital divide persisted at different intensities for each technology type. CONCLUSIONS This study revealed that appropriate technology options and considerations may differ depending on the characteristics of users. It also emphasises the role of humans in designing and managing technology to apply digital healthcare technology more effectively.
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Affiliation(s)
- Minsung Sohn
- Division of Health and Medical Sciences, The Cyber University of Korea, Seoul, Republic of Korea
| | - JungYeon Yang
- Transdisciplinary Major in Learning Health Systems, Department of Public Health Science, Graduate School, Korea University, Republic of Korea
| | - Junyoung Sohn
- Department of Artificial Intelligence, Korea University, Seoul, Republic of Korea
| | - Jun-Hyup Lee
- Department of Health Policy and Management, College of Health Sciences, Korea University, Republic of Korea.
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Smith SK, Wolverson EL, Mountain GA. What is intended by the term “participation” and what does it mean to people living with dementia? A conceptual overview and directions for future research. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:952722. [PMID: 36189033 PMCID: PMC9397697 DOI: 10.3389/fresc.2022.952722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022]
Abstract
Policy continues to emphasise the importance of wellbeing in dementia. However, there is a vital need for psychosocial interventions that can promote positive outcomes to enhance “living well with dementia”. Our developing understanding of what people living with dementia report as being important to them, has resulted in new interpretations of what constitutes wellbeing including constructs such as “growth”, “purpose” and “participation”. These exciting and important constructs are not currently captured by outcome measures within dementia research. This limits our understanding of the value of psychosocial interventions. This paper explores the concept of participation and how continued participation in social life can make a difference to the rights of people living with dementia as citizens. We will firstly consider why participation is important for how we might measure outcomes in dementia research and care. Secondly, we will explore how we might measure participation. Finally, we will consider the value of participation as a psychosocial outcome in future research.
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Affiliation(s)
- Sarah Kate Smith
- Health, Wellbeing & Lifesciences, Sheffield Hallam University, Sheffield, United Kingdom
- Correspondence: Sarah Kate Smith
| | - Emma Louise Wolverson
- Health Sciences, University of Hull, Hull, United Kingdom
- Clinical Psychology for Older People, Humber Teaching NHS Foundation, Hull, United Kingdom
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Applications and Outcomes of Internet of Things for Patients with Alzheimer’s Disease/Dementia: A Scoping Review. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6274185. [PMID: 35342749 PMCID: PMC8948545 DOI: 10.1155/2022/6274185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/01/2022] [Accepted: 02/22/2022] [Indexed: 11/24/2022]
Abstract
Objectives We aimed to identify and classify the Internet of Things (IoT) technologies used for Alzheimer's disease (AD)/dementia as well as the healthcare aspects addressed by these technologies and the outcomes of the IoT interventions. Methodology. We searched PubMed/MEDLINE, IEEE Explore, Web of Science, OVID, Scopus, Embase, Cochrane, and Google Scholar. In total, 13,005 papers were reviewed, 36 of which were finally selected. All the reviews were independently carried out by two researchers. In the case of any disagreement, the problem was resolved by holding a meeting and exchanging views. Due to the diversity of the reviewed studies, narrative analysis was performed. Results Among the technologies used for the patients including radio frequency identification (RFID), near field communication (NFC), ZigBee, Bluetooth, global positioning system (GPS), sensors, and cameras, the sensors were employed in 36 studies, most of which were switch and vital sign monitoring sensors. The most common aspects of AD/dementia care monitored using these technologies were activities of daily living (ADLs) in 27 studies, followed by sleep patterns and disease diagnosis in 19 and 14 studies, respectively. Sleeping, medication, vital signs, agitation, memory, social interaction, apathy, movement, tracking, and fall were other aspects monitored by IoT. Then, their outcomes were reported. Conclusion Using IoT for AD/dementia provides many opportunities for considering various aspects of this disease. Moreover, the ability to use various technologies for gathering patient-related data provides a comprehensive application for almost all aspects of the patients' care with high accuracy.
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Garcia-Moreno FM, Bermudez-Edo M, Rodríguez-García E, Pérez-Mármol JM, Garrido JL, Rodríguez-Fórtiz MJ. A machine learning approach for semi-automatic assessment of IADL dependence in older adults with wearable sensors. Int J Med Inform 2021; 157:104625. [PMID: 34763192 DOI: 10.1016/j.ijmedinf.2021.104625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE The assessment of dependence in older adults currently requires a manual collection of data taken from questionnaires. This process is time consuming for the clinicians and intrudes the daily life of the elderly. This paper aims to semi-automate the acquisition and analysis of health data to assess and predict the dependence in older adults while executing one instrumental activity of daily living (IADL). METHODS In a mobile-health (m-health) scenario, we analyze whether the acquisition of data through wearables during the performance of IADLs, and with the help of machine learning techniques could replace the traditional questionnaires to evaluate dependence. To that end, we collected data from wearables, while older adults do the shopping activity. A trial supervisor (TS) labelled the different shopping stages (SS) in the collected data. We performed data pre-processing techniques over those SS and analyzed them with three machine learning algorithms: k-Nearest Neighbors (k-NN), Random Forest (RF) and Support Vector Machines (SVM). RESULTS Our results confirm that it is possible to replace the traditional questionnaires with wearable data. In particular, the best learning algorithm we tried reported an accuracy of 97% in the assessment of dependence. We tuned the hyperparameters of this algorithm and used embedded feature selection technique to get the best performance with a subset of only 10 features out of the initial 85. This model considers only features extracted from four sensors of a single wearable: accelerometer, heart rate, electrodermal activity and temperature. Although these features are not observational, our current proposal is semi-automatic, because it needs a TS labelling the SS (with a smartphone application). In the future, this labelling process could be automatic as well. CONCLUSIONS Our method can semi-automatically assess the dependence, without disturbing daily activities of elderly people. This method can save clinicians' time in the evaluation of dependence in older adults and reduce healthcare costs.
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Affiliation(s)
- Francisco M Garcia-Moreno
- Department of Software Engineering, Computer Sciences School, University of Granada, C/ Periodista Daniel Saucedo Aranda, s/n, 18014 Granada, Spain.
| | - Maria Bermudez-Edo
- Department of Software Engineering, Computer Sciences School, University of Granada, C/ Periodista Daniel Saucedo Aranda, s/n, 18014 Granada, Spain.
| | - Estefanía Rodríguez-García
- Department of Physiology, Faculty of Health Sciences, University of Granada, Av. de la Ilustración, 60, 18016 Granada, Spain.
| | - José Manuel Pérez-Mármol
- Department of Physiology, Faculty of Health Sciences, University of Granada, Av. de la Ilustración, 60, 18016 Granada, Spain.
| | - José Luis Garrido
- Department of Software Engineering, Computer Sciences School, University of Granada, C/ Periodista Daniel Saucedo Aranda, s/n, 18014 Granada, Spain.
| | - María José Rodríguez-Fórtiz
- Department of Software Engineering, Computer Sciences School, University of Granada, C/ Periodista Daniel Saucedo Aranda, s/n, 18014 Granada, Spain.
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Li J, Antonecchia E, Camerlenghi M, Chiaravalloti A, Chu Q, Costanzo AD, Li Z, Wan L, Zhang X, D'Ascenzo N, Schillaci O, Xie Q. Correlation of [ 18F]florbetaben textural features and age of onset of Alzheimer's disease: a principal components analysis approach. EJNMMI Res 2021; 11:40. [PMID: 33881633 PMCID: PMC8060386 DOI: 10.1186/s13550-021-00774-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/15/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND When Alzheimer's disease (AD) is occurring at an early onset before 65 years old, its clinical course is generally more aggressive than in the case of a late onset. We aim at identifying [[Formula: see text]F]florbetaben PET biomarkers sensitive to differences between early-onset Alzheimer's disease (EOAD) and late-onset Alzheimer's disease (LOAD). We conducted [[Formula: see text]F]florbetaben PET/CT scans of 43 newly diagnosed AD subjects. We calculated 93 textural parameters for each of the 83 Hammers areas. We identified 41 independent principal components for each brain region, and we studied their Spearman correlation with the age of AD onset, by taking into account multiple comparison corrections. Finally, we calculated the probability that EOAD and LOAD patients have different amyloid-[Formula: see text] ([Formula: see text]) deposition by comparing the mean and the variance of the significant principal components obtained in the two groups with a 2-tailed Student's t-test. RESULTS We found that four principal components exhibit a significant correlation at a 95% confidence level with the age of onset in the left lateral part of the anterior temporal lobe, the right anterior orbital gyrus of the frontal lobe, the right lateral orbital gyrus of the frontal lobe and the left anterior part of the superior temporal gyrus. The data are consistent with the hypothesis that EOAD patients have a significantly different [[Formula: see text]F]florbetaben uptake than LOAD patients in those four brain regions. CONCLUSIONS Early-onset AD implies a very irregular pattern of [Formula: see text] deposition. The authors suggest that the identified textural features can be used as quantitative biomarkers for the diagnosis and characterization of EOAD patients.
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Affiliation(s)
- Jing Li
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Luoyu Road, Wuhan, 430074, China
| | - Emanuele Antonecchia
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Luoyu Road, Wuhan, 430074, China.,Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo NEUROMED I.R.C.C.S, Via Dell'Elettronica, 83008, Pozzilli, Italy
| | - Marco Camerlenghi
- NIM Competence Center for Digital Healthcare GmbH, Potsdamerplatz, 10, 10785, Berlin, Germany
| | - Agostino Chiaravalloti
- Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo NEUROMED I.R.C.C.S, Via Dell'Elettronica, 83008, Pozzilli, Italy. .,Department of Biomedicine and Prevention, University of Tor Vergata, 86100, Rome, Italy.
| | - Qian Chu
- Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road, Wuhan, 430030, China.,Department of Oncology, Tongji Hospital, Jiefang Avenue, Wuhan, 430030, China
| | - Alfonso Di Costanzo
- Universita degli Studi del Molise, Via Francesco de Sanctis, 1, 10115, Campobasso, Italy
| | - Zhen Li
- Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road, Wuhan, 430030, China.,Department of Radiology, Tongji Hospital, Jiefang Avenue, Wuhan, 430030, China
| | - Lin Wan
- Department of Software Engineering, Huazhong University of Science and Technology, Luoyu Road, Wuhan, 430074, China
| | - Xiangsong Zhang
- The First Affiliated Hospital, Sun Yat-sen University, Zhongshan 2nd Road, Guangzhou, 510080, China
| | - Nicola D'Ascenzo
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Luoyu Road, Wuhan, 430074, China. .,Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo NEUROMED I.R.C.C.S, Via Dell'Elettronica, 83008, Pozzilli, Italy.
| | - Orazio Schillaci
- Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo NEUROMED I.R.C.C.S, Via Dell'Elettronica, 83008, Pozzilli, Italy.,Department of Biomedicine and Prevention, University of Tor Vergata, 86100, Rome, Italy
| | - Qingguo Xie
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Luoyu Road, Wuhan, 430074, China. .,Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo NEUROMED I.R.C.C.S, Via Dell'Elettronica, 83008, Pozzilli, Italy.
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Fares N, Sherratt RS, Elhajj IH. Directing and Orienting ICT Healthcare Solutions to Address the Needs of the Aging Population. Healthcare (Basel) 2021; 9:147. [PMID: 33540510 PMCID: PMC7912863 DOI: 10.3390/healthcare9020147] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND With an aging population, it is essential to maintain good health and autonomy for as long as possible. Instead of hospitalisation or institutionalisation, older people with chronic conditions can be assisted in their own home with numerous "smart" devices that support them in their activities of daily living, manage their medical conditions, and prevent fall incidents. Information and Communication Technology (ICT) solutions facilitate the monitoring and management of older people's health to improve quality of life and physical activity with a decline in caregivers' burden. METHOD The aim of this paper was to conduct a systematic literature review to analyse the state of the art of ICT solutions for older people with chronic conditions, and the impact of these solutions on their quality of life from a biomedical perspective. RESULTS By analysing the literature on the available ICT proposals, it is shown that different approaches have been deployed by noticing that the more cross-interventions are merged then the better the results are, but there is still no evidence of the effects of ICT solutions on older people's health outcomes. Furthermore, there are still unresolved ethical and legal issues. CONCLUSION While there has been much research and development in healthcare ICT solutions for the aging population, ICT solutions still need significant development in order to be user-oriented, affordable, and to manage chronic conditions in the aging wider population.
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Affiliation(s)
- Nada Fares
- Department of Biomedical Engineering, School of Biological Sciences, University of Reading, Berkshire RG6 6AY, UK;
| | - R. Simon Sherratt
- Department of Biomedical Engineering, School of Biological Sciences, University of Reading, Berkshire RG6 6AY, UK;
| | - Imad H. Elhajj
- Department of Electrical and Computer Engineering, American University of Beirut, Beirut 1107 2020, Lebanon;
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Lenouvel E, Novak L, Nef T, Klöppel S. Advances in Sensor Monitoring Effectiveness and Applicability: A Systematic Review and Update. THE GERONTOLOGIST 2020; 60:e299-e308. [PMID: 31102436 DOI: 10.1093/geront/gnz049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To provide an updated review article studying the applicability and effectiveness of sensor networks in measuring and supporting activities of daily living (ADLs) among non-demented older adults. RESEARCH DESIGN AND METHODS Systematic review following PRISMA guidelines. Systematic search of PubMed, Embase, PsycINFO, INSPEC, and the Cochrane Library, from October 26, 2012 to January 3, 2018 for empirical studies, measuring and supporting ADLs among independently living, non-demented older adults, investigating wireless sensor monitoring networks. RESULTS The search queries yielded 10,782 hits of which 162 articles were manually reviewed. Following exclusion criteria, 13 relevant articles were retained. Although various types of sensor networks with different analyzing algorithms were proposed, from simple video monitoring to complex sensor networks distributed throughout a house, all articles supported the use of wireless sensors for identifying changes in activity patterns. DISCUSSION AND IMPLICATIONS Wireless sensor networks appear to be developing into an effective solution for measuring ADLs and for identifying changes in their patterns. They offer a promising solution to support older adults living independently at home. However, there is too much focus on technology, and practical usefulness still needs to be further elaborated. Sensors should focus on ADLs that are sensitive to the earliest signs of cognitive decline, as well as quantitative markers, such as errors in the execution of ADLs.
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Affiliation(s)
- Eric Lenouvel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland.,Faculty of Medicine, University of Bern, Switzerland
| | - Lan Novak
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland.,Faculty of Medicine, University of Bern, Switzerland
| | - Tobias Nef
- Gerontechnology and Rehabilitation Research Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland
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Myszczynska MA, Ojamies PN, Lacoste AMB, Neil D, Saffari A, Mead R, Hautbergue GM, Holbrook JD, Ferraiuolo L. Applications of machine learning to diagnosis and treatment of neurodegenerative diseases. Nat Rev Neurol 2020; 16:440-456. [DOI: 10.1038/s41582-020-0377-8] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2020] [Indexed: 12/11/2022]
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Husebo BS, Heintz HL, Berge LI, Owoyemi P, Rahman AT, Vahia IV. Sensing Technology to Monitor Behavioral and Psychological Symptoms and to Assess Treatment Response in People With Dementia. A Systematic Review. Front Pharmacol 2020; 10:1699. [PMID: 32116687 PMCID: PMC7011129 DOI: 10.3389/fphar.2019.01699] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/31/2019] [Indexed: 01/28/2023] Open
Abstract
Background The prevalence of dementia is expected to rapidly increase in the next decades, warranting innovative solutions improving diagnostics, monitoring and resource utilization to facilitate smart housing and living in the nursing home. This systematic review presents a synthesis of research on sensing technology to assess behavioral and psychological symptoms and to monitor treatment response in people with dementia. Methods The literature search included medical peer-reviewed English language publications indexed in Embase, Medline, Cochrane library and Web of Sciences, published up to the 5th of April 2019. Keywords included MESH terms and phrases synonymous with "dementia", "sensor", "patient", "monitoring", "behavior", and "therapy". Studies applying both cross sectional and prospective designs, either as randomized controlled trials, cohort studies, and case-control studies were included. The study was registered in PROSPERO 3rd of May 2019. Results A total of 1,337 potential publications were identified in the search, of which 34 were included in this review after the systematic exclusion process. Studies were classified according to the type of technology used, as (1) wearable sensors, (2) non-wearable motion sensor technologies, and (3) assistive technologies/smart home technologies. Half of the studies investigated how temporarily dense data on motion can be utilized as a proxy for behavior, indicating high validity of using motion data to monitor behavior such as sleep disturbances, agitation and wandering. Further, up to half of the studies represented proof of concept, acceptability and/or feasibility testing. Overall, the technology was regarded as non-intrusive and well accepted. Conclusions Targeted clinical application of specific technologies is poised to revolutionize precision care in dementia as these technologies may be used both by patients and caregivers, and at a systems level to provide safe and effective care. To highlight awareness of legal regulations, data risk assessment, and patient and public involvement, we propose a necessary framework for sustainable ethical innovation in healthcare technology. The success of this field will depend on interdisciplinary cooperation and the advance in sustainable ethic innovation. Systematic Review Registration PROSPERO, identifier CRD42019134313.
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Affiliation(s)
- Bettina S Husebo
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway.,Department of Nursing Home Medicine, Municipality of Bergen, Bergen, Norway
| | - Hannah L Heintz
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, United States
| | - Line I Berge
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway.,NKS Olaviken Gerontopsychiatric Hospital, Bergen, Norway
| | - Praise Owoyemi
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, United States
| | - Aniqa T Rahman
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, United States
| | - Ipsit V Vahia
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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12
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Costanzo MC, Arcidiacono C, Rodolico A, Panebianco M, Aguglia E, Signorelli MS. Diagnostic and interventional implications of telemedicine in Alzheimer's disease and mild cognitive impairment: A literature review. Int J Geriatr Psychiatry 2020; 35:12-28. [PMID: 31617247 DOI: 10.1002/gps.5219] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 09/15/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Worldwide, life expectancy, and aging-related disorders as mild cognitive impairment (MCI) and Alzheimer disease (AD) are increasing, having a rising impact on patients' quality of life and caregivers' distress. Telemedicine offers many possibilities, such as remote diagnosing and monitoring of patients. OBJECTIVE The purpose of this study is to provide a narrative synthesis of the literature about the implementation of telemedicine for diagnosis, treatment, and follow-up of patients with AD and MCI and their caregivers. METHODS A systematic literature review was conducted on MEDLINE, EMBASE, and the Cochrane Library databases up to September 2018. MCI or AD diagnoses were the conditions of interest. We excluded other dementias. RESULTS Fifty-six articles met inclusion criteria. We identified two main categories: diagnosis group (DG) and follow-up/interventional group (FIG). Fifteen articles suggested how to make a remote or earlier diagnosis: four were case-control accuracy studies, nine were paired comparative accuracy studies, and two were prospective single-arm accuracy studies. Among these, four focused on MCI, six on AD, and five on both. Forty one focused on supporting patients during the stages of the disease (28 articles), patient's caregivers (nine articles), or both (four articles). CONCLUSIONS The rising use of telemedicine could actively improve AD and MCI patients' lives, reduce caregivers' burden, and facilitate an early diagnosis if patients live in remote places. However, as some studies report, it is relevant to take into account the emotional impact of telemedicine on patients and not only on the effectiveness.
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Affiliation(s)
- Maria Cristina Costanzo
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Chiara Arcidiacono
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Alessandro Rodolico
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Mariangela Panebianco
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
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13
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Bankole A, Anderson MS, Homdee N, Alam R, Lofton A, Fyffe N, Goins H, Newbold T, Smith-Jackson T, Lach J. BESI: Behavioral and Environmental Sensing and Intervention for Dementia Caregiver Empowerment-Phases 1 and 2. Am J Alzheimers Dis Other Demen 2020; 35:1533317520906686. [PMID: 32162529 PMCID: PMC10624017 DOI: 10.1177/1533317520906686] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Caregiver burden associated with dementia-related agitation is one of the commonest reasons a community-dwelling person with dementia (PWD) transitions to a care facility. Behavioral and Environmental Sensing and Intervention for Dementia Caregiver Empowerment (BESI) is a system of body-worn and in-home sensors developed to provide continuous, noninvasive agitation assessment and environmental context monitoring to detect early signs of agitation and its environmental triggers. RESEARCH DESIGN AND METHODS This mixed methods, remote ethnographic study is explored in a 3-phase, multiyear plan. In Phase 1, we developed and refined the BESI system and completed usability studies. Validation of the system and the development of dyad-specific models of the relationship between agitation and the environment occurred in Phase 2. RESULTS Phases 1 and 2 results facilitated targeted changes in BESI, thus improving its overall usability for the final phase of the study, when real-time notifications and interventions will be implemented. CONCLUSION Our results show a valid relationship between the presence of dementia related agitation and environmental factors and that persons with dementia and their caregivers prefer a home-based monitoring system like BESI.
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Affiliation(s)
- Azziza Bankole
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Martha S. Anderson
- Department of Interprofessionalism, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Nutta Homdee
- Department of Electrical and Computer Engineering, University of Virginia, Charlottesville, VA, USA
| | - Ridwan Alam
- Department of Electrical and Computer Engineering, University of Virginia, Charlottesville, VA, USA
| | - Ashley Lofton
- Department of Industrial and Systems Engineering, North Carolina A&T State University, Greensboro, NC, USA
| | - Nykesha Fyffe
- Department of Industrial and Systems Engineering, North Carolina A&T State University, Greensboro, NC, USA
| | - Hilda Goins
- Department of Industrial and Systems Engineering, North Carolina A&T State University, Greensboro, NC, USA
| | - Temple Newbold
- Department of Geriatric Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Tonya Smith-Jackson
- Department of Industrial and Systems Engineering, North Carolina A&T State University, Greensboro, NC, USA
| | - John Lach
- Department of Electrical and Computer Engineering, University of Virginia, Charlottesville, VA, USA
- Department of Electrical and Computer Engineering, George Washington University, Washington, DC, USA
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14
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Mancioppi G, Fiorini L, Timpano Sportiello M, Cavallo F. Novel Technological Solutions for Assessment, Treatment, and Assistance in Mild Cognitive Impairment. Front Neuroinform 2019; 13:58. [PMID: 31456679 PMCID: PMC6700331 DOI: 10.3389/fninf.2019.00058] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/15/2019] [Indexed: 12/14/2022] Open
Abstract
Alzheimer's disease, and dementia, represent a common cause of disability and one of the most relevant challenges in the health world. In addition, these conditions do not have, at moment, a pharmacological treatment that can stop the pathological progress. Mild cognitive impairment (MCI), defined as the borderline between normal aging and early dementia, represents a meaningful field of study because, in the transition to dementia, clinicians have defined a useful therapeutic window. Additionally, due to the lack of effective pharmacological interventions, recent years have seen an increase in research into new technological solutions to assess, stimulate, and assist patients afflicted with Alzheimer's disease. This review aims to outline the use of information and communication technologies in the field studying MCI. Particularly, the goal is to depict the framework and describe the most worthwhile research efforts, in order to display the current technologies available, describe the research objectives, and delineate prospective future researches. Regarding data sources, the research was conducted within three databases, PubMed Central, Web of Science, and Scopus, between January 2009 and December 2017. A total of 646 articles were found in the initial search. Accurate definition of the exclusion criteria and selection strategy allowed identification of the most relevant papers to use for the study. Finally, 56 papers were fully evaluated and included in this review. Three major clinical application areas have been portrayed, namely “Cognitive Assessment,” “Treatment,” and “Assistance.” These have been combined with three main technological solutions, specifically “Sensors,” “Personal Devices,” and “Robots.” Furthermore, the study of the publications time series illustrates a steadily increasing trend, characterized by the enrollment of small groups of subjects, and particularly oriented to the subjects assistance using robots companion. In conclusion, despite the new technological solutions for people with MCI have received much interest, particularly regarding robots for assistance, nowadays it still owns vast room for improvement.
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Affiliation(s)
| | - Laura Fiorini
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | - Filippo Cavallo
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
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15
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Turjamaa R, Pehkonen A, Kangasniemi M. How smart homes are used to support older people: An integrative review. Int J Older People Nurs 2019; 14:e12260. [DOI: 10.1111/opn.12260] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/29/2019] [Accepted: 06/12/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Riitta Turjamaa
- School of Health Care Kuopio Savonia University of Applied Sciences Kuopio Finland
- Department of Nursing Science, Faculty of Health Sciences University of Eastern Finland Kuopio Finland
| | - Aki Pehkonen
- Department of Nursing Science, Faculty of Health Sciences University of Eastern Finland Kuopio Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine University of Turku Turku Finland
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16
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Reasoning with smart objects’ affordance for personalized behavior monitoring in pervasive information systems. Knowl Inf Syst 2019. [DOI: 10.1007/s10115-019-01357-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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17
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Zucchella C, Sinforiani E, Tamburin S, Federico A, Mantovani E, Bernini S, Casale R, Bartolo M. The Multidisciplinary Approach to Alzheimer's Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment. Front Neurol 2018; 9:1058. [PMID: 30619031 PMCID: PMC6300511 DOI: 10.3389/fneur.2018.01058] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/21/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Alzheimer's disease (AD) and dementia are chronic diseases with progressive deterioration of cognition, function, and behavior leading to severe disability and death. The prevalence of AD and dementia is constantly increasing because of the progressive aging of the population. These conditions represent a considerable challenge to patients, their family and caregivers, and the health system, because of the considerable need for resources allocation. There is no disease modifying intervention for AD and dementia, and the symptomatic pharmacological treatments has limited efficacy and considerable side effects. Non-pharmacological treatment (NPT), which includes a wide range of approaches and techniques, may play a role in the treatment of AD and dementia. Aim: To review, with a narrative approach, current evidence on main NPTs for AD and dementia. Methods: PubMed and the Cochrane database of systematic reviews were searched for studies written in English and published from 2000 to 2018. The bibliography of the main articles was checked to detect other relevant papers. Results: The role of NPT has been largely explored in AD and dementia. The main NPT types, which were reviewed here, include exercise and motor rehabilitation, cognitive rehabilitation, NPT for behavioral and psychological symptoms of dementia, occupational therapy, psychological therapy, complementary and alternative medicine, and new technologies, including information and communication technologies, assistive technology and domotics, virtual reality, gaming, and telemedicine. We also summarized the role of NPT to address caregivers' burden. Conclusions: Although NPT is often applied in the multidisciplinary approach to AD and dementia, supporting evidence for their use is still preliminary. Some studies showed statistically significant effect of NPT on some outcomes, but their clinical significance is uncertain. Well-designed randomized controlled trials with innovative designs are needed to explore the efficacy of NPT in AD and dementia. Further studies are required to offer robust neurobiological grounds for the effect of NPT, and to examine its cost-efficacy profile in patients with dementia.
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Affiliation(s)
| | - Elena Sinforiani
- Alzheimer's Disease Assessment Unit, Laboratory of Neuropsychology, IRCCS Mondino Foundation, Pavia, Italy
| | - Stefano Tamburin
- Neurology Unit, University Hospital of Verona, Verona, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Angela Federico
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sara Bernini
- Alzheimer's Disease Assessment Unit, Laboratory of Neuropsychology, IRCCS Mondino Foundation, Pavia, Italy
| | - Roberto Casale
- Neurorehabilitation Unit, Department of Rehabilitation, HABILITA, Bergamo, Italy
| | - Michelangelo Bartolo
- Neurorehabilitation Unit, Department of Rehabilitation, HABILITA, Bergamo, Italy
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18
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Kenigsberg PA, Aquino JP, Bérard A, Brémond F, Charras K, Dening T, Droës RM, Gzil F, Hicks B, Innes A, Nguyen SM, Nygård L, Pino M, Sacco G, Salmon E, van der Roest H, Villet H, Villez M, Robert P, Manera V. Assistive Technologies to Address Capabilities of People with Dementia: From Research to Practice. DEMENTIA 2017; 18:1568-1595. [PMID: 28699364 DOI: 10.1177/1471301217714093] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Assistive technologies became pervasive and virtually present in all our life domains. They can be either an enabler or an obstacle leading to social exclusion. The Fondation Médéric Alzheimer gathered international experts of dementia care, with backgrounds in biomedical, human and social sciences, to analyze how assistive technologies can address the capabilities of people with dementia, on the basis of their needs. Discussion covered the unmet needs of people with dementia, the domains of daily life activities where assistive technologies can provide help to people with dementia, the enabling and empowering impact of technology to improve their safety and wellbeing, barriers and limits of use, technology assessment, ethical and legal issues. The capability approach (possible freedom) appears particularly relevant in person-centered dementia care and technology development. The focus is not on the solution, rather on what the person can do with it: seeing dementia as disability, with technology as an enabler to promote capabilities of the person, provides a useful framework for both research and practice. This article summarizes how these concepts took momentum in professional practice and public policies in the past 15 years (2000-2015), discusses current issues in the design, development and economic model of assistive technologies for people with dementia, and covers how these technologies are being used and assessed.
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Affiliation(s)
| | | | | | | | | | - Tom Dening
- Institute of Mental Health, University of Nottingham, UK
| | - Rose-Marie Droës
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Ben Hicks
- Bournemouth University Dementia Institute, UK
| | - Anthea Innes
- Salford Institute for Dementia University of Salford, Salford, United Kingdom
| | - Sao-Mai Nguyen
- Lab-STICC, Institut Mines-Télécom Bretagne, Brest, France
| | - Louise Nygård
- Department of Neurobiology, Care sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Maribel Pino
- Laboratoire Lusage, Hôpital Broca, Assistance publique-Hôpitaux de Paris, France
| | - Guillaume Sacco
- Centre Mémoire de Ressources et de Recherche, CHU de Nice; Université Côte-d'Azur, CoBTeK, Nice, France
| | - Eric Salmon
- Department of Neurology, Liège University Hospital, Belgium
| | - Henriëtte van der Roest
- Department of General Practice and Elderly Care Medicine, Amsterdaù Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Marion Villez
- Laboratoire LIRTES, Université Paris-Est-Val de Marne, Créteil, France
| | - Philippe Robert
- Université Côte-d'Azur, CoBTeK, & Innovation Alzheimer Association, Nice, France
| | - Valeria Manera
- Université Côte-d'Azur, INRIA STARS & CoBTeK, Nice, France
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19
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Satler C, Guimarães L, Tomaz C. Planning ability impairments in probable Alzheimer's disease patients: Evidence from the Tower of London test. Dement Neuropsychol 2017; 11:137-144. [PMID: 29213505 PMCID: PMC5710682 DOI: 10.1590/1980-57642016dn11-020006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Alzheimer's disease (AD) is associated with progressive impairment of
higher-level cognitive abilities. Previous research suggests that early
impairment of executive functions occurs during the course of the disease, but
few studies have specifically investigated planning ability in an AD
population.
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Affiliation(s)
- Corina Satler
- PhD, Adjunct Professor, Faculty of Ceilandia, UnB, University of Brasilia, Brasilia, DF, Brazil
| | - Luiza Guimarães
- Undergraduate Student, Laboratory of Neurosciences and Behavior, Department of Physiological Sciences, University of Brasilia, Brasilia, DF, Brazil
| | - Carlos Tomaz
- Undergraduate Student, Laboratory of Neurosciences and Behavior, Department of Physiological Sciences, University of Brasilia, Brasilia, DF, Brazil.,PhD, Full Professor, Neuroscience Research Program, University CEUMA, São Luis, MA, Brazil
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20
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Jekel K, Damian M, Storf H, Hausner L, Frölich L. Development of a Proxy-Free Objective Assessment Tool of Instrumental Activities of Daily Living in Mild Cognitive Impairment Using Smart Home Technologies. J Alzheimers Dis 2017; 52:509-17. [PMID: 27031479 PMCID: PMC4927882 DOI: 10.3233/jad-151054] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The assessment of activities of daily living (ADL) is essential for dementia diagnostics. Even in mild cognitive impairment (MCI), subtle deficits in instrumental ADL (IADL) may occur and signal a higher risk of conversion to dementia. Thus, sensitive and reliable ADL assessment tools are important. Smart homes equipped with sensor technology and video cameras may provide a proxy-free assessment tool for the detection of IADL deficits. OBJECTIVE The aim of this paper is to investigate the potential of a smart home environment for the assessment of IADL in MCI. METHOD The smart home consisted of a two-room flat equipped with activity sensors and video cameras. Participants with either MCI or healthy controls (HC) had to solve a standardized set of six tasks, e.g., meal preparation, telephone use, and finding objects in the flat. RESULTS MCI participants needed more time (1384 versus 938 seconds, p < 0.001) and scored less total points (48 versus 57 points, p < 0.001) while solving the tasks than HC. Analyzing the subtasks, intergroup differences were observed for making a phone call, operating the television, and retrieving objects. MCI participants showed more searching and task-irrelevant behavior than HC. Task performance was correlated with cognitive status and IADL questionnaires but not with participants' age. CONCLUSION This pilot study showed that smart home technologies offer the chance for an objective and ecologically valid assessment of IADL. It can be analyzed not only whether a task is successfully completed but also how it is completed. Future studies should concentrate on the development of automated detection of IADL deficits.
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Affiliation(s)
- Katrin Jekel
- Network Aging Research, Heidelberg University, Germany.,Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Marinella Damian
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Holger Storf
- Fraunhofer Institute for Experimental Software Engineering IESE, Kaiserslautern, Germany
| | - Lucrezia Hausner
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany
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21
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Lindbergh CA, Dishman RK, Miller LS. Functional Disability in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2016; 26:129-59. [PMID: 27393566 DOI: 10.1007/s11065-016-9321-5] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 05/12/2016] [Indexed: 02/07/2023]
Abstract
Accumulating evidence suggests that the pre-dementia syndrome mild cognitive impairment (MCI) is characterized by decrements in instrumental activities of daily living (IADL). The current review was a quantitative synthesis of the available literature to objectively characterize IADL disability in MCI while clarifying inconsistencies in findings across studies. It was hypothesized that individuals with MCI would display significantly greater functional impairment relative to cognitively intact controls. Candidate moderators specified a priori included functional assessment approach, MCI subtype, depressive symptoms, and language conducted. Online databases (PubMed/MEDLINE and PsycINFO) and reference lists were searched to identify peer-reviewed publications assessing IADL in MCI compared to normal aging. A total of 151 effect sizes derived from 106 studies met inclusionary criteria (N = 62,260). Random effects models yielded a large overall summary effect size (Hedges' g = 0.76, 95 % confidence interval: 0.68 - 0.83, p < .001) confirmed in multi-level analyses adjusted for nesting of effect sizes within studies (g = 0.78, 95 % confidence interval: 0.69 - 0.87). Functional assessment strategy and MCI subtype were significant moderators of effect size, whereas depressive symptoms and language were not. Results convincingly demonstrate that MCI is associated with significant difficulties in the performance of complex everyday tasks. It appears that functional decline, like cognitive decline, exists on a continuum from healthy aging to dementia onset. Implications for clinical practice and research priorities are discussed.
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Affiliation(s)
- Cutter A Lindbergh
- Department of Psychology, University of Georgia, Athens, GA, 30602, USA.
| | - Rodney K Dishman
- Department of Kinesiology, University of Georgia, Athens, GA, 30602, USA
| | - L Stephen Miller
- Department of Psychology, University of Georgia, Athens, GA, 30602, USA.,Bio-Imaging Research Center, Paul D. Coverdell Center, University of Georgia, Athens, GA, 30602, USA
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22
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Martínez-Alcalá CI, Pliego-Pastrana P, Rosales-Lagarde A, Lopez-Noguerola JS, Molina-Trinidad EM. Information and Communication Technologies in the Care of the Elderly: Systematic Review of Applications Aimed at Patients With Dementia and Caregivers. JMIR Rehabil Assist Technol 2016; 3:e6. [PMID: 28582258 PMCID: PMC5454565 DOI: 10.2196/rehab.5226] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 11/11/2015] [Accepted: 01/03/2016] [Indexed: 11/17/2022] Open
Abstract
Background The interest in applying information and communications technology (ICT) in older adult health care is frequently promoted by the increasing and unsustainable costs of health care services. In turn, the unprecedented growth of the elderly population around the globe has urged institutions, companies, industries, and governments to respond to older adults’ medical needs. Objective The aim of this review is to systematically identify the opportunities that ICT offers to health services, specifically for patients with dementia and their families. Methods A systematic review of the literature about ICT applications that have been developed to assist patients with Alzheimer’s disease (AD) and their primary caregivers was conducted. The bibliographic search included works published between January 2005 and July 2015 in the databases Springer Link, Scopus, and Google Scholar. Of the published papers, 902 were obtained in the initial search, of which 214 were potentially relevant. Included studies fulfilled the following inclusion criteria: (1) studies carried out between the years of 2005 and 2015, (2) studies were published in English or Spanish, (3) studies with titles containing the keywords, (4) studies with abstracts containing information on ICT applications and AD, and (5) studies published in indexed journals, proceedings, and book chapters. Results A total of 26 studies satisfied the inclusion criteria for the current review. Among them, 16 were aimed at the patient with AD and 10 at the primary caregivers and/or family members. The studies targeted applications that included assistive technology (44%, 7/16), telecare (37%, 6/16), and telemedicine (31%, 5/16). The information systems (56%, 9/16) and Internet (44%, 7/16) were the most commonly used enabling technologies for the studies. Finally, areas of attention more covered by the studies were care (56%, 9/16), treatment (56%, 9/16), and management (50%, 8/16). Furthermore, it was found that 20 studies (77%, 8/26) evaluated their ICT applications through carrying out tests with patients with dementia and caregivers. Conclusions The key finding of this systematic review revealed that the use of ICT tools can be strongly recommended to be used as a lifestyle in the elderly in order to improve the quality of life for the elderly and their primary caregivers. Since patients with AD are completely dependent in most activities, it is necessary to give attention to their primary caregivers to avoid stress and depression. In addition, the use of ICT in the daily life of caregivers can help them understand the disease process and manage situations in a way that is beneficial for both parties. It is expected that future developments concerning technological projects can support this group of people.
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Affiliation(s)
- Claudia I Martínez-Alcalá
- Consejo Nacional de Ciencia y Tecnología, Research Fellow, Ciudad de Mexico, Mexico.,School of Health Sciences, Department of Gerontology, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Patricia Pliego-Pastrana
- School of Health Sciences, Department of Gerontology, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Alejandra Rosales-Lagarde
- School of Health Sciences, Department of Gerontology, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico.,Consejo Nacional de Ciencia y Tecnología, Research Fellow, Ciudad de México, Mexico
| | - J S Lopez-Noguerola
- School of Health Sciences, Department of Gerontology, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico.,Division of Molecular Psychiatry, Department of Psychiatry and Psychotherapy, University Medicine Göttingen, Göttingen, Germany
| | - Eva M Molina-Trinidad
- School of Health Sciences, Department of Medicine, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
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Identifying factors of activities of daily living important for cost and caregiver outcomes in Alzheimer's disease. Int Psychogeriatr 2016; 28:247-59. [PMID: 26307191 DOI: 10.1017/s1041610215001349] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND We aimed to obtain a better understanding of how different aspects of patient functioning affect key cost and caregiver outcomes in Alzheimer's disease (AD). METHODS Baseline data from a prospective observational study of community-living AD patients (GERAS) were used. Functioning was assessed using the Alzheimer's Disease Cooperative Study-Activities of Daily Living Scale. Generalized linear models were conducted to analyze the relationship between scores for total activities of daily living (ADL), basic ADL (BADL), instrumental ADL (IADL), ADL subdomains (confirmed through factor analysis) and individual ADL questions, and total societal costs, patient healthcare and social care costs, total and supervision caregiver time, and caregiver burden. RESULTS Four distinct ADL subdomains were confirmed: basic activities, domestic/household activities, communication, and outside activities. Higher total societal costs were associated with impairments in all aspects of ADL, including all subdomains; patient costs were associated with total ADL and BADL, and basic activities subdomain scores. Both total and supervision caregiver hours were associated with total ADL and IADL scores, and domestic/household and outside activities subdomain scores (greater hours associated with greater functional impairments). There was no association between caregiver burden and BADL or basic activities subdomain scores. The relationship between total ADL, IADL, and the outside activities subdomain and outcomes differed between patients with mild and moderate-to-severe AD. CONCLUSIONS Identification of ADL subdomains may lead to a better understanding of the association between patient function and costs and caregiver outcomes at different stages of AD, in particular the outside activities subdomain within mild AD.
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Riboni D, Bettini C, Civitarese G, Janjua ZH, Helaoui R. SmartFABER: Recognizing fine-grained abnormal behaviors for early detection of mild cognitive impairment. Artif Intell Med 2016; 67:57-74. [PMID: 26809483 DOI: 10.1016/j.artmed.2015.12.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 10/26/2015] [Accepted: 12/29/2015] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In an ageing world population more citizens are at risk of cognitive impairment, with negative consequences on their ability of independent living, quality of life and sustainability of healthcare systems. Cognitive neuroscience researchers have identified behavioral anomalies that are significant indicators of cognitive decline. A general goal is the design of innovative methods and tools for continuously monitoring the functional abilities of the seniors at risk and reporting the behavioral anomalies to the clinicians. SmartFABER is a pervasive system targeting this objective. METHODS A non-intrusive sensor network continuously acquires data about the interaction of the senior with the home environment during daily activities. A novel hybrid statistical and knowledge-based technique is used to analyses this data and detect the behavioral anomalies, whose history is presented through a dashboard to the clinicians. Differently from related works, SmartFABER can detect abnormal behaviors at a fine-grained level. RESULTS We have fully implemented the system and evaluated it using real datasets, partly generated by performing activities in a smart home laboratory, and partly acquired during several months of monitoring of the instrumented home of a senior diagnosed with MCI. Experimental results, including comparisons with other activity recognition techniques, show the effectiveness of SmartFABER in terms of recognition rates.
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Affiliation(s)
- Daniele Riboni
- Department of Mathematics and Computer Science, Università degli Studi di Cagliari, Via Ospedale 72, I-09124 Cagliari, Italy.
| | - Claudio Bettini
- Department of Computer Science, Università degli Studi di Milano, Via Comelico 39, I-20135 Milano, Italy.
| | - Gabriele Civitarese
- Department of Computer Science, Università degli Studi di Milano, Via Comelico 39, I-20135 Milano, Italy.
| | - Zaffar Haider Janjua
- Department of Computer Science, Università degli Studi di Milano, Via Comelico 39, I-20135 Milano, Italy.
| | - Rim Helaoui
- Philips Research Personal Health, High Tech Campus 34, 5656 AE Eindhoven, The Netherlands.
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Place des nouvelles technologies dans les stratégies de dépistage et d’évaluation des troubles thymiques et cognitifs. Eur Psychiatry 2015. [DOI: 10.1016/j.eurpsy.2015.09.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
L’évaluation médicale en psychiatrie repose encore aujourd’hui principalement sur l’examen clinique du patient. Les techniques de l’information et de la communication (TIC) sont cependant en plein essor dans le domaine de la santé. Basées sur l’intelligence artificielle, les méthodes d’analyse automatisée pourraient permettre d’améliorer le diagnostic clinique avec l’identification de nouveaux « biomarqueurs », notamment dans le domaine des pathologies neuropsychiatriques . Le signal acquis à l’aide de nouveaux capteurs pouvant surpasser les limites perceptives du médecin pourrait permettre une évaluation plus fiable et objective du patient. L’augmentation de l’accessibilité aux technologies, comme l’apparition du Smartphone dans le quotidien du médecin, laisse la possibilité à une analyse physiologique peu coûteuse, rapide et applicable en pratique courante. Les maladies neuropsychiatriques nécessitent une amélioration des outils de dépistage du fait d’un retard diagnostique souvent important pour ces pathologies. L’enjeu est particulièrement important dans les maladies neurodégénératives où l’effet modeste des traitements nécessite une mise en place rapide des mesures thérapeutiques afin de prévenir au mieux les symptômes et la perte d’autonomie associée [2,3]. Les troubles anxieux présentent des perturbations physiologiques bien décrites et nécessitent de même une prise en charge précoce dans l’histoire de la maladie afin d’éviter leur complication et faciliter leur traitement. Le traitement du signal issu de paramètres physiologiques tels que l’analyse du signal vocal et la variabilité de la fréquence cardiaque, reflétant l’état du système sympathique, pourraient permettre le développement d’outils de dépistage et d’évaluation des troubles anxieux afin de faciliter l’accès aux soins à temps ainsi qu’aider à leur évaluation au cours du suivi.
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Vahia IV, Ng B, Camacho A, Cardenas V, Cherner M, Depp CA, Palmer BW, Jeste DV, Agha Z. Telepsychiatry for Neurocognitive Testing in Older Rural Latino Adults. Am J Geriatr Psychiatry 2015; 23:666-70. [PMID: 25708655 PMCID: PMC4363076 DOI: 10.1016/j.jagp.2014.08.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 08/14/2014] [Accepted: 08/18/2014] [Indexed: 01/17/2023]
Abstract
As the population of older Latinos in the U.S. increases, availability of culturally adapted geriatric psychiatry services is becoming a growing concern. This issue is exacerbated for rural Latino populations. In this study, we assessed whether neurocognitive assessment via telepsychiatry (TP) using a Spanish-language battery would be comparable to in-person (IP) testing using the same battery in a sample of Spanish-speaking older adults in a rural setting. Patients (N = 22) received IP and TP testing 2 weeks apart. The order of IP and TP test administrations in individual subjects was determined randomly. Comparison of scores indicated that there were no significant differences between IP and TP test performance though both groups scored non-significantly higher at the second visit. This study demonstrates feasibility and utility of neurocognitive testing in Spanish using TP among older rural Latinos.
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Affiliation(s)
- Ipsit V Vahia
- Department of Psychiatry, University of California, San Diego, CA; Sam and Rose Stein Institute for Research in Aging, University of California, San Diego, CA.
| | - Bernardo Ng
- Department of Psychiatry, University of California, San Diego, CA; Sun Valley Behavioral & Research Center, Imperial, CA; Department of Psychology, San Diego State University, San Diego, CA
| | - Alvaro Camacho
- Department of Psychiatry, University of California, San Diego, CA; Sun Valley Behavioral & Research Center, Imperial, CA; Department of Psychology, San Diego State University, San Diego, CA
| | - Veronica Cardenas
- Department of Psychiatry, University of California, San Diego, CA; Sam and Rose Stein Institute for Research in Aging, University of California, San Diego, CA
| | - Mariana Cherner
- Department of Psychiatry, University of California, San Diego, CA; HIV Neurobehavioral Research Program, University of California, San Diego, CA
| | - Colin A Depp
- Department of Psychiatry, University of California, San Diego, CA; Sam and Rose Stein Institute for Research in Aging, University of California, San Diego, CA
| | - Barton W Palmer
- Department of Psychiatry, University of California, San Diego, CA; Sam and Rose Stein Institute for Research in Aging, University of California, San Diego, CA
| | - Dilip V Jeste
- Department of Psychiatry, University of California, San Diego, CA; Sam and Rose Stein Institute for Research in Aging, University of California, San Diego, CA
| | - Zia Agha
- Department of Veterans Affairs, University of California, San Diego, CA; Department of Medicine, University of California, San Diego, CA
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König A, Sacco G, Bensadoun G, Bremond F, David R, Verhey F, Aalten P, Robert P, Manera V. The Role of Information and Communication Technologies in Clinical Trials with Patients with Alzheimer's Disease and Related Disorders. Front Aging Neurosci 2015; 7:110. [PMID: 26106324 PMCID: PMC4460798 DOI: 10.3389/fnagi.2015.00110] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 05/23/2015] [Indexed: 12/04/2022] Open
Affiliation(s)
- Alexandra König
- CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, University of Nice Sophia Antipolis , Nice , France ; School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , Netherlands
| | - Guillaume Sacco
- CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, University of Nice Sophia Antipolis , Nice , France ; Rehabilitation Unit, Department of Geriatrics, CHU de Nice , Nice , France ; Centre d'Innovation et d'Usages en Santé (CIU-S), Cimiez Hospital, University Hospital of Nice , Nice , France
| | - Gregory Bensadoun
- CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, University of Nice Sophia Antipolis , Nice , France
| | | | - Renaud David
- CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, University of Nice Sophia Antipolis , Nice , France ; Centre Mémoire de Ressources et de Recherche, CHU de Nice , Nice , France
| | - Frans Verhey
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , Netherlands
| | - Pauline Aalten
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , Netherlands
| | - Philippe Robert
- CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, University of Nice Sophia Antipolis , Nice , France ; Centre d'Innovation et d'Usages en Santé (CIU-S), Cimiez Hospital, University Hospital of Nice , Nice , France ; Centre Mémoire de Ressources et de Recherche, CHU de Nice , Nice , France
| | - Valeria Manera
- CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, University of Nice Sophia Antipolis , Nice , France
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König A, Crispim-Junior CF, Covella AGU, Bremond F, Derreumaux A, Bensadoun G, David R, Verhey F, Aalten P, Robert P. Ecological Assessment of Autonomy in Instrumental Activities of Daily Living in Dementia Patients by the Means of an Automatic Video Monitoring System. Front Aging Neurosci 2015; 7:98. [PMID: 26082715 PMCID: PMC4451587 DOI: 10.3389/fnagi.2015.00098] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 05/07/2015] [Indexed: 12/22/2022] Open
Abstract
Currently, the assessment of autonomy and functional ability involves clinical rating scales. However, scales are often limited in their ability to provide objective and sensitive information. By contrast, information and communication technologies may overcome these limitations by capturing more fully functional as well as cognitive disturbances associated with Alzheimer disease (AD). We investigated the quantitative assessment of autonomy in dementia patients based not only on gait analysis but also on the participant performance on instrumental activities of daily living (IADL) automatically recognized by a video event monitoring system (EMS). Three groups of participants (healthy controls, mild cognitive impairment, and AD patients) had to carry out a standardized scenario consisting of physical tasks (single and dual task) and several IADL such as preparing a pillbox or making a phone call while being recorded. After, video sensor data were processed by an EMS that automatically extracts kinematic parameters of the participants’ gait and recognizes their carried out activities. These parameters were then used for the assessment of the participants’ performance levels, here referred as autonomy. Autonomy assessment was approached as classification task using artificial intelligence methods that takes as input the parameters extracted by the EMS, here referred as behavioral profile. Activities were accurately recognized by the EMS with high precision. The most accurately recognized activities were “prepare medication” with 93% and “using phone” with 89% precision. The diagnostic group classifier obtained a precision of 73.46% when combining the analyses of physical tasks with IADL. In a further analysis, the created autonomy group classifier which obtained a precision of 83.67% when combining physical tasks and IADL. Results suggest that it is possible to quantitatively assess IADL functioning supported by an EMS and that even based on the extracted data the groups could be classified with high accuracy. This means that the use of such technologies may provide clinicians with diagnostic relevant information to improve autonomy assessment in real time decreasing observer biases.
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Affiliation(s)
- Alexandra König
- EA CoBTeK, Université Côte d'Azur (UCA) , Nice , France ; Alzheimer Center Limburg, Maastricht University Medical Center, School for Mental Health and Neuroscience , Maastricht , Netherlands
| | | | | | - Francois Bremond
- EA CoBTeK, Université Côte d'Azur (UCA) , Nice , France ; STARS, INRIA , Sophia Antipolis , France
| | | | | | - Renaud David
- EA CoBTeK, Université Côte d'Azur (UCA) , Nice , France ; Centre Mémoire de Ressources et de Recherche, CHU de Nice , Nice , France
| | - Frans Verhey
- Alzheimer Center Limburg, Maastricht University Medical Center, School for Mental Health and Neuroscience , Maastricht , Netherlands
| | - Pauline Aalten
- Alzheimer Center Limburg, Maastricht University Medical Center, School for Mental Health and Neuroscience , Maastricht , Netherlands
| | - Philippe Robert
- EA CoBTeK, Université Côte d'Azur (UCA) , Nice , France ; Centre Mémoire de Ressources et de Recherche, CHU de Nice , Nice , France
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Ciro CA, Anderson MP, Hershey LA, Prodan CI, Holm MB. Instrumental activities of daily living performance and role satisfaction in people with and without mild cognitive impairment: a pilot project. Am J Occup Ther 2015; 69:6903270020p1-10. [PMID: 25871600 PMCID: PMC4453037 DOI: 10.5014/ajot.2014.015198] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We investigated differences in observed performance of instrumental activities of daily living (IADLs) and self-reported satisfaction with social role performance between people with amnestic mild cognitive impairment (a-MCI) and age- and gender-matched control participants. METHOD We measured observed performance of 14 IADLs using the Independence, Safety, and Adequacy domains of the Performance Assessment of Self-Care Skills (PASS) and the Patient-Reported Outcomes Measurement Information Systems (PROMIS) to examine satisfaction with social role performance. RESULTS Total PASS scores were significantly lower in participants with a-MCI (median=40.6) than in control participants (median=44.2; p=.006). Adequacy scores were also significantly lower. No significant differences were found between groups on the PROMIS measures. CONCLUSION IADL differences between groups were related more to errors in adequacy than to safety and independence. Occupational therapy practitioners can play a key role in the diagnosis and treatment of subtle IADL deficits in people with MCI.
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Affiliation(s)
- Carrie A Ciro
- Carrie A. Ciro, PhD, OTR/L, FAOTA, is Assistant Professor, University of Oklahoma Health Sciences Center, Oklahoma City;
| | - Michael P Anderson
- Michael P. Anderson, PhD, is Assistant Professor, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Linda A Hershey
- Linda A. Hershey, MD, PhD, is Professor, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Calin I Prodan
- Calin I. Prodan, MD, is Associate Professor, Veterans Affairs Medical Center, Oklahoma City, OK
| | - Margo B Holm
- Margo B. Holm, PhD, OTR/L, FAOTA, ABDA, is Professor Emerita, University of Pittsburgh, Pittsburgh, PA
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Seligman SC, Giovannetti T. The Potential Utility of Eye Movements in the Detection and Characterization of Everyday Functional Difficulties in Mild Cognitive Impairment. Neuropsychol Rev 2015; 25:199-215. [PMID: 25851239 DOI: 10.1007/s11065-015-9283-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 03/25/2015] [Indexed: 10/23/2022]
Abstract
Mild cognitive impairment (MCI) refers to the intermediate period between the typical cognitive decline of normal aging and more severe decline associated with dementia, and it is associated with greater risk for progression to dementia. Research has suggested that functional abilities are compromised in MCI, but the degree of impairment and underlying mechanisms remain poorly understood. The development of sensitive measures to assess subtle functional decline poses a major challenge for characterizing functional limitations in MCI. Eye-tracking methodology has been used to describe visual processes in everyday, naturalistic action among healthy older adults as well as several case studies of severely impaired individuals, and it has successfully differentiated healthy older adults from those with MCI on specific visual tasks. These studies highlight the promise of eye-tracking technology as a method to characterize subtle functional decline in MCI. However, to date no studies have examined visual behaviors during completion of naturalistic tasks in MCI. This review describes the current understanding of functional ability in MCI, summarizes findings of eye-tracking studies in healthy individuals, severe impairment, and MCI, and presents future research directions to aid with early identification and prevention of functional decline in disorders of aging.
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Affiliation(s)
- Sarah C Seligman
- Department of Psychology, Temple University, 1701 N. 13th Street, 6th Floor Weiss Hall, Philadelphia, PA, 19122, USA
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König A, Satt A, Sorin A, Hoory R, Toledo-Ronen O, Derreumaux A, Manera V, Verhey F, Aalten P, Robert PH, David R. Automatic speech analysis for the assessment of patients with predementia and Alzheimer's disease. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2015; 1:112-24. [PMID: 27239498 PMCID: PMC4876915 DOI: 10.1016/j.dadm.2014.11.012] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background To evaluate the interest of using automatic speech analyses for the assessment of mild cognitive impairment (MCI) and early-stage Alzheimer's disease (AD). Methods Healthy elderly control (HC) subjects and patients with MCI or AD were recorded while performing several short cognitive vocal tasks. The voice recordings were processed, and the first vocal markers were extracted using speech signal processing techniques. Second, the vocal markers were tested to assess their “power” to distinguish among HC, MCI, and AD. The second step included training automatic classifiers for detecting MCI and AD, using machine learning methods and testing the detection accuracy. Results The classification accuracy of automatic audio analyses were as follows: between HCs and those with MCI, 79% ± 5%; between HCs and those with AD, 87% ± 3%; and between those with MCI and those with AD, 80% ± 5%, demonstrating its assessment utility. Conclusion Automatic speech analyses could be an additional objective assessment tool for elderly with cognitive decline.
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Affiliation(s)
- Alexandra König
- Research Unit CoBTeK - Cognition Behaviour Technology, Edmond & Lily Safra Research Center, University of Nice Sophia Antipolis, Nice, France; Alzheimer Centre Limburg, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Aharon Satt
- Speech Technologies, IBM Research, Haifa, Israel
| | | | - Ron Hoory
- Speech Technologies, IBM Research, Haifa, Israel
| | | | - Alexandre Derreumaux
- Research Unit CoBTeK - Cognition Behaviour Technology, Edmond & Lily Safra Research Center, University of Nice Sophia Antipolis, Nice, France
| | - Valeria Manera
- Research Unit CoBTeK - Cognition Behaviour Technology, Edmond & Lily Safra Research Center, University of Nice Sophia Antipolis, Nice, France
| | - Frans Verhey
- Alzheimer Centre Limburg, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Pauline Aalten
- Alzheimer Centre Limburg, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Phillipe H Robert
- Research Unit CoBTeK - Cognition Behaviour Technology, Edmond & Lily Safra Research Center, University of Nice Sophia Antipolis, Nice, France; Centre Mémoire de Ressources et de Recherche, CHU de Nice, Nice, France
| | - Renaud David
- Research Unit CoBTeK - Cognition Behaviour Technology, Edmond & Lily Safra Research Center, University of Nice Sophia Antipolis, Nice, France; Centre Mémoire de Ressources et de Recherche, CHU de Nice, Nice, France
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Sacco G, Turpin JM, Marteu A, Sakarovitch C, Teboul B, Boscher L, Brocker P, Robert P, Guerin O. Inertial sensors as measurement tools of elbow range of motion in gerontology. Clin Interv Aging 2015; 10:491-7. [PMID: 25759568 PMCID: PMC4345924 DOI: 10.2147/cia.s70452] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND PURPOSE Musculoskeletal system deterioration among the aging is a major reason for loss of autonomy and directly affects the quality of life of the elderly. Articular evaluation is part of physiotherapeutic assessment and helps in establishing a precise diagnosis and deciding appropriate therapy. Reference instruments are valid but not easy to use for some joints. The main goal of our study was to determine reliability and intertester reproducibility of the MP-BV, an inertial sensor (the MotionPod(®) [MP]) combined with specific software (BioVal [BV]), for elbow passive range-of-motion measurements in geriatrics. METHODS This open, monocentric, randomized study compared inertial sensor to inclinometer in patients hospitalized in an acute, post-acute, and long-term-care gerontology unit. RESULTS Seventy-seven patients (mean age 83.5±6.4 years, sex ratio 1.08 [male/female]) were analyzed. The MP-BV was reliable for each of the three measurements (flexion, pronation, and supination) for 24.3% (CI 95% 13.9-32.8) of the patients. Separately, the percentages of reliable measures were 59.7% (49.2-70.5) for flexion, 68.8% (58.4-79.5) for pronation, and 62.3% (51.2-73.1) for supination. The intraclass correlation coefficients were 0.15 (0.07-0.73), 0.46 (0.27-0.98), and 0.50 (0.31-40 0.98) for flexion, pronation, and supination, respectively. CONCLUSION This study shows the convenience of the MP-BV in terms of ease of use and of export of measured data. However, this instrument seems less reliable and valuable compared to the reference instruments used to measure elbow range of motion in gerontology.
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Affiliation(s)
- G Sacco
- Memory Center, Claude Pompidou Institut, Department of Geriatrics, University Hospital of Nice, Nice, France ; Centre d'Innovation et d'Usages en Santé (CIU-S), University Hospital of Nice, Cimiez Hospital, Nice, France ; CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, Nice Sophia-Antipolis University, Nice, France
| | - J M Turpin
- CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, Nice Sophia-Antipolis University, Nice, France ; Rehabilitation Unit, Department of Geriatrics, University Hospital of Nice, Cimiez Hospital, Nice, France
| | - A Marteu
- Rehabilitation Unit, Department of Neurosciences, University Hospital of Nice, L'Archet Hospital, Nice, France
| | - C Sakarovitch
- Department of Clinical Research and Innovation, University Hospital of Nice, Cimiez Hospital, Nice, France
| | - B Teboul
- Centre d'Innovation et d'Usages en Santé (CIU-S), University Hospital of Nice, Cimiez Hospital, Nice, France
| | - L Boscher
- Rehabilitation Unit, Department of Geriatrics, University Hospital of Nice, Cimiez Hospital, Nice, France ; Rehabilitation Unit, Department of Neurosciences, University Hospital of Nice, L'Archet Hospital, Nice, France
| | - P Brocker
- Rehabilitation Unit, Department of Geriatrics, University Hospital of Nice, Cimiez Hospital, Nice, France
| | - P Robert
- Memory Center, Claude Pompidou Institut, Department of Geriatrics, University Hospital of Nice, Nice, France ; Centre d'Innovation et d'Usages en Santé (CIU-S), University Hospital of Nice, Cimiez Hospital, Nice, France ; CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, Nice Sophia-Antipolis University, Nice, France
| | - O Guerin
- Centre d'Innovation et d'Usages en Santé (CIU-S), University Hospital of Nice, Cimiez Hospital, Nice, France ; CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, Nice Sophia-Antipolis University, Nice, France ; Acute Geriatrics Unit, Department of Geriatrics, University Hospital of Nice, Cimiez Hospital, Nice, France
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Sikkes SAM, Rotrou JD. A qualitative review of instrumental activities of daily living in dementia: what's cooking? Neurodegener Dis Manag 2014; 4:393-400. [DOI: 10.2217/nmt.14.24] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
SUMMARY The measurement of instrumental activities of daily living (IADL) is common in clinical practice and research into dementia. IADL are cognitively complex daily activities, such as cooking and doing finances. Their measurement is required for the diagnostic process of dementia, and also useful for the monitoring of disease progression. Since problems in IADL contribute to the disease burden of both patient and caregiver, it is a relevant outcome measure for disease-modifying and non-pharmacological interventions. Despite the widespread use of IADL instruments, an overview of its theoretical background, measurement methods, and potential sources of bias is lacking. In the current manuscript, we therefore aim to provide a selective overview of these topics.
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Affiliation(s)
- Sietske AM Sikkes
- Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
- Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Jocelyne de Rotrou
- AP-HP, Hôpital Broca, Service de Gérontologie, Paris, 75013, France
- Université Paris Descartes, Sorbonne Paris Cité, EA 4468, Paris, 75006, France
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Peetoom KKB, Lexis MAS, Joore M, Dirksen CD, De Witte LP. Literature review on monitoring technologies and their outcomes in independently living elderly people. Disabil Rehabil Assist Technol 2014; 10:271-94. [PMID: 25252024 DOI: 10.3109/17483107.2014.961179] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To obtain insight into what kind of monitoring technologies exist to monitor activity in-home, what the characteristics and aims of applying these technologies are, what kind of research has been conducted on their effects and what kind of outcomes are reported. METHODS A systematic document search was conducted within the scientific databases Pubmed, Embase, Cochrane, PsycINFO and Cinahl, complemented by Google Scholar. Documents were included in this review if they reported on monitoring technologies that detect activities of daily living (ADL) or significant events, e.g. falls, of elderly people in-home, with the aim of prolonging independent living. RESULTS Five main types of monitoring technologies were identified: PIR motion sensors, body-worn sensors, pressure sensors, video monitoring and sound recognition. In addition, multicomponent technologies and smart home technologies were identified. Research into the use of monitoring technologies is widespread, but in its infancy, consisting mainly of small-scale studies and including few longitudinal studies. CONCLUSIONS Monitoring technology is a promising field, with applications to the long-term care of elderly persons. However, monitoring technologies have to be brought to the next level, with longitudinal studies that evaluate their (cost-) effectiveness to demonstrate the potential to prolong independent living of elderly persons. [Box: see text].
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Affiliation(s)
- Kirsten K B Peetoom
- Research Centre for Technology in Care, Zuyd University of Applied Sciences , Heerlen , the Netherlands
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Pastorino M, Fioravanti A, Arredondo MT, Cogollor JM, Rojo J, Ferre M, Bienkiewicz M, Hermsdörfer J, Fringi E, Wing AM. Preliminary evaluation of a personal healthcare system prototype for cognitive eRehabilitation in a living assistance domain. SENSORS (BASEL, SWITZERLAND) 2014; 14:10213-33. [PMID: 24922452 PMCID: PMC4118340 DOI: 10.3390/s140610213] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 05/29/2014] [Accepted: 05/31/2014] [Indexed: 11/17/2022]
Abstract
The integration of rehabilitation systems in an ambient assisted living environment can provide a powerful and versatile tool for long-term stroke rehabilitation goals. This paper introduces a novel concept of a personalized cognitive rehabilitation system in a naturalistic setting. The proposed platform was developed within the CogWatch project, with the intent of fostering independence in activities of daily living in patients with apraxia and action disorganization syndrome. Technical usability was evaluated in a series of pilot experiments, which illustrate how this approach may help to retrain patients in activities of daily living. The first system prototype has been tested with 36 participants divided into three groups, providing an exploratory evaluation of the usability of this solution and its acceptability. The technical solutions used within the CogWatch project are targeted to meet both the end users' needs from the interaction and usability point of views and the clinical requirements associated with the use of such systems. The challenges behind the development of ambient assisted living systems for cognitive rehabilitation are discussed.
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Affiliation(s)
- Matteo Pastorino
- Life Supporting Technologies, Universidad Politecnica de Madrid, Avenida Complutense 30, Madrid 28040, Spain.
| | - Alessio Fioravanti
- Life Supporting Technologies, Universidad Politecnica de Madrid, Avenida Complutense 30, Madrid 28040, Spain.
| | - Maria Teresa Arredondo
- Life Supporting Technologies, Universidad Politecnica de Madrid, Avenida Complutense 30, Madrid 28040, Spain.
| | - José M Cogollor
- Centre for Automation and Robotics UPM-CSIC, Universidad Politecnica de Madrid, Calle de José Gutiérrez Abascal 2, Madrid 28006, Spain.
| | - Javier Rojo
- Centre for Automation and Robotics UPM-CSIC, Universidad Politecnica de Madrid, Calle de José Gutiérrez Abascal 2, Madrid 28006, Spain.
| | - Manuel Ferre
- Centre for Automation and Robotics UPM-CSIC, Universidad Politecnica de Madrid, Calle de José Gutiérrez Abascal 2, Madrid 28006, Spain.
| | - Marta Bienkiewicz
- Institute of Movement Science, Department of Sport and Health Science, Technische Universität München, Munich 80992, Germany.
| | - Joachim Hermsdörfer
- Institute of Movement Science, Department of Sport and Health Science, Technische Universität München, Munich 80992, Germany.
| | - Evangelia Fringi
- School of Psychology, the University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | - Alan M Wing
- School of Psychology, the University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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36
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König A, Aalten P, Verhey F, Bensadoun G, Petit PD, Robert P, David R. A review of current information and communication technologies: can they be used to assess apathy? Int J Geriatr Psychiatry 2014; 29:345-58. [PMID: 24006215 DOI: 10.1002/gps.4017] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 07/30/2013] [Indexed: 11/11/2022]
Abstract
BACKGROUND Neuropsychiatric symptoms, such as apathy, have an important impact on the quality of life of both patients diagnosed with dementia and their caregivers and represent a strong predictor of progression of the illness. Current clinical assessment methods risk bias resulting from the assessor's subjectivity, pointing to a need for additional objective and systematic assessment tools. Therefore, the use of information and communication technologies (ICT) such as actigraphy and automatized video monitoring are of interest in addition to current assessment methods. AIM The goal of this study is to give an overview of current assessment tools for apathy in clinical practice and new approaches to assessment methods with the help ICT. METHODS This study was conducted with the use of narrative literature overview. RESULTS There is evidence that apart from the currently used assessment methods for apathy, new ICT approaches could provide clinicians with valuable additional information for an earlier detection and therefore more accurate diagnosis of apathy. CONCLUSIONS There are no ICT techniques specifically designed for the assessment of apathy, but nevertheless several techniques seem to be promising and deserve more study.
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Affiliation(s)
- Alexandra König
- Centre Mémoire de Ressources et de Recherche, Hôpital de Cimiez, Nice, France; School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, the Netherlands
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37
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Robert P, Castelli E, Chung PC, Chiroux T, Crispim-Junior C, Mallea P, Bremond F. SWEET-HOME ICT technologies for the assessment of elderly subjects. Ing Rech Biomed 2013. [DOI: 10.1016/j.irbm.2013.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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38
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Robert PH, Konig A, Andrieu S, Bremond F, Chemin I, Chung PC, Dartigues JF, Dubois B, Feutren G, Guillemaud R, Kenisberg PA, Nave S, Vellas B, Verhey F, Yesavage J, Mallea P. Recommendations for ICT use in Alzheimer's disease assessment: Monaco CTAD Expert Meeting. J Nutr Health Aging 2013; 17:653-60. [PMID: 24097018 DOI: 10.1007/s12603-013-0046-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Alzheimer disease (AD) and other related dementia represent a major challenge for health care systems within the aging population. It is therefore important to develop better instruments for assessing disease severity and disease progression to optimize patient's care and support to care providers, and also provide better tools for clinical research. In this area, Information and Communication Technologies (ICT) are of particular interest. Such techniques enable accurate and standardized assessments of patients' performance and actions in real time and real life situations. The aim of this article is to provide basic recommendation concerning the development and the use of ICT for Alzheimer's disease and related disorders. During he ICT and Mental Health workshop (CTAD meeting held in Monaco on the 30th October 2012) an expert panel was set up to prepare the first recommendations for the use of ICT in dementia research. The expert panel included geriatrician, epidemiologist, neurologist, psychiatrist, psychologist, ICT engineers, representatives from the industry and patient association. The recommendations are divided into three sections corresponding to 1/ the clinical targets of interest for the use of ICT, 2/ the conditions, the type of sensors and the outputs (scores) that could be used and obtained, 3/ finally the last section concerns specifically the use of ICT within clinical trials.
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Affiliation(s)
- P H Robert
- Pr Philippe. H. Robert, EA CoBTek - Centre Mémoire de Ressources et de Recherche, Pavillon Mossa, Hôpital de Cimiez 4 av Victoria 06000 - Nice France, E mail:
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