Role of Artificial Intelligence (AI) art in care of ageing society: focus on dementia

open access articleBackground: Art enhances both physical and mental health wellbeing. The health benefits include reduction in blood pressure, heart rate, pain perception and briefer inpatient stays, as well as improvement of communication skills and self-esteem. In addition to these, people living with dementia benefit from reduction of their noncognitive, behavioural changes, enhancement of their cognitive capacities and being socially active. Methods: The current study represents a narrative general literature review on available studies and knowledge about contribution of Artificial Intelligence (AI) in creative arts. Results: We review AI visual arts technologies, and their potential for use among people with dementia and care, drawing on similar experiences to date from traditional art in dementia care. Conclusion: The virtual reality, installations and the psychedelic properties of the AI created art provide a new venue for more detailed research about its therapeutic use in dementia

The effect of memory test instructions on shifts in response bias in individuals with and without Alzheimer's disease

Patients with dementia due to Alzheimer's disease (AD) tend to exhibit impairments in in their episodic memory. In yes-no tests of recognition memory, patients with AD often display liberal response bias, a stronger tendency to recognize unstudied items as already-studied "old" items. Such tendency is believed to be related to false memory, which can decrease the quality of life in many AD patients. In this study, we analyzed the effect of different instructional manipulations within yes-no recognition memory task on response bias. Younger healthy adults, older healthy adults and one AD patient were evaluated for recognition memory performance and response bias in three different conditions of instructional manipulation. In each session separated by a week-long interval, participants were shown 120 words to study and 240 words, half of which were studied items, to be tested for recognition memory. Instructional manipulation was added in the testing phase of each condition. In one session, the participants were asked if the words were old, studied items; in another session, they were asked if the words were new, unstudied items; finally in the third session, participants were asked to identify if the words were either old or new. Our findings corroborated previous studies by observing liberal response bias in AD and moderately conservative response bias in health adults. We found that the instructional manipulations did not have a significant effect on response bias in either control group while the effect in the AD patient was inconclusive

Technologies to support community-dwelling persons with dementia: a position paper on issues regarding development, usability, effectiveness and cost-effectiveness, deployment, and ethics

Background: With the expected increase in the numbers of persons with dementia, providing timely, adequate, and affordable care and support is challenging. Assistive and health technologies may be a valuable contribution in dementia care, but new challenges may emerge. Objective: The aim of our study was to review the state of the art of technologies for persons with dementia regarding issues on development, usability, effectiveness and cost-effectiveness, deployment, and ethics in 3 fields of application of technologies: (1) support with managing everyday life, (2) support with participating in pleasurable and meaningful activities, and (3) support with dementia health and social care provision. The study also aimed to identify gaps in the evidence and challenges for future research. Methods: Reviews of literature and expert opinions were used in our study. Literature searches were conducted on usability, effectiveness and cost-effectiveness, and ethics using PubMed, Embase, CINAHL, and PsycINFO databases with no time limit. Selection criteria in our selected technology fields were reviews in English for community-dwelling persons with dementia. Regarding deployment issues, searches were done in Health Technology Assessment databases Results: According to our results, persons with dementia want to be included in the development of technologies; there is little research on the usability of assistive technologies; various benefits are reported but are mainly based on low-quality studies; barriers to deployment of technologies in dementia care were identified, and ethical issues were raised by researchers but often not studied. Many challenges remain such as including the target group more often in development, performing more high-quality studies on usability and effectiveness and cost-effectiveness, creating and having access to high-quality datasets on existing technologies to enable adequate deployment of technologies in dementia care, and ensuring that ethical issues are considered an important topic for researchers to include in their evaluation of assistive technologies. Conclusions: Based on these findings, various actions are recommended for development, usability, effectiveness and cost-effectiveness, deployment, and ethics of assistive and health technologies across Europe. These include avoiding replication of technology development that is unhelpful or ineffective and focusing on how technologies succeed in addressing individual needs of persons with dementia. Furthermore, it is suggested to include these recommendations in national and international calls for funding and assistive technology research programs. Finally, practitioners, policy makers, care insurers, and care providers should work together with technology enterprises and researchers to prepare strategies for the implementation of assistive technologies in different care settings. This may help future generations of persons with dementia to utilize available and affordable technologies and, ultimately, to benefit from them

Case Record

UNDIFFERENTIATED SCHIZOPHRENIA: Mr. R was reported to be normal 4 years back, he was found to be preoccupied and not communicating well with his family members and preferred to stay alone. He was talking and laughing to self. When asked he said that he heard voices speaking to him and he were replying to it. Gradually his sleep decreased and he would sleep only for 3 to 4 hours at night. He did not attend classes. He was started washing his room many times. He was taking bath frequently. He was started worshiping god Anjanaya many times a day and also avoiding to speak with female family members. This continued for 2 months after which he started to be abusive and assaultive others for no reason. So he was taken to a psychiatrist, was admitted for 10 days and treated with ECT. After discharge he would discontinue medications on and off during which his symptoms would get exacerbated. He continued his studies but performance was poor. He also exhibited suicidal gestures on three occasions in the form of cutting his harms and carrying kerosene and matchbox inside the bathroom, saved by family members. Again the mother took him to psychiatrist and continued medication the symptoms were under the control. He completed his course but did not complete his studies. Then he got employment into Ford Company, his performance was average, he continued his job for 5 months with medication. After discontinue of treatment he became self-withdrawn, slowly he was neglecting self-care, attempted suicide, coworkers informed to his parents. Hence he was brought to IMH and admitted. No H/O sad mood, crying spells. No H/O tall claims, spending spree. No H/O thoughts being known to others or withdrawn. No H/O substance use. No H/O head injury, LOC, seizures. No H/O fever or any prolonged drug intake. SUBSTANCE INDUCED MOOD DISORDER: The patient was introduced to using betelnut along with his friends around 18 years of age. Later be continued to use tobacco in the form of Panparag, Hans, Shanthi betelnut 4-6 packets per day. Later after 3 years of tobacco intake, he started consuming alcohol for the first time along with his friends on some occasion, he consumed beer around 200ml. As he enjoyed the high produced by the drink, he continued to take alcohol at regular interval. After 1 year of beginning alcohol intake, he got married, after 6months of marriage life he started consuming alcohol in the form of brandy almost every night. He would become intoxicated, come home, abuse and assault his wife frequently. Due to frequent marrital dishormony his wife left and living with her grand parants for past 8 months. Now according to his be continued to drink alcohol, but the past two months he was engaged in some temple work, where he is supposedto have been introduced to cannabis.After consuming cannabis, his behavior became unmanageble. He frequently keep standing in the middle of the road and appear to make gesturesas if regulating the traffic. He would keep talking excessively and laugh for unprovoked reasons. His sleep patterns also worsened. All through out the night he would keep wandering in the street. And also he was started talking irrelevantly and would not be able to brought back home. He would also talk high about himself. He would claim himself to be God and capable of doing lot of things and able to grant wishes to all people. His selfcare also deteriorated, he started picking up quarrles and assaulted others. Nighbours made complaint against him. So, the family members brought him in the confused state to IMH. He was treated with Ing. Lorazepam 4 mg IM stat and referred to GGH for favour ofadmission and rule out other causes of delirium. He was treated at GGH for one week with Inj. Haloperidal 5 mg, Inj. Lorazepam 4 mg im, Inj.Thiamine and has been referred to IMH for further management. No h/o head injury/LOC/seizures. No h/o low mood/crying spells/suicidal attempts. No h/o hearing voices No h/o repititive washing/cheeking etc., DELUSIONAL DISORDER-MIXED: The patient was reported to be normal till one year eight months back. She claimed hat her co-tenant Mr. V called her for sexual relationship and she refused after that she started telling that he is setting people against her to harm her and also setup prostitutes as a co-tenants, to move her away from the place She also says that he tried to kill her with ambulance 108 and milk van by using his political influence. Patient gave complaint in nearby police station about Mr. Enquiry done. But the police Also turned against her by his political influence. So, she used to go to SP office, collector office daily and shout to arrest Mr. V. Mean while she vacated that house and shifted to Mr. S house who is friend of her brother. He is a widower, living alone. After 2 months of shifting to new house she started believing that the house owner was deeply loved with her whom she understands by his Gestures. And he did not admit his love for her has he did not want others to know. She was fought with the co-tenant once for silly reason. They were assaulted her with an aluminum mug and broken house hold article. And she assumed that Mr. V. only arranged them to fight with her. And also without any reason the patient was fought with the female Co-tenants whoever talking to Mr. S. She uses to tell everybody that the Mr. S. loves with her. The house owner warned them to vacate the house. But she did not vacate the house. The house owner slowly cut power supply, water supply to her portion. After 4 months she vacated the house to Next Street. Even after vacating, patient goes to Mr. S. house and starts quarrel with the new tenants that they should vacate and only because of them he is avoiding her. Every day she was going to her old house and tells everybody that the house owner loves with her. The husband told her not to go there, but she poured kerosene on him and try to kill him. So, the house owner filed a case against her, she was arrested and kept in observation at IMH. During observation she was continuously blaming the old co-tenant that all because him only it happen. Still the house owner his loves with her, she also loves him deeply. DEMENTIA IN ALZHEIMER’S DISEASE: The patient was reported to be normal till one year back. Then, her daughter noticed that the patient repeatedly searched for certain things in the house. She would forget simple things in the house like the way for going to toilet. At times she also found it difficult to return to her house after going for a walk. In course of time, she was not able to identify her close relatives. She was not able to remember whether she had taken her food or not. Her personal hygiene decreased gradually. She did not take bath and did not dress properly. She would pass urine inside the house itself at times. She slept for very little time and would wake up in the middle of the night and keep pacing inside the house.Slowly she was not able to identify her own family members. MENTAL RETARDATION-MILD: Patient was born out of non consanguineous marriage, full term normal delivery. Mother was 22 yrs and fathers age was 298 yrs. No history of any drug intake, fever or exanthematous eruptions in the ante natal period. No ante natal checkup was done. No history of radiation, injury, malnutrition, or vaginal bleeding. Delivery was conducted by local dhai; h/o prolonged 2nd stage of labor, the baby cried soon after birth and was breast fed after a short while. No h/o neonatal seizures or difficulty in feeding. No h/o of jaundice, breast fed up to 10 months, and there were no weaning difficulties

Context-Awareness: Assistive android mobile application for Alzheimer Patient With Location-Awareness element

This project presents a new approach that uses the context aware standards to provide a location awareness support for early stage of Alzheimer patient. The proposed context model enables the development of a mobile application to assists the Alzheimer patient when they cannot remember where there are and on how the assistive device would be able to guide their way home by integrated some technology that is already out there. In particular, we describe in this paper the nature of the Alzheimer disease, about the framework and the definition of the context aware especially on location awareness and on how the application will assists the Alzheimer Disease patient in their daily life

Touchscreen interventions and the wellbeing of people with dementia and caregivers: a systematic review

Background: Dementia can have significant detrimental impacts on the wellbeing of those with the disease and their carers. A range of computer-based interventions, including touchscreen-based interventions have been researched for use with this population in the hope that they might improve psychological wellbeing. This article reviews touchscreen-based interventions designed to be used by people with dementia, with a specific focus in assessing their impact on wellbeing. Method: The data bases, PsycInfo, ASSIA, Medline, CINAHL and Cochrane were searched for touchscreen-based interventions designed to be used by people with dementia with reported psychological wellbeing outcomes. Methodological quality was assessed using Pluye et al.’s (2011) Mixed Methods Appraisal Tool (MMAT) checklist. Results: Sixteen papers were eligible. They covered fourteen methodologically diverse interventions. Interventions were reported to be beneficial in relation to mental health, social interaction and sense of mastery. Touchscreen interventions also reportedly benefit informal carers in relation to their perceived burden and the quality of their relationships with the people they care for. Key aspects included the user interface, provision of support, learning style, tailored content, appropriate challenge, ergonomics and users’ dementia progression. Conclusions: Whilst much of the existing research is relatively small-scale, the findings tentatively suggest that touchscreen based interventions can improve the psychological wellbeing of people with dementia, and possibilities for more rigorous future research are suggested

Seeing the wood for the trees. Carer related research and knowledge: A scoping review

This NIHR-SSCR funded scoping review provides a comprehensive mapping of what is known about carers and caring, and aims to help inform policy, practice and research in relation to carers. The review was undertaken by searching 10 electronic bibliographic databases, supplemented by additional web searches to identify academic research, grey literature and wider knowledge. The analysis adopts a selective thematic approach covering: carer variables - the characteristics of different types of carer and different caring situations; types of care - the nature of needs of the cared for person and the features of the care situation; the impact of caring – resilience and coping, employment and health; and carer support and needs assessment. The final section highlights key messages identified from the review. It found that caring involves all sections and age groups of the population, with people are likely to experience one or more periods of caregiving over their lifetime. The uniqueness of each caring relationship is also highlighted. In relation to types of carers, knowledge about ‘hard to reach’ groups, such as BAME and LGBT carers, remains sparse. Older carers are also relatively invisible in policy and research terms. It found that much of the knowledge about carers identified in the review relates to their characteristics, their lived experience and the nature of their caregiving, with relatively less being known about the effectiveness of interventions to support them. The report concludes by offering suggestions for policy and practice. An appendix provides a bibliography of the 3,434 items identified in review, classified into 17 types of reference

Using an assessment tool to support capacity assessments undertaken remotely in the context of a global health crisis:A feasibility study

This thesis comprises a systematic literature review, an empirical paper and a critical appraisal. A systematic review of quantitative studies examining the efficacy of cognitive interventions to improve decision-making in people with Mild Cognitive Impairment (MIC) was conducted. Twenty-six papers were identified. Results indicate that interventions to improve decision-making in people with MCI can be effective. Most studies tested interventions designed to improve higher-order thinking skills, or executive functions, that are thought to underpin decision-making. Of these, interventions targeting logical reasoning, cognitive control and inhibition demonstrated the best results. Risk of bias arising from poor quality research design or reporting affected most studies. Consequently, it was not possible to draw clear conclusions about the efficacy of particular interventions at this time. Implications and recommendations for research are discussed. The empirical paper explores the feasibility of using a capacity assessment tool designed to support remote working during the COVID-19 health crisis. Views were gathered from eight participants either through online focus groups or online individual interviews. Data from transcribed discussions, notes taken by a focus group assistant and notes from focus group debrief sessions between the researcher and focus group assistant were analysed using thematic analysis. Findings indicate that the tool is perceived to be feasible for use in practice and merits additional research. The assessment tool was praised for its structure and for prompts, questions and examples that enabled participants to obtain useful data in a pressurised context. Clinical implications are discussed and recommendations for research are outlined. The critical appraisal section offers reflections on the process of undertaking research into mental capacity and decision making. Ethical, philosophical and practical benefits and challenges are explored. The experience of undertaking research during a significant health crisis is examined and recommendations made for future applied research in these areas