Monitoring and detection of agitation in dementia: towards real-time and big-data solutions

The changing demographic profile of the population has potentially challenging social, geopolitical, and financial consequences for individuals, families, the wider society, and governments globally. The demographic change will result in a rapidly growing elderly population with healthcare implications which importantly include Alzheimer type conditions (a leading cause of dementia). Dementia requires long term care to manage the negative behavioral symptoms which are primarily exhibited in terms of agitation and aggression as the condition develops. This paper considers the nature of dementia along with the issues and challenges implicit in its management. The Behavioral and Psychological Symptoms of Dementia (BPSD) are introduced with factors (precursors) to the onset of agitation and aggression. Independent living is considered, health monitoring and implementation in context-aware decision-support systems is discussed with consideration of data analytics. Implicit in health monitoring are technical and ethical constraints, we briefly consider these constraints with the ability to generalize to a range of medical conditions. We postulate that health monitoring offers exciting potential opportunities however the challenges lie in the effective realization of independent assisted living while meeting the ethical challenges, achieving this remains an open research question remains.Peer ReviewedPostprint (author's final draft

Emerging technologies for monitoring behavioural and psychological symptoms of dementia

(c) 2014 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other users, including reprinting/ republishing this material for advertising or promotional purposes, creating new collective works for resale or redistribution to servers or lists, or reuse of any copyrighted components of this work in other works.Behavioural and psychological symptoms of dementia (BPSD) are complex array of symptoms that have devastating impact on patients, carers and their loved ones. In this paper we argue that with the combined use of pervasive computing and big data, we could make significant progress in the diagnosis of the causes of BPSD, monitoring response to treatment and helping in the prevention of these symptoms. We review the available technologies, such as Cloud computing and context aware systems, and how they could help in managing and hopefully preventing the Behavioural and Psychological Symptoms of Dementia.Peer ReviewedPostprint (author's final draft

Exploring the Landscape of Ubiquitous In-home Health Monitoring: A Comprehensive Survey

Ubiquitous in-home health monitoring systems have become popular in recent years due to the rise of digital health technologies and the growing demand for remote health monitoring. These systems enable individuals to increase their independence by allowing them to monitor their health from the home and by allowing more control over their well-being. In this study, we perform a comprehensive survey on this topic by reviewing a large number of literature in the area. We investigate these systems from various aspects, namely sensing technologies, communication technologies, intelligent and computing systems, and application areas. Specifically, we provide an overview of in-home health monitoring systems and identify their main components. We then present each component and discuss its role within in-home health monitoring systems. In addition, we provide an overview of the practical use of ubiquitous technologies in the home for health monitoring. Finally, we identify the main challenges and limitations based on the existing literature and provide eight recommendations for potential future research directions toward the development of in-home health monitoring systems. We conclude that despite extensive research on various components needed for the development of effective in-home health monitoring systems, the development of effective in-home health monitoring systems still requires further investigation.Comment: 35 pages, 5 figure

Modern Views of Machine Learning for Precision Psychiatry

In light of the NIMH's Research Domain Criteria (RDoC), the advent of functional neuroimaging, novel technologies and methods provide new opportunities to develop precise and personalized prognosis and diagnosis of mental disorders. Machine learning (ML) and artificial intelligence (AI) technologies are playing an increasingly critical role in the new era of precision psychiatry. Combining ML/AI with neuromodulation technologies can potentially provide explainable solutions in clinical practice and effective therapeutic treatment. Advanced wearable and mobile technologies also call for the new role of ML/AI for digital phenotyping in mobile mental health. In this review, we provide a comprehensive review of the ML methodologies and applications by combining neuroimaging, neuromodulation, and advanced mobile technologies in psychiatry practice. Additionally, we review the role of ML in molecular phenotyping and cross-species biomarker identification in precision psychiatry. We further discuss explainable AI (XAI) and causality testing in a closed-human-in-the-loop manner, and highlight the ML potential in multimedia information extraction and multimodal data fusion. Finally, we discuss conceptual and practical challenges in precision psychiatry and highlight ML opportunities in future research

Multimodal Assessment of Cognitive Decline: Applications in Alzheimer’s Disease and Depression

The initial diagnosis and assessment of cognitive decline are generally based around the judgement of clinicians, and commonly used semi-structured interviews, guided by pre-determined sets of topics, in a clinical set-up. Publicly available multimodal datasets have provided an opportunity to explore a range of experiments in the automatic detecting of cognitive decline. Drawing on the latest developments in representation learning, machine learning, and natural language processing, we seek to develop models capable of identifying cognitive decline with an eye to discovering the differences and commonalities that should be considered in computational treatment of mental health disorders. We present models that learn the indicators of cognitive decline from audio and visual modalities as well as lexical, syntactic, disfluency and pause information. Our study is carried out in two parts: moderation analysis and predictive modelling. We do some experiments with different fusion techniques. Our approaches are motivated by some of the recent efforts in multimodal fusion for classifying cognitive states to capture the interaction between modalities and maximise the use and combination of each modality. We create tools for detecting cognitive decline and use them to analyze three major datasets containing speech produced by people with and without cognitive decline. These findings are being used to develop multimodal models for the detection of depression and Alzheimer’s dementia

Early diagnosis of disorders based on behavioural shifts and biomedical signals

There are many disorders that directly affect people’s behaviour. The people that are suffering from such a disorder are not aware of their situation, and too often the disorders are identified by relatives or co-workers because they notice behavioural shifts. However, when these changes become noticeable, it is often too late and irreversible damages have already been produced. Early detection is the key to prevent severe health-related damages and healthcare costs, as well as to improve people’s quality of life. Nowadays, in full swing of ubiquitous computing paradigm, users’ behaviour patterns can be unobtrusively monitored by means of interactions with many electronic devices. The application of this technology for the problem at hand would lead to the development of systems that are able to monitor disorders’ onset and progress in an ubiquitous and unobtrusive way, thus enabling their early detection. Some attempts for the detection of specific disorders based on these technologies have been proposed, but a global methodology that could be useful for the early detection of a wide range of disorders is still missing. This thesis aims to fill that gap by presenting as main contribution a global screening methodology for the early detection of disorders based on unobtrusive monitoring of physiological and behavioural data. The proposed methodology is the result of a cross-case analysis between two individual validation scenarios: stress in the workplace and Alzheimer’s Disease (AD) at home, from which conclusions that contribute to each of the two research fields have been drawn. The analysis of similarities and differences between the two case studies has led to a complete and generalized definition of the steps to be taken for the detection of a new disorder based on ubiquitous computing.Jendearen portaeran eragin zuzena duten gaixotasun ugari daude. Hala ere, askotan, gaixotasuna pairatzen duten pertsonak ez dira euren egoerataz ohartzen, eta familiarteko edo lankideek identifikatu ohi dute berau jokabide aldaketetaz ohartzean. Portaera aldaketa hauek nabarmentzean, ordea, beranduegi izan ohi da eta atzerazeinak diren kalteak eraginda egon ohi dira. Osasun kalte larriak eta gehiegizko kostuak ekiditeko eta gaixoen bizi kalitatea hobetzeko gakoa, gaixotasuna garaiz detektatzea da. Gaur egun, etengabe zabaltzen ari den Nonahiko Konputazioaren paradigmari esker, erabiltzaileen portaera ereduak era diskretu batean monitorizatu daitezke, gailu teknologikoekin izandako interakzioari esker. Eskuartean dugun arazoari konponbidea emateko teknologi hau erabiltzeak gaixotasunen sorrera eta aurrerapena nonahi eta era diskretu batean monitorizatzeko gai diren sistemak garatzea ekarriko luke, hauek garaiz hautematea ahalbidetuz. Gaixotasun konkretu batzuentzat soluzioak proposatu izan dira teknologi honetan oinarrituz, baina metodologia orokor bat, gaixotasun sorta zabal baten detekzio goiztiarrerako erabilgarria izango dena, oraindik ez da aurkeztu. Tesi honek hutsune hori betetzea du helburu, mota honetako gaixotasunak garaiz hautemateko, era diskretu batean atzitutako datu fisiologiko eta konportamentalen erabileran oinarritzen den behaketa sistema orokor bat proposatuz. Proposatutako metodologia bi balidazio egoera desberdinen arteko analisi gurutzatu baten emaitza da: estresa lantokian eta Alzheimerra etxean, balidazio egoera bakoitzari dagozkion ekarpenak ere ondorioztatu ahal izan direlarik. Bi kasuen arteko antzekotasun eta desberdintasunen analisiak, gaixotasun berri bat nonahiko konputazioan oinarrituta detektatzeko jarraitu beharreko pausoak bere osotasunean eta era orokor batean definitzea ahalbidetu du

AI and Non AI Assessments for Dementia

Current progress in the artificial intelligence domain has led to the development of various types of AI-powered dementia assessments, which can be employed to identify patients at the early stage of dementia. It can revolutionize the dementia care settings. It is essential that the medical community be aware of various AI assessments and choose them considering their degrees of validity, efficiency, practicality, reliability, and accuracy concerning the early identification of patients with dementia (PwD). On the other hand, AI developers should be informed about various non-AI assessments as well as recently developed AI assessments. Thus, this paper, which can be readable by both clinicians and AI engineers, fills the gap in the literature in explaining the existing solutions for the recognition of dementia to clinicians, as well as the techniques used and the most widespread dementia datasets to AI engineers. It follows a review of papers on AI and non-AI assessments for dementia to provide valuable information about various dementia assessments for both the AI and medical communities. The discussion and conclusion highlight the most prominent research directions and the maturity of existing solutions.Comment: 49 page

Distributed Computing and Monitoring Technologies for Older Patients

This book summarizes various approaches for the automatic detection of health threats to older patients at home living alone. The text begins by briefly describing those who would most benefit from healthcare supervision. The book then summarizes possible scenarios for monitoring an older patient at home, deriving the common functional requirements for monitoring technology. Next, the work identifies the state of the art of technological monitoring approaches that are practically applicable to geriatric patients. A survey is presented on a range of such interdisciplinary fields as smart homes, telemonitoring, ambient intelligence, ambient assisted living, gerontechnology, and aging-in-place technology. The book discusses relevant experimental studies, highlighting the application of sensor fusion, signal processing and machine learning techniques. Finally, the text discusses future challenges, offering a number of suggestions for further research directions

Real-time human action and gesture recognition using skeleton joints information towards medical applications

Des efforts importants ont été faits pour améliorer la précision de la détection des actions humaines à l’aide des articulations du squelette. Déterminer les actions dans un environnement bruyant reste une tâche difficile, car les coordonnées cartésiennes des articulations du squelette fournies par la caméra de détection à profondeur dépendent de la position de la caméra et de la position du squelette. Dans certaines applications d’interaction homme-machine, la position du squelette et la position de la caméra ne cessent de changer. La méthode proposée recommande d’utiliser des valeurs de position relatives plutôt que des valeurs de coordonnées cartésiennes réelles. Les récents progrès des réseaux de neurones à convolution (RNC) nous aident à obtenir une plus grande précision de prédiction en utilisant des entrées sous forme d’images. Pour représenter les articulations du squelette sous forme d’image, nous devons représenter les informations du squelette sous forme de matrice avec une hauteur et une largeur égale. Le nombre d’articulations du squelette fournit par certaines caméras de détection à profondeur est limité, et nous devons dépendre des valeurs de position relatives pour avoir une représentation matricielle des articulations du squelette. Avec la nouvelle représentation des articulations du squelette et le jeu de données MSR, nous pouvons obtenir des performances semblables à celles de l’état de l’art. Nous avons utilisé le décalage d’image au lieu de l’interpolation entre les images, ce qui nous aide également à obtenir des performances similaires à celle de l’état de l’art.There have been significant efforts in the direction of improving accuracy in detecting human action using skeleton joints. Recognizing human activities in a noisy environment is still challenging since the cartesian coordinate of the skeleton joints provided by depth camera depends on camera position and skeleton position. In a few of the human-computer interaction applications, skeleton position, and camera position keep changing. The proposed method recommends using relative positional values instead of actual cartesian coordinate values. Recent advancements in CNN help us to achieve higher prediction accuracy using input in image format. To represent skeleton joints in image format, we need to represent skeleton information in matrix form with equal height and width. With some depth cameras, the number of skeleton joints provided is limited, and we need to depend on relative positional values to have a matrix representation of skeleton joints. We can show the state-of-the-art prediction accuracy on MSR data with the help of the new representation of skeleton joints. We have used frames shifting instead of interpolation between frames, which helps us achieve state-of-the-art performance