Musiquence – Design, Implementation and Validation of a Customizable Music and Reminiscence Cognitive Stimulation Platform for People with Dementia

Dementia is a neurodegenerative disease that affects millions of individuals worldwide and is challenging to diagnose as symptoms may only perceivable decades later. The disease leads to a gradual loss of memory, learning, orientation, language, and comprehension skills, which compromises activities of daily living. Health-related costs caused by dementia will continue to increase over the next few years; between the years 2005 and 2009, an increase of 34% (from $315 to$422 billion worldwide) was observed in treating dementia-related issues. Pharmaceutical approaches have been developed to treat dementia symptoms; unfortunately, the risk of side effects is high. For this reason, nonpharmaceutical methods such as music and reminiscence therapies have gained acceptance as patients with dementia positively respond to such approaches even at later stages of the disease. Nevertheless, further research is needed to understand how music and reminiscence therapy should be used and to quantify their impact on individuals with dementia. The development of serious games has gained attention as an alternative approach to stimulate patients. However, the clinical impact that serious games have on individuals with dementia is still unclear. In this dissertation, we contribute with new knowledge regarding the usage of music and reminiscence approaches in people with dementia through a theoretical model. Based on Baddeley’s working memory model, our model aims to explain how the therapeutic properties of music and reminiscence can have a beneficial effect. To test our model, we developed a novel interactive platform called Musiquence, in which healthcare professionals can create music and reminiscence based cognitive activities to stimulate people with dementia. In this dissertation, we present the results from several studies about the usage and effects that music and reminiscence have on such a population. We performed two studies using Musiquence to study the feasibility of a novel learning method based on musical feedback to aid people with dementia during task performance in virtual reality settings. Results show that participants relied more on music-based feedback during the task performance of virtual reality activities than in other forms of feedback. Also, data suggest that the music-based feedback system can improve task performance, compensating for some dementia-related deficits. We also used Musiquence in a longitudinal one-month-long pilot study to assess its efficacy when used for a cognitive stimulation intervention in dementia patients. The results of the study are promising. The 3 participants showed improvements in terms of general cognition, quality of life, mood, and verbal fluency

A framework and serious game to support those with mild cognitive impairment

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonCognitive decline is common in the elderly. As a result, a range of cognitive rehabilitation games have been proposed to supplement or replace traditional rehabilitative training by offering benefits such as improved engagement. This research project focuses on mild cognitive impairment (MCI), an initial stage of cognitive decline that does not affect functioning in daily life, but which may progress towards more serious cognitive deteriorations, notably dementia. Unfortunately, while a variety of serious game frameworks and rehabilitative serious games have been proposed, there is a distinct lack of those which support the distinctive characteristics of MCI patients. Consequently, to optimise the advantages of serious games for MCI, the research proposes the MCI-GaTE (MCI-Game Therapy Experience) framework that may be used to develop serious games as effective cognitive and physical rehabilitation tools. The framework is derived from a combination of a survey of related research literature in the area, analysis of resident profiles from a nursing home, and in-depth interviews with occupational therapists (OTs) who work with MCI patients on a daily basis to help them overcome the disabling effects so that they can carry out everyday tasks. The conceptual framework comprises four sectors that may be used to guide game design and development: an MCI player profile that represents the capabilities of a player with MCI, core gaming elements that support gameful and playful activities, therapeutic elements that support cognitive and physical rehabilitation through tasks and scenarios according to the player’s abilities, and motivational elements to enhance the player’s attitude towards the serious tasks. Together, they provide tailored support for rehabilitation needs and may also serve as a set of comprehensive and established criteria by which an MCI serious game may be evaluated. To demonstrate the use of MCI-GaTE, an immersive and gesture-based serious game, A go!, is designed that exploits the framework to enable MCI-diagnosed players to undertake a series of tailored therapeutic tasks supported by an assigned OT. To this end, a goal-directed design approach is employed, whereby personas, scenarios and journey maps are developed that satisfy the goals of both the MCI player and their OT, and enable the derivation of functional requirements leading to a visual design. A-go! is realised as a responsive and interactive high-fidelity prototype that supports gesture recognition and 3D game objects from a first-person perspective to facilitate immersion without the need for additional worn devices, such as headsets, which would prove impractical for the targeted elderly players. Evaluation with OTs revealed that the immersive game potentially offers more effective and tailored support to MCI patients than traditional methods, contributing new possibilities for enhancing MCI rehabilitative training, while a comparative assessment of MCI-GaTE demonstrated that it provides a comprehensive approach not currently offered by state-of-the-art rehabilitative frameworks.GRACE Healthcare Ltd. & Hong Kong Caritas in Evergreen Home and Integrated Home Care Services, TWGHs Fung Yiu King Hospital HA, Kwai Chung Hospital HA, and TWGHs Jockey Club Rehabilitation Comple

Mind the Gap: the Importance of Pluralistic Discourse in Computing for Mental Health

A large amount of HCI research leverages studies from psychology to try to understand how humans work. Unfortunately, there is often a disconnect between the tightly- controlled laboratory studies being referenced and the application of this knowledge in practice. At the same time, many mental health practitioners are beginning to turn toward computational tools to help stretch limited resources and support equitable access to mental healthcare. These efforts could be dramatically enhanced by leveraging what the HCI community has learned about promoting active engagement and designing unobtrusive interfaces. By facilitating collaboration between HCI researchers and practitioners in the field of human services, we are working to understand how our historically separate disciplines might better be able to support one another and together reimagine what constitutes a therapeutic intervention in the 21st century

Using Music Technology Creatively to Enrich Later-Life: A Literature Review

Background: A growing body of evidence has demonstrated significant social and emotional benefits of music-making amongst senior citizens. However, several as-yet unresolved age-related barriers to “musicking” have been identified. Positioned within the emergent field of gerontechnology, concerned with the interface between aging and technology research, this review of literature thus explores the potential for music technologies to function as a vehicle for creative musical opportunities in later-life.Methods: ERIC, PsychInfo, and Web of Science databases were searched, focusing on the intersection between music, technology, and aging. The criteria for inclusion were that the paper should: (1) be in English; (2) report empirical research involving the use of music technologies intended to support receptive (listening, interpreting, reflecting) or active (playing, creating, performing) engagement with music amongst older persons, defined as being aged 60 years or above (United Nations, 2017); (3) be published as a peer reviewed journal article.Results: Of 144 papers screened, 18 papers were retained. 10 studies focused on using technology to support musicking in the form of listening, reflecting, and interpreting. Just five studies explored the utility of technology in promoting singing or playing instruments, while a further three were focused on music and movement.Conclusions: Overall, the literature reviewed suggests that older people, even those with complex needs, are capable of, and interested in using music technologies to access and create personally meaningful music. The limited research that does exist points to multiple and significant benefits that may be derived from receptive or active musicking supported by a range of music technologies

Multisensory stimulation on mood, behavior, and biomedical parameters in people with dementia: is it more effective than conventional one-to-one stimulation?

[Abstract] The purpose of this study was to assess the effects of multisensory stimulation in a multisensory stimulation environment (MSSE) such as a Snoezelen room versus one-to-one activity sessions with regard to mood, behavior, and biomedical parameters (heart rate and blood oxygen saturation). The MSSE group and activity group (one-to-one activities) of patients with dementia participated in 2 weekly individualized intervention sessions over 16 weeks, where mood and behavior before, during, and after the sessions, and biomedical parameters immediately before and after, were recorded. Immediately after the sessions, patients spoke more spontaneously, related better to others, were more attentive to their environments, more active/alert, less bored/inactive, and more relaxed/content. Both groups exhibited decreases in heart rate and increases in oxygen saturation (SpO2) values from before to after the sessions. The MSSE sessions in a Snoezelen room were found to be as effective as activity sessions, highlighting the importance of the one-to-one interaction with the therapist

Robotics for social welfare

Supported by developments in the field of social robotics, virtual worlds and ICT tools it is possible to build new solutions in health and welfare. Two projects are described in this article. They are intended to improve efficiency and quality of current therapeutic procedures. The ESTIMULO project improves emotional and cognitive status of people with dementia using a reactive pet-robot. The ELDERTOY project modifies the classical concept from the toy industry to develop a new solution for the aged people. ELDERTOY involves a double purpose, fun and therapeutic. In a complementary way, these projects aim to be an example of the breaking of the technology gap both of seniors and of people with disabilities. Therefore, the ultimate goal is to promote and adapt scientific and technological knowledge to be applied to improve significantly the standard of quality of life in society