28 research outputs found

    Computer mouse movement patterns: A potential marker of mild cognitive impairment

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    AbstractIntroductionSubtle changes in cognitively demanding activities occur in mild cognitive impairment (MCI) but are difficult to assess with conventional methods. In an exploratory study, we examined whether patterns of computer mouse movements obtained from routine home computer use discriminated between older adults with and without MCI.MethodsParticipants were 42 cognitively intact and 20 older adults with MCI enrolled in a longitudinal study of in-home monitoring technologies. Mouse pointer movement variables were computed during one week of routine home computer use using algorithms that identified and characterized mouse movements within each computer use session.ResultsMCI was associated with making significantly fewer total mouse moves (P < .01) and making mouse movements that were more variable, less efficient, and with longer pauses between movements (P < .05). Mouse movement measures were significantly associated with several cognitive domains (P values <.01–.05).DiscussionRemotely monitored computer mouse movement patterns are a potential early marker of real-world cognitive changes in MCI

    Weekly observations of online survey metadata obtained through home computer use allow for detection of changes in everyday cognition before transition to mild cognitive impairment

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    IntroductionSubtle changes in instrumental activities of daily living often accompany the onset of mild cognitive impairment (MCI) but are difficult to measure using conventional tests.MethodsWeekly online survey metadata metrics, annual neuropsychological tests, and an instrumental activity of daily living questionnaire were examined in 110 healthy older adults with intact cognition (mean age = 85 years) followed up for up to 3.6 years; 29 transitioned to MCI during study follow‐up.ResultsIn the baseline period, incident MCI participants completed their weekly surveys 1.4 hours later in the day than stable cognitively intact participants, P = .03, d = 0.47. Significant associations were found between earlier survey start time of day and higher memory (r = −0.34; P < .001) and visuospatial test scores (r = −0.37; P < .0001). Longitudinally, incident MCI participants showed an increase in survey completion time by 3 seconds per month for more than the year before diagnosis compared with stable cognitively intact participants (β = 0.12, SE = 0.04, t = 2.8; P = .006).DiscussionWeekly online survey metadata allowed for detection of changes in everyday cognition before transition to MCI.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152601/1/alzjjalz201707756.pd

    SMART ENVIRONMENT PROMPTING TECHNOLOGIES FOR EVERYDAY ACTIVITIES IN MILD COGNITIVE IMPAIRMENT

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    Older adults with mild cognitive impairment (MCI) often have difficulty performing complex instrumental activities of daily living (IADLs). Smart environment prompting technologies have gained popularity over the last decade and have the potential to assist these individuals with IADLs in order to live independently. In the current study, we developed and experimented with a graded hierarchy of prompts to examine whether individuals with MCI would benefit from receiving prompts when errors occurred during completion of eight scripted IADLs in an experimenter-assisted smart apartment environment. Thirty individuals who met criteria for multi-domain MCI, 23 individuals who met criteria for single-domain MCI, and 50 healthy older adult controls participated in this study. Results showed that the multi-domain MCI group received more prompts and required that more activity steps be prompted than the single-domain MCI and healthy older adult groups. Similar to the other two groups, the multi-domain MCI group responded accurately to the indirect prompts and did not more often need a higher level of prompting to reengage with the tasks. The total number of prompts received was best predicted by executive abilities in single-domain MCI and verbal memory abilities in multi-domain MCI. Experimenter activity quality ratings were best predicted by executive abilities in healthy older adults and individuals with single-domain MCI. These findings suggest that future IADL prompting technologies can be tailored specifically for individuals with MCI

    A Mobile Multimedia Reminiscence Therapy Application to Reduce Behavioral and Psychological Symptoms in Persons with Alzheimer’s

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    The goal of this project is to develop a novel and innovative mobile solution to address behavioral and psychological symptoms of dementia (BPSD) that occur in individuals with Alzheimer’s. BPSD can include agitation, restlessness, aggression, apathy, obsessive-compulsive and repetitive behaviors, hallucinations, delusions, paranoia, and wandering. Alzheimer’s currently affects 5.4 million adults in the United States and that number is projected to increase to 14 million by 2050. Almost 90% of all affected with AD experience BPSD, resulting in increased healthcare costs, heavier burden on caregivers, poor patient outcomes, early nursing home placement, long-term hospitalizations, and misuse of medications. Pharmacological support may have undesirable side effects such as sedation. Nonpharmacological interventions are alternative solutions that have shown to be effective without undesirable side effects. Music therapy has been found to lower BPSD symptoms significantly. Our study is based on combination of the reminiscence and the music therapies where past memorable events are recalled using prompts such as photos, videos, and music. We are proposing a mobile multimedia solution, a technical version of the combined reminiscence, and music therapies to prevent the occurrence of BPSD, especially for the rural population who have reduced access to dementia care services

    Status of computerized cognitive testing in aging: a systematic review. Alzheimers Demen 2008;4

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    Abstract Background: Early detection of cognitive decline in the elderly has become of heightened importance in parallel with the recent advances in therapeutics. Computerized assessment might be uniquely suited to early detection of changes in cognition in the elderly. We present here a systematic review of the status of computer-based cognitive testing, focusing on detection of cognitive decline in the aging population. Methods: All studies purporting to assess or detect age-related changes in cognition or early dementia/ mild cognitive impairment by means of computerized testing were included. Each test battery was rated on availability of normative data, level of evidence for test validity and reliability, comprehensiveness, and usability. All published studies relevant to a particular computerized test were read by a minimum of two reviewers, who completed rating forms containing the abovementioned criteria. Results: Of the 18 test batteries identified from the initial search, 11 were appropriate to cognitive testing in the elderly and were subjected to systematic review. Of those 11, five were either developed specifically for application with the elderly or have been used extensively with that population. Even within the computerized testing genre, great variability existed in manner of administration, ranging from fully examiner-administered to fully self-administered. All tests had at least minimal reliability and validity data, commonly reported in peer-reviewed articles. However, level of rigor of validity testing varied widely. Conclusion: All test batteries exhibited some of the strengths of computerized cognitive testing: standardization of administration and stimulus presentation, accurate measures of response latencies, automated comparison in real time with an individual&apos;s prior performance as well as with age-related norms, and efficiencies of staffing and cost. Some, such as the Mild Cognitive Impairment Screen, adapted complicated scoring algorithms to enhance the information gathered from already existing tests. Others, such as CogState, used unique interfaces and subtests. We found that although basic indices of psychometric properties were typically addressed, sufficient variability exists that currently available computerized test batteries must be judged on a case-by-case basis

    Naturalistic Assessment of Everyday Activities and Prompting Technologies in Mild Cognitive Impairment

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    Older adults with mild cognitive impairment (MCI) often have difficulty performing complex instrumental activities of daily living (IADLs), which are critical to independent living. In this study, amnestic multi-domain MCI (N = 29), amnestic single-domain MCI (N = 18), and healthy older participants (N = 47) completed eight scripted IADLs (e.g., cook oatmeal on the stove) in a smart apartment testbed. We developed and experimented with a graded hierarchy of technology-based prompts to investigate both the amount of prompting and type of prompts required to assist individuals with MCI in completing the activities. When task errors occurred, progressive levels of assistance were provided, starting with the lowest level needed to adjust performance. Results showed that the multi-domain MCI group made more errors and required more prompts than the single-domain MCI and healthy older adult groups. Similar to the other two groups, the multi-domain MCI group responded well to the indirect prompts and did not need a higher level of prompting to get back on track successfully with the tasks. Need for prompting assistance was best predicted by verbal memory abilities in multi-domain amnestic MCI. Participants across groups indicated that they perceived the prompting technology to be very helpful. (JINS, 2013, 19, 1–11
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