I-CONECT: CHALLENGES AND OPPORTUNITIES

Abstract In our previous NIH-funded randomized controlled behavioral clinical trial, we developed a conversation-based social interaction cognitive stimulation protocol delivered by trained interviewers through webcams and a user-friendly interactive Internet interface. Daily 30 minute face-to-face video-chats were conducted for 6 weeks. Despite a short duration, this proof of concept study demonstrated high adherence among older adults (mean age 80 years) and showed improvement in cognitive domains which tap language-based executive functions and semantic memory among the experimental group compared to the control group who did not engage in any video-chats. Building on these results, we are now conducting two NIH-funded projects (https://www.i-conect.org), targeting socially isolated older adults who are less likely to participate in clinical trials despite their high risk of cognitive decline. In this presentation, we introduce a series of projects outlined above and share the challenges and opportunities identified in our behavioral intervention trials focused on social interaction.

Download Full-text

I-CONECT PROJECT: CAN SOCIAL INTERACTION IMPROVE COGNITIVE FUNCTIONS AMONG SOCIALLY ISOLATED OLDER ADULTS?

Innovation in Aging ◽

10.1093/geroni/igz038.824 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S224-S224

Author(s):

Hiroko H Dodge ◽

Karen Hooker ◽

Toni C Antonucci

Keyword(s):

Older Adults ◽

Social Interaction ◽

Social Isolation ◽

Cognitive Functions ◽

Well Being ◽

Epidemiological Studies ◽

Video Data ◽

Protective Effects ◽

Socially Isolated ◽

Intervention Trials

Abstract Epidemiological studies have demonstrated that larger social networks or more frequent social interactions may have protective effects against cognitive decline and the incidence of dementia. Therefore, increasing social interaction could be a promising intervention for improving cognitive well-being in socially isolated older adults. We have conducted multiple NIH-funded randomized controlled trials (RCT) over 10 years, examining whether conversational interactions through webcam and internet can improve cognitive functions and enhance cognitive reserve. In this symposium, we will introduce this series of behavioral intervention trials through 4 presentations. First, Dodge will provide background and results of their previous RCT where they showed efficacy of conversational intervention on domain-specific cognitive functions and introduce the ongoing larger project called I-CONECT (https://www.i-conect.org). Second, Lindsey will introduce technological innovations used in the I-CONECT project including development of user-friendly video-chat devices, recording of audio and video data and innovative recruitment efforts. Third, Asgari will share results on how speech utterance and characteristics collected through the project could distinguish those with mild cognitive impairment from those with normal cognition using machine learning modelling approaches. Finally, Cerino and his team will show results of the study which examined whether cognitive improvements through conversation-based intervention depend on an individual’s personality, laying the groundwork for a personalized intervention trial in the future. The symposium is of interest for those who study social isolation and its prevention, the link among cognition, social isolation and personality, as well as those who focus on technology as a tool for improving well-being of older adults.

Download Full-text

Older Adults’ Experiences of a Physical Activity and Sedentary Behaviour Intervention: A Nested Qualitative Study in the SITLESS Multi-Country Randomised Clinical Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094730 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4730

Author(s):

Nicole Blackburn ◽

Mathias Skjodt ◽

Mark Tully ◽

Ilona Mc Mullan ◽

Maria Giné-Garriga ◽

...

Keyword(s):

Older Adults ◽

Social Interaction ◽

Qualitative Study ◽

Management Strategies ◽

Randomised Clinical Trial ◽

Control Group ◽

Individual Interviews ◽

Perceived Effects ◽

Qualitative Methodologies ◽

Exercise Referral

Background: The SITLESS programme comprises exercise referral schemes and self-management strategies and has been evaluated in a trial in Denmark, Spain, Germany and Northern Ireland. The aim of this qualitative study was to understand the implementation and contextual aspects of the intervention in relation to the mechanisms of impact and to explore the perceived effects. Methods: Qualitative methodologies were nested in the SITLESS trial including 71 individual interviews and 12 focus groups targeting intervention and control group participants from postintervention to 18-month follow-up in all intervention sites based on a semi-structured topic guide. Results: Overarching themes were identified under the framework categories of context, implementation, mechanisms of impact and perceived effects. The findings highlight the perceived barriers and facilitators to older adults’ engagement in exercise referral schemes. Social interaction and enjoyment through the group-based programmes are key components to promote adherence and encourage the maintenance of targeted behaviours through peer support and connectedness. Exit strategies and signposting to relevant classes and facilities enabled the maintenance of positive lifestyle behaviours. Conclusions: When designing and implementing interventions, key components enhancing social interaction, enjoyment and continuity should be in place in order to successfully promote sustained behaviour change.

Download Full-text

Reducing Ageism: PEACE (Positive Education about Aging and Contact Experiences) Model

Innovation in Aging ◽

10.1093/geroni/igaa057.2226 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 647-647

Author(s):

Sheri Levy ◽

Ashley Lytle ◽

Jamie Macdonald ◽

MaryBeth Apriceno

Keyword(s):

Older Adults ◽

Community Sample ◽

Control Group ◽

Positive Education ◽

Experimental Control ◽

Face To Face ◽

Post Test ◽

Aging Anxiety ◽

Model Components ◽

Aging Knowledge

Abstract Drawing on interdisciplinary theorizing and research, the PEACE (Positive Education about Aging and Contact Experiences) model points to two interrelated factors that reduce ageism: providing education about aging and positive intergenerational contact experiences with older adults (Levy 2016). Evidence supporting the model will be discussed including a semester-long pre-posttest intervention with undergraduates (non-gerontology course) who learned about aging and had face-to-face and Instagram contact with older adults (Lytle, Nowacek, & Levy, 2020), brief online pre-post test experimental-control group studies with undergraduates and a community sample who learned about aging and positive intergenerational contact experiences (Lytle & Levy, 2017), and an online experimental-control group study with undergraduates who viewed brief videos addressing PEACE model components (Lytle, Macdonald, Apriceno, & Levy, under review). Across studies, PEACE model interventions promoted increased aging knowledge as well as reduced negative stereotyping of older adults, aging anxiety, and concerns about aging. Future directions will be discussed.

Download Full-text

Older Adults, Social Technologies, and the Coronavirus Pandemic: Challenges, Strengths, and Strategies for Support

Social Media + Society ◽

10.1177/2056305120948162 ◽

2020 ◽

Vol 6 (3) ◽

pp. 205630512094816

Author(s):

Ryan C. Moore ◽

Jeffrey T. Hancock

Keyword(s):

Older Adults ◽

Social Interaction ◽

Digital Media ◽

Social Connection ◽

Older Individuals ◽

Social Distancing ◽

Face To Face ◽

Key Stakeholders ◽

Social Technologies ◽

Additional Challenge

COVID-19 is a threat to everyone’s health but can be especially devastating to older individuals. To prevent spread of the virus, social distancing has become the norm worldwide. However, with social distancing comes significantly less face-to-face interaction, which may be particularly harmful to older adults given their existing levels of loneliness. While social technologies can be used to provide critical social interaction during this time of necessary physical distancing, older adults tend to either lack access to these technologies or the skills and experience necessary to use them effectively. Once online, older adults face the additional challenge of being outsized targets of misinformation and scams, both of which abound in the context of COVID-19. In this essay, we discuss the challenges faced by older adults in their use of digital media for social connection in the present pandemic, as well as highlight some of the population’s untapped strengths which can be leveraged to help them live prosperous online lives. Finally, we provide recommendations for actions which key stakeholders can take to support older adults in this pursuit.

Download Full-text

A Home-Based Individual Cognitive Stimulation Program for Older Adults With Cognitive Impairment: A Randomized Controlled Trial

Frontiers in Psychology ◽

10.3389/fpsyg.2021.741955 ◽

2021 ◽

Vol 12 ◽

Author(s):

Rosa Silva ◽

Elzbieta Bobrowicz-Campos ◽

Paulo Santos-Costa ◽

Ana Rita Cruz ◽

João Apóstolo

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Cognitive Impairment ◽

Controlled Trial ◽

Intervention Group ◽

Cognitive Stimulation ◽

Attrition Rate ◽

Control Group ◽

Randomized Controlled ◽

Home Based

Objective: This study aims to assess the feasibility and meaningfulness of a home-based individual cognitive stimulation (iCS) program delivered by caregivers to persons with cognitive impairment (PwCIs). It also aims to assess whether the older adults receiving this program improved their cognitive, neuropsychiatric, and depressive symptoms and quality of life and whether their caregivers improved their mental and physical health.Methods: A randomized controlled trial (RCT) was conducted with PwCI-caregiver dyads recruited from the community. Participants were allocated to two groups: intervention (n = 28) and control (n = 24). The intervention group received the European Portuguese version of the Individual Cognitive Stimulation Program—Making a Difference 3 (MD3-P). The control group received usual care. The iCS therapy program was implemented three times a week for 12 weeks. Caregivers were supported by the researchers to deliver the sessions at home. Participants were assessed at baseline and at the end of the intervention (week 13). Feasibility and meaningfulness were assessed through the attrition rate, adherence, and degree of satisfaction with the sessions. Four interviews were conducted (after week 13) to understand participants’ experiences.Results: The attrition rate was 23.1%. The dyads reported that they did not have high expectations about the iCS program before starting the study. Nevertheless, as the program evolved, caregivers noted that their family members had improved some areas of functioning. Intention-to-treat analysis based on group differences revealed a significant improvement in PwCIs’ cognition, specifically in their orientation and ability to follow commands. The intervention had no impact on other variables such as caregivers’ physical and mental health.Conclusion: The iCS program implemented by caregivers showed promising results in improving PwCIs’ cognition. The participants who completed the intervention attributed a positive meaning to the MD3-P, confirming it as a valid non-pharmacological therapeutic approach to reducing frailty in PwCIs in community settings.Clinical Trial Registration:www.ClinicalTrials.gov, identifier [NCT03514095].

Download Full-text

Effect of 3-Months Home-Based Exercise Program on Changes of Cognitive Functioning in Older Adults Living in Old People’s Home

Acta Facultatis Educationis Physicae Universitatis Comenianae ◽

10.1515/afepuc-2016-0002 ◽

2016 ◽

Vol 56 (1) ◽

pp. 16-29 ◽

Cited By ~ 2

Author(s):

Dagmar Nemček ◽

Alexander Simon

Keyword(s):

Older Adults ◽

Cognitive Functioning ◽

Cognitive Functions ◽

Cognitive Rehabilitation ◽

Exercise Program ◽

Cognitive Stimulation ◽

Rank Test ◽

Control Group ◽

Home Based ◽

And Control

SummaryThe aim of the study was to determine the effect of regular participation in home-based exercise programme on cognitive functioning changes in institutionalised older adults. Two groups of participants were recruited for the study: experimental (n = 17) in mean age 76 ± 5.6 years, who participated in home-based exercise program and control (n = 14) in mean age 80 ± 4.2 years. The standardised Stroop Color-Word Test-Victoria version (VST) was used to measure the level of cognitive functions. Group differences were analyzed with Mann-Whitney U-test for independent samples and for differences between pre-measurements and post-measurements on experimental and control group we used non-parametric Wilcoxon Signed - Rank Test. The level of significance was α < 0.05. Application of 3-months home-based exercise program significantly improved the cognitive functions only in one (Word condition; p<0.01) from three VST conditions in institutionalised older adults. That’s why we recommend longer participation in home-based exercise program, at least 6- months, with combination of various types of cognitive interventions, like concepts of cognitive training, cognitive rehabilitation, and cognitive stimulation to improve cognitive functioning in older adults living in old peoples’ homes.

Download Full-text

Effects of Systematic Categorization Training on Cognitive Performance in Healthy Older Adults and in Adults with Traumatic Brain Injury

Behavioural Neurology ◽

10.1155/2019/9785319 ◽

2019 ◽

Vol 2019 ◽

pp. 1-17

Author(s):

Fofi Constantinidou

Keyword(s):

Older Adults ◽

Traumatic Brain Injury ◽

Young Adults ◽

Brain Injury ◽

Cognitive Rehabilitation ◽

Neuropsychological Testing ◽

Cognitive Learning ◽

Cognitive Stimulation ◽

Future Research ◽

Control Group

This study investigated the effects of hierarchical cognitive training using the categorization program (CP), designed initially for adults with cognitive deficits associated with traumatic brain injury (TBI). Fifty-eight participants were included: a group of fifteen young adults with TBI (ages 18-48), another group of fifteen noninjured young adults (ages 18-50), and two groups of adults over 60 randomly assigned into the experimental group (n=14) or the control group (n=14). Following neuropsychological testing, the two young adult groups and the experimental older adult group received the CP training for 10-12 weeks. The CP training consisted of 8 levels targeting concept formation, object categorization, and decision-making abilities. Two CP tests (administered before and after the training) and three probe tasks (administered at specified intervals during the training) assessed skills relating to categorization. All treated groups showed significant improvement in their categorization performance, although younger participants (with or without TBI) demonstrated greater gains. Gains on the categorization measures were maintained by a subgroup of older adults up to four months posttraining. Implications of these findings in terms of adult cognitive learning and directions for future research on adult cognitive rehabilitation and cognitive stimulation programs are discussed.

Download Full-text

Literacy and Cognitive Function in the Context of Marriage: A Study of Older Mexican Couples

Innovation in Aging ◽

10.1093/geroni/igaa057.3168 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 859-859

Author(s):

Joseph Saenz

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Cognitive Ability ◽

Cognitive Stimulation ◽

Cognitive Outcomes ◽

General Cognitive Ability ◽

Cognitive Domains ◽

Aging Study ◽

Cognitive Benefits ◽

Important Form

Abstract Many studies have reported that literacy is associated with favorable cognitive outcomes in late-life. Few have evaluated whether the cognitive benefits of literacy extend to a spouse’s cognitive ability. Among married husband-wife dyads from the 2012 Mexican Health and Aging Study (n=4,078 dyads), literacy was assessed as self-reported ability to read and write. General cognitive ability was assessed using performance across several cognitive domains. Approximately 11% and 15% of husbands and wives, respectively, could not read or write. For both husbands and wives, both own literacy, and having a spouse who could read and write were independently associated with better cognitive ability even after accounting for both partners’ education. Literacy may represent an important form of capital that may be beneficial to preserve cognitive function among older adults. Benefits of spousal literacy may operate by facilitating access to resources such as information and cognitive stimulation.

Download Full-text

A Mobile App (iBeni) With a Neuropsychological Basis for Cognitive Stimulation for Elderly Adults: Pilot and Validation Study (Preprint)

10.2196/preprints.9603 ◽

2017 ◽

Author(s):

Claudia I Martínez-Alcalá ◽

Alejandra Rosales-Lagarde ◽

Esmeralda Hernández-Alonso ◽

Roberto Melchor-Agustin ◽

Erika E Rodriguez-Torres ◽

...

Keyword(s):

Older Adults ◽

Adult Population ◽

Pilot Trial ◽

Mobile App ◽

Cognitive Stimulation ◽

Control Group ◽

Elderly Adults ◽

Paper And Pencil ◽

Neuropsychological Evaluations ◽

Experimental Group

BACKGROUND Cognitive impairment is considered one of the most feared chronic conditions among the older adult population since its incidence is approximately twice more frequent than that of dementia. In Mexico, no studies or reports of older adults using technology for cognitive interventions have been published, given that institutions usually frame cognitive stimulation tasks in paper and pencil (ie, in the traditional manner). OBJECTIVE The objective of this study was to create and analyze the effect, viability, and impact of a mobile app for cognitive stimulation implemented among a group of elderly adults (over 60 years of age) from the state of Hidalgo in Mexico. METHODS This study was a nonprobabilistic pilot trial using convenience sampling. An intervention was implemented among a group of 22 older adults between 60 and 80 years of age over 12 weeks. Half of the older adults were stimulated with the mobile app (experimental group) and the other half followed the traditional paper and pencil training (control group). Assessments with the Mini-Mental State Examination (MMSE) and the Neuropsi, a neuropsychological test validated in Mexico, were done before and after both cognitive stimulations. RESULTS According to the analyzed data, 6/11 (55%) participants from the experimental group obtained better results in their cognitive skills, and 5 (45%) of the adults maintained their score, given that the participants were able to execute the exercises repetitively. Meanwhile, for the control group, only 3/11 (27%) participants obtained better results in the postevaluation. Significant values for results of the MMSE were obtained in the postevaluation for the experimental group compared to the control group, while results did not show significant differences in the Neuropsi. Regarding the validation of the app, all the participants evaluated its pertinence positively. CONCLUSIONS The intervention data show that the experimental group obtained better results in the postevaluation given that the participants were able to execute the exercises repetitively. The control group could not accomplish this since they had to respond on the manual and no further attempts were provided. However, both groups increased their score in the neuropsychological evaluations. This suggests that a longer and more frequent intervention is required. REGISTERED REPORT IDENTIFIER RR1-10.2196/9603

Download Full-text

EXPRESS: Age-related changes in gaze behavior during social interaction: an eye-tracking study with an embodied conversational agent

Quarterly Journal of Experimental Psychology ◽

10.1177/1747021820982165 ◽

2020 ◽

pp. 174702182098216

Author(s):

Katarina Pavic ◽

Ali Oker ◽

Mohamed Chetouani ◽

Laurence Chaby

Keyword(s):

Older Adults ◽

Social Interaction ◽

Eye Tracking ◽

Virtual Agents ◽

Conversational Agent ◽

Gaze Behavior ◽

Embodied Conversational Agent ◽

Face To Face ◽

Age Related ◽

Gaze Behaviour

Previous research has highlighted age-related differences in social perception, in particular emotional expression processing. To date, such studies have largely focused on approaches that use static emotional stimuli that the participant has to identify passively without the possibility of any interaction. In this study, we propose an interactive virtual environment to better address age-related variations in social and emotional perception. A group of 22 young (18-30 years) and 20 older (60-80 years) adults were engaged in a face-to-face conversation with an embodied conversational agent. Participants were invited to interact naturally with the agent and to identify his facial expression. Their gaze behaviour was captured by an eye-tracking device throughout the interaction. We also explored whether the Big Five personality traits (particularly extraversion) and anxiety modulated gaze during the social interaction. Findings suggested that age-related differences in gaze behaviour was were only apparent when decoding social signals (i.e., listening to a partner's question, identifying facial expressions) and not when communicating social information (i.e. when speaking). Furthermore, higher extraversion levels consistently lead to a shorter amount of time gazing toward the eyes, whereas higher anxiety levels lead to slight modulations of gaze only when participants are were listening to questions. Face-to-face conversation with virtual agents can provide a more naturalistic framework for the assessment of online socio-emotional interaction in older adults, which is not easily observable in classical offline paradigms. This study provides novel and important insights into the specific circumstances in which older adults may experience difficulties in social interactions.

Download Full-text