Using Digital Technology for Cognitive Assessment and Enhancement in Older Adults

2020 ◽  
pp. 357-372
Author(s):  
Sheida Rabipour ◽  
Patrick S. R. Davidson
Keyword(s):  
Older Adults ◽  
Digital Technology ◽  
Cognitive Assessment ◽  
Cognitive Testing ◽  
Future Research ◽  
Web Based ◽  
Computer Interfaces ◽  
Practical Guidelines ◽  
Behavioral Methods ◽  
Digital Tracking

Digital technology is becoming increasingly prevalent in cognitive research and clinical applications for older adults. Innovations in web-based cognitive testing, digital tracking tools, and brain–computer interfaces show promise. Digital technology offers potentially safer, more effective, and less costly alternatives to pharmacological and behavioral methods. Computerized cognitive assessment and training show particular promise. However, a number of possible limitations must be kept in mind. This chapter outlines how digital technology shows promise for improving cognitive assessment and support of older adults while stressing caveats that researchers and clinicians should bear in mind. The chapter concludes with highlights of current challenges and practical guidelines for future research

scholarly journals M108. CONCA: AN ONLINE COGNITIVE ASSESSMENT FOR USE WITH PATIENTS WITH PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S176-S176
Author(s):  
Amy Lynham ◽  
Jeremy Hall ◽  
Ian Jones ◽  
James Walters
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Cognitive Assessment ◽  
Large Scale ◽  
Cognitive Testing ◽  
World Health ◽  
Web Based ◽  
Highly Educated ◽  
Treatment Research

Abstract Background Cognition is impaired in patient with psychosis and is predictive of functional outcomes. Despite this, cognitive function is not routinely assessed in clinical services in the United Kingdom. Collecting cognitive data for research is also labour-intensive and expensive. Web-based assessments may be a solution for these issues but to date, these have not been utilised in patients with psychosis or other psychiatric disorders. Methods We have developed an online cognitive battery for use in psychosis research (and broader mental health research) in collaboration with The Many Brains Project, website developers, patients and clinicians (Cardiff ONline Cognitive Assessment, CONCA). Tasks were selected to measure the domains outlined by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative. We have undertaken a cross-validation study in those with schizophrenia (N=15), bipolar disorder (N=16), depression (N=15) and healthy controls (N=19) to compare the online tasks with the MATRICS battery. Following validation, we invited participants from the Cardiff Cognition in Schizophrenia Study (CardiffCOGS) and the National Centre for Mental Health (NCMH) to complete CONCA. Results Correlations between CONCA and MATRICS tasks ranged from 0.25 to 0.73 in our validation sample (N=65). A total of 6960 individuals were invited to participate and 1227 consented to take part. There was a better response rate from NCMH participants (who were recruited more recently) compared to those from CardiffCOGS. Online participants recruited from NCMH were more highly educated (W=1171600, p<0.001) and more likely to be professionals (χ2(1)=5.4, p=0.02) than the original NCMH cohort. In CardiffCOGS, online participants were more highly educated than non-responders (W=7786.5, p=0.003). A total of 887 individuals met inclusion criteria for our analyses including 43 participants with schizophrenia, 146 with bipolar disorder, 261 with unipolar depression, 187 controls and 250 participants with other psychiatric disorders. Consistent with studies using offline assessments, participants with schizophrenia were the most severely impaired group (compared to controls: g=1.36, p<0.001), exhibiting greater impairments than participants with depression (g=1.04, p<0.001) and bipolar disorder (g=0.71, p=0.002). Of note, lower performance on the battery was associated with poorer functional outcome as assessed using the World Health Organisation’s Disability Assessment Scale (B=-1.77, SE=0.3, p=5.8 x 10–9). Discussion Web-based cognitive testing is a suitable method for collecting large-scale data in psychiatric populations, although there was some evidence of recruitment bias. The results of the validation and recruitment phases were used to inform selection of the final battery. We consulted with patients and health professionals from a youth psychosis service and NCMH’s patient involvement group to create a user-friendly interface and will continue to work with these groups to develop clinically useful feedback to facilitate patient monitoring in early intervention psychosis services.

scholarly journals 207 - Cognitive deficits in specific settings: challenges for the assessment and disease management

2020 ◽  
Vol 32 (S1) ◽  
pp. 45-47
Keyword(s):  
Older Adults ◽  
Mental Illness ◽  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Cognitive Assessment ◽  
Cognitive Testing ◽  
Geriatric Syndrome ◽  
Clinical Scenarios ◽  
Status Assessment ◽  
Global Population

General synopsis of the Symposium: Cognitive impairment is an important geriatric syndrome. As the global population ages exponentially, the prevalence of cognitive impairment and dementia is increasing, and mental status assessment is key in the evaluation of older adults. However, there are several pitfalls during cognitive testing and special clinical situations that demands a more in-depth knowledge and attention from the examiner. The overall objective of this symposium is to show strategies and particularities of cognitive assessment in different settings (in the clinic, inside the hospital) and clinical scenarios (early onset impairment, mental illness comorbidity).

scholarly journals Take Action or Worry? Older Adults’ Anticipated Responses to Concerning Cognitive Assessment Results

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 366-366
Author(s):  
Claudia Jacova ◽  
Sara Wong ◽  
Samantha Smith
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Cognitive Assessment ◽  
Theoretical Models ◽  
Cognitive Disorder ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Cognitive Assessments ◽  
Cognitive Problems ◽  
Assessment Results

Abstract Under a third of older adults (28%) report having ever received an assessment for cognitive problems in US primary care settings. Patient resistance is cited as a major reason cognitive assessments are not performed. Theoretical models emphasize the role of anticipated benefits and harms in shaping health behaviors. Accordingly, here we investigated older adults’ anticipated actions and worries regarding their cognitive assessment results. A total of 393 community-dwelling respondents between ages 50 and 91, 65% female, 89% college/university-educated, with no diagnosed cognitive disorder, completed Attitudes Around Cognitive Testing (AACT) at primary care sites (n=98) and through an online platform (www.mturk.com) (n=298). AACT examines older adults’ preferences and concerns about cognitive assessment. It includes questions about actions participants would take and worries they would have if assessment results indicated cognitive problems. Willingness to take part in testing (yes or unsure/no) was also assessed. We found that seeking a formal diagnosis (84%), talking to family about healthcare (77%), and planning one’s own future (70%) were highly endorsed actions, and becoming depressed (48%), becoming anxious (47%), and losing driving privileges (41%) highly endorsed worries. Logistic regression showed that total worries and worry-action difference scores predicted reduced willingness (OR=0.84, CI=0.75-0.93 and OR=0.82, CI=0.74-0.82, respectively), whereas total actions did not. Our results suggest that older adults view concerning cognitive assessment outcomes as an opportunity for taking action as well as a reason for worrying. Both worries and actions appear to play a role in deciding whether to take part in a cognitive assessment.

scholarly journals Evaluation of the Effectiveness of Digital Technology Interventions to Reduce Loneliness in Older Adults: Systematic Review and Meta-analysis (Preprint)

2020 ◽  
Author(s):  
Syed Ghulam Sarwar Shah ◽  
David Nogueras ◽  
Hugo Cornelis van Woerden ◽  
Vasiliki Kiparoglou
Keyword(s):  
Older Adults ◽  
Clinical Trials ◽  
Digital Technology ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Public Health Issue ◽  
Future Research ◽  
Physical And Mental Health ◽  
Significant Difference

BACKGROUND Loneliness is a serious public health issue, and its burden is increasing in many countries. Loneliness affects social, physical, and mental health, and it is associated with multimorbidity and premature mortality. In addition to social interventions, a range of digital technology interventions (DTIs) are being used to tackle loneliness. However, there is limited evidence on the effectiveness of DTIs in reducing loneliness, especially in adults. The effectiveness of DTIs in reducing loneliness needs to be systematically assessed. OBJECTIVE The objective of this study is to assess the effectiveness of DTIs in reducing loneliness in older adults. METHODS We conducted electronic searches in PubMed, MEDLINE, CINAHL, Embase, and Web of Science for empirical studies published in English from January 1, 2010, to July 31, 2019. The study selection criteria included interventional studies that used any type of DTIs to reduce loneliness in adults (aged ≥18 years) with a minimum intervention duration of 3 months and follow-up measurements at least 3 months after the intervention. Two researchers independently screened articles and extracted data using the PICO (participant, intervention, comparator, and outcome) framework. The primary outcome measure was loneliness. Loneliness scores in both the intervention and control groups at baseline and at follow-up at 3, 4, 6, and 12 months after the intervention were extracted. Data were analyzed via narrative synthesis and meta-analysis using RevMan (The Cochrane Collaboration) software. RESULTS A total of 6 studies were selected from 4939 screened articles. These studies included 1 before and after study and 5 clinical trials (4 randomized clinical trials and 1 quasi-experimental study). All of these studies enrolled a total of 646 participants (men: n=154, 23.8%; women: n=427, 66.1%; no gender information: n=65, 10.1%) with an average age of 73-78 years (SD 6-11). Five clinical trials were included in the meta-analysis, and by using the random effects model, standardized mean differences (SMDs) were calculated for each trial and pooled across studies at the 3-, 4-, and 6-month follow-ups. The overall effect estimates showed no statistically significant difference in the effectiveness of DTIs compared with that of usual care or non-DTIs at follow-up at 3 months (SMD 0.02; 95% CI −0.36 to 0.40; <i>P</i>=.92), 4 months (SMD −1.11; 95% CI −2.60 to 0.38; <i>P</i>=.14), and 6 months (SMD −0.11; 95% CI −0.54 to 0.32; <i>P</i>=.61). The quality of evidence was very low to moderate in these trials. CONCLUSIONS Our meta-analysis shows no evidence supporting the effectiveness of DTIs in reducing loneliness in older adults. Future research may consider randomized controlled trials with larger sample sizes and longer durations for both the interventions and follow-ups. INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2019-032455

scholarly journals Digital Technologies as a Means to Reducing Mental Health Disparities: The Role of Ethnicity, SES, and Geography

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 662-663
Author(s):  
Giyeon Kim
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Health Disparities ◽  
Digital Technology ◽  
Technology Use ◽  
Digital Technologies ◽  
Current Status ◽  
Future Research ◽  
Mental Health Disparities

Abstract This presentation discusses the importance of using digital technologies on reducing mental health disparities among older adults from diverse backgrounds. This talk primarily focuses on the role of ethnicity, socioeconomic status and geography. First, the speaker presents the current status of digital technology use among older adults and how different levels of digital technology use affect mental health disparities by ethnicity, SES, and place of residence. Second, the speaker introduces a recently funded government project on developing an IoT-based home system (Internet of Things) to screen mild cognitive function for Korean older adults. Lastly, the speaker discusses potential implications, as well as directions for future research on using digital technologies to reduce mental health disparities among diverse populations.

The Impact of Subjective and Objective Hearing Loss on Cognition and Memory in Older Adults

2015 ◽  
Vol 20 (2) ◽  
pp. 49-57 ◽  
Author(s):  
Yvonne Rogalski ◽  
Amy Rominger
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Reading Aloud ◽  
Cognitive Testing ◽  
Professional Collaboration ◽  
Cognitive Screening ◽  
Speech Language Pathologist ◽  
Text Passage ◽  
The Impact ◽  
Audiologic Evaluation

For this exploratory cross-disciplinary study, a speech-language pathologist and an audiologist collaborated to investigate the effects of objective and subjective hearing loss on cognition and memory in 11 older adults without hearing loss (OAs), 6 older adults with unaided hearing loss (HLOAs), and 16 young adults (YAs). All participants received cognitive testing and a complete audiologic evaluation including a subjective questionnaire about perceived hearing difficulty. Memory testing involved listening to or reading aloud a text passage then verbally recalling the information. Key findings revealed that objective hearing loss and subjective hearing loss were correlated and both were associated with a cognitive screening test. Potential clinical implications are discussed and include a need for more cross-professional collaboration in assessing older adults with hearing loss.

Regulation of Experienced and Anticipated Regret for Daily Decisions in Younger and Older Adults in a Swedish One-Week Diary Study

GeroPsych ◽  
2013 ◽  
Vol 26 (4) ◽  
pp. 233-241 ◽  
Author(s):  
Pär Bjälkebring ◽  
Daniel Västfjäll ◽  
Boo Johansson
Keyword(s):  
Older Adults ◽  
Diary Study ◽  
Anticipated Regret ◽  
Younger Adults ◽  
Web Based ◽  
Decision Regret ◽  
Diary Method ◽  
Regulation Strategies

Regret and regret regulation were studied using a weeklong web-based diary method. 108 participants aged 19 to 89 years reported regret for a decision made and a decision to be made. They also reported the extent to which they used strategies to prevent or regulate decision regret. Older adults reported both less experienced and anticipated regret compared to younger adults. The lower level of experienced regret in older adults was mediated by reappraisal of the decision. The lower level of anticipated regret was mediated by delaying the decision, and expecting regret in older adults. It is suggested that the lower level of regret observed in older adults is partly explained by regret prevention and regulation strategies.

Refining Evidence-Based Treatments for Late-Life Depression

GeroPsych ◽  
2015 ◽  
Vol 28 (2) ◽  
pp. 67-76
Author(s):  
Grace C. Niu ◽  
Patricia A. Arean
Keyword(s):  
Older Adults ◽  
Mental Illness ◽  
Brain Plasticity ◽  
Late Life ◽  
Aging Population ◽  
The United States ◽  
Future Research ◽  
Evidence Based ◽  
Late Life Depression ◽  
Evidence Based Treatments

The recent increase in the aging population, specifically in the United States, has raised concerns regarding treatment for mental illness among older adults. Late-life depression (LLD) is a complex condition that has become widespread among the aging population. Despite the availability of behavioral interventions and psychotherapies, few depressed older adults actually receive treatment. In this paper we review the research on refining treatments for LLD. We first identify evidence-based treatments (EBTs) for LLD and the problems associated with efficacy and dissemination, then review approaches to conceptualizing mental illness, specifically concepts related to brain plasticity and the Research Domain Criteria (RDoc). Finally, we introduce ENGAGE as a streamlined treatment for LLD and discuss implications for future research.

THE „CLOUDY“ CLASSROOM

2020 ◽  
Vol 11 (2) ◽  
pp. 347-352
Author(s):  
Atanaska Peneva ◽  
Keyword(s):  
Information And Communication Technologies ◽  
Mobile Communications ◽  
Teaching And Learning ◽  
Communication Technologies ◽  
Web Based ◽  
Modern Approach ◽  
Building Information ◽  
Practical Guidelines ◽  
Information And Communication ◽  
Cloud Technologies

The report presents the author’s experience in integrating modern ICT technologies in the process of teaching and learning in school. The emphasis is on the use of mobile devices and the integration of cloud technologies in schools. As an ICT teacher, the author provides some practical guidelines on how to apply innovation. The generation of 7 screens does not know a world without digital technologies and mobile communications. The discrepancy between the expectations of the digital generation and the reality in our schools is in terms of the information and communication technologies (ICT) used in them and the didactic models. Adolescents, when they find themselves in an environment that does not meet their expectations, are demotivated and redirect their attention to other objects and goals and stop being active in class. The use of the so-called. „Cloud“ technologies will significantly increase the interest and retention of students. The modern approach to building information systems is focused on developing solutions in which the collection, input and output of information is carried out through WEB-based applications or platforms.

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