Bridging the digital divide in older adults: A study from an initiative to inform older adults ab... more Bridging the digital divide in older adults: A study from an initiative to inform older adults about new technologies
The living lab is an approach that encourages the design and development of innovative technologi... more The living lab is an approach that encourages the design and development of innovative technological solutions in a process of coconstruction involving users and other key players. Its methodology develops the technologies of the Broca living lab, dedicated to the care of elderly people with cognitive disorders and their carers.
with no evidence of accumulation over 14 days. At the 560 mg dose, CSF levels of CT1812 correspon... more with no evidence of accumulation over 14 days. At the 560 mg dose, CSF levels of CT1812 correspond to estimated brain concentrations equivalent to 95% receptor occupancy. Conclusions: In healthy volunteers, CT1812 was well tolerated with single doses up to 1120 mg and with multiple doses up to 840 mg in healthy young volunteers and 560 mg in healthy elderly volunteers. Multiple dose exposure of CT1812 corresponded to more than 20x the expected minimum therapeutic dose while CSF analysis indicated that brain concentrations exceeded the minimum target expected to improve memory (>80% receptor occupancy). CT1812 is designed to directly test the oligomer hypothesis of AD treatment. Further development will test the ability of CT1812 to improve cognitive ability in AD patients.
Researchers have hypothesized that learning a foreign language could be beneficial for seniors, a... more Researchers have hypothesized that learning a foreign language could be beneficial for seniors, as language learning requires the use of extensive neural networks. We developed and qualitatively evaluated an English training program for older French adults; our principal objective was to determine whether a program integrating technology is feasible for this population. We conducted a 4-month pilot study (16, 2-h sessions) with 14 French participants, (nine women, five men, average age 75). Questionnaires were administered pre- and post-intervention to measure cognitive level and subjective feelings of loneliness or social isolation; however, these scores did not improve significantly. Post-intervention, semi-directive interviews were carried out with participants, and a content/theme analysis was performed. Five main themes were identified from the interviews: Associations with school, attitudes toward English, motivation for learning English, attitudes toward the program's org...
Journal of Clinical and Experimental Neuropsychology, 2016
The K-T cancellation test (K-T) has been validated as a measure of executive functions (EF) but i... more The K-T cancellation test (K-T) has been validated as a measure of executive functions (EF) but its clinical utility has not yet been examined. This study aimed to validate K-T in a memory clinic setting by examining its capacity to discriminate older adults with normal cognition (NC) from those with mild cognitive impairment (MCI) and Alzheimer's disease (AD). K-T was administered to 120 NC subjects, 146 patients with MCI, and 93 patients with AD. A one-way analysis of covariance was used to compare the correct cancellations of K-T between the groups. Linear regressions were run to identify significant demographic predictors of K-T for NC subjects and to determine the equation to calculate z scores for all subjects. The area under the curve (AUC), sensitivity (Se), specificity (Sp), and positive (PPV) and negative (NPV) predictive values were assessed to compare the diagnostic performance between K-T and the Mini-Mental State Examination (MMSE) for discrimination between NC subjects and patients with cognitive impairment. After adjusting for age, education, and gender, the groups were significantly different from each other regarding the number of correct cancellations of K-T, F(2, 353) = 116.6, p < .001, η(2)p = .40. Compared to the NC group (Z = 0, SD = 1), the mean z score was -1.52 for the MCI group and -2.53 for the AD group, suggesting impaired performance for the patient groups. K-T showed a better diagnostic performance for discrimination between the NC subjects and the patients with MCI (AUC = .83; 95% CI [.79, .88]; Se = .79; Sp = .74; PPV = .79; NPV = .74), compared to that of MMSE (AUC = .74, 95% CI [.68, .80]; Se = .68; Sp = .73; PPV = .79; NPV = .64). The K-T cancellation test showed a good diagnostic performance in discriminating cognitively normal older adults from cognitively impaired patients. Our findings support the clinical utility of K-T in geriatric neuropsychological assessment for detection of early cognitive impairment.
Abstract. The ROBADOM project aims at conceiving an assistive robot capable of expressing some ba... more Abstract. The ROBADOM project aims at conceiving an assistive robot capable of expressing some basic emotions and language in order to support the elderly with Mild Cognitive Impairment (MCI), living alone at home. In order to ensure the appropriateness of the design of this kind of robot, technical solutions as well as social, psychological and ethical issues of robot use in the elder care are investigated. This paper presents the system design and some preliminary results from our multi-disciplinary studies. Keywords: assistive robot, elder care, ethical issue, mild cognitive impairment
A variety of technology-based products and services are designed to meet the needs of older adult... more A variety of technology-based products and services are designed to meet the needs of older adults in regard to healthcare, safety and autonomy. The Living Lab is an approach promoting the design and development of innovative technological solutions in a co-creation process which involves users and all other stakeholders. This paper presents the contribution of Living Lab methodology to the development of solutions in the field of gerontechnology by focusing on the case of the LUSAGE laboratory that specifically targets elderly people with cognitive impairment and their caregivers.
Background: Neurofeedback (NF) training, as a method of self-regulation of brain activity, may be... more Background: Neurofeedback (NF) training, as a method of self-regulation of brain activity, may be beneficial in elderly patients with mild cognitive impairment (MCI). In this pilot study, we investigated whether a sensorimotor (SMR)/theta NF training could improve cognitive performance and brain electrical activity in elderly patients with MCI. Methods: Twenty elderly patients with MCI were assigned to 20 consecutive sessions of sensorimotor (SMR)/theta NF training, during 10 weeks, on a basis of two sessions each week. Neuropsychological assessments and questionnaires, as well as electroencephalogram (EEG), were performed and compared between baseline (T0), after the last NF training session at 10 weeks (T1), and 1-month follow-up (T2). Results: Repeated measures ANOVA revealed that from baseline to post-intervention, participants showed significant improvement in the Montreal cognitive assessment (MoCa, F = 4.78; p = 0.012), the delayed recall of the Rey auditory verbal learning test (RAVLT, F = 3.675; p = 0.032), the Forward digit span (F = 13.82; p < 0.0001), the Anxiety Goldberg Scale (F = 4.54; p = 0.015), the Wechsler Adult Intelligence Score-Fourth Edition (WAIS-IV; F = 24.75; p < 0.0001), and the Mac Nair score (F = 4.47; p = 0.016). EEG theta power (F = 4.44; p = 0.016) and alpha power (F = 3.84; p = 0.027) during eyes-closed resting-state significantly increased after the NF training and showed sustained improvement at a 1-month follow-up.
The ROBADOM project aims at conceiving an assistive robot capable of expressing some basic emotio... more The ROBADOM project aims at conceiving an assistive robot capable of expressing some basic emotions and language in order to support the elderly with Mild Cognitive Impairment (MCI), living alone at home. In order to ensure the appropriateness of the design of this kind of robot, technical solutions as well as social, psychological and ethical issues of robot use in the elder care are investigated. This paper presents the system design and some preliminary results from our multi-disciplinary studies.
This study aimed to explore whether a computerized cognitive stimulation program (CCS) induced di... more This study aimed to explore whether a computerized cognitive stimulation program (CCS) induced differential effects in older adults with mild cognitive impairment (MCI) according to the severity of white matter hyperintensities (WMH), which are associated with cognitive impairment and increased risk of progression to Alzheimer's disease because of the damage they cause to cortical and subcortical networks. Patients and methods: Twenty-nine MCI patients with no or little WMH (MCI-non-WMH) and 22 MCI patients with moderate or severe WMH (MCI-WMH) attended a 24-session CCS program (two sessions per week for a duration of 3 months) focused on executive functions, attention, and processing speed. Cognitive and psychosocial assessments were performed at baseline, postintervention, and 3 months after the intervention. Results: Both groups improved on several cognitive measures after the intervention. However, the MCI-non-WMH group improved on a higher number of cognitive measures than the MCI-WMH group. At postintervention assessment, CCS had a more beneficial effect on the MCI-non-WMH group than on the MCI-WMH group with regard to improving categorical fluency (4.6±6.8 vs 0.4±6.4; effect size=0.37; p=0.002). During the 3-month follow-up assessment, significantly higher score improvements were observed in the MCInon-WMH group for the paired-associate learning test (6.4±3 vs 4.7±3.5 points; effect size=0.43; p=0.005) as well as categorical fluency (3.8±7.8 vs −0.7±6 points; effect size=0.55; p=0.0003). Conclusions: These findings suggest that WMH severity was related to cognitive improvement induced by a CCS program and highlight the importance of considering WMH in interventional studies on subjects with MCI.
This study investigated cognitive function in relation to the use of a computer and a touchscreen... more This study investigated cognitive function in relation to the use of a computer and a touchscreen device among older adults attending a memory clinic. The entire sample (n = 323) was categorized into four profiles, according to the frequency of digital device use (either daily or non-daily usage). Results showed that on a daily basis, 26% of the sample used both a computer and a touchscreen device, 26.9% used only a computer, 7.1% used only a touchscreen device, and 39.9% used neither type of digital device. There were significant group differences on age, education, and clinical diagnosis (p < .001). Non-daily users of digital devices had significantly lower performance, compared with daily users of both types of digital device, on measures of global cognitive function, processing speed, short-term memory, and several components of executive function (p < .001). Falling behind with regard to the use of digital devices might reflect underlying poor cognitive capacities.
Mild cognitive impairment (MCI) is associated with a higher risk of dementia and is becoming a to... more Mild cognitive impairment (MCI) is associated with a higher risk of dementia and is becoming a topic of interest for pharmacological and nonpharmacological interventions. With advances in technology, computer-based cognitive exercises are increasingly integrated into traditional cognitive interventions, such as cognitive training. Another type of cognitive intervention involving technology use is cognitive engagement, consisting of involving participants in highly motivational and mentally challenging activities, such as learning to use a form of new digital technology. This study examined the feasibility and acceptability of a computerized cognitive stimulation (CCS) program and a computerized cognitive engagement (CCE) program, and then compared their effects in older adults with MCI. In this randomized study, data from 19 MCI patients were analyzed (n=9 in CCS and n=10 in CCE). The patients attended a group weekly session for a duration of 3 months. Assessments of cognitive and p...
Background and objective There has been a growing interest in using computerized cognitive assess... more Background and objective There has been a growing interest in using computerized cognitive assessment to detect age-related cognitive disorders. We have developed a tablet-based cancellation test (e-CT), previously shown as a reliable measure of executive functions and free of effect of familiarity with computer-based devices in healthy older adults. This study aimed to investigate the influence of demographics and current daily use of computer-based devices in older adults with Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD). We further studied the ability of the e-CT to discriminate MCI and AD patients from older adults with normal cognition (NC). Methods The e-CT was administered to 325 older adults (NC = 112, MCI = 129, AD = 84). Subjects also performed the K-T test, a paper-and-pencil cancellation test from which the e-CT was developed. Multiple linear regression analyses were conducted to assess the contribution of demographics and current daily use of computer-based devices on the e-CT in patient groups. The Receiver Operating Characteristic (ROC) curves and the Area Under the Curve (AUC) were established to compare the efficacy of the e-CT and the K-T test to classify subjects into diagnostic groups.
Bridging the digital divide in older adults: A study from an initiative to inform older adults ab... more Bridging the digital divide in older adults: A study from an initiative to inform older adults about new technologies
The living lab is an approach that encourages the design and development of innovative technologi... more The living lab is an approach that encourages the design and development of innovative technological solutions in a process of coconstruction involving users and other key players. Its methodology develops the technologies of the Broca living lab, dedicated to the care of elderly people with cognitive disorders and their carers.
with no evidence of accumulation over 14 days. At the 560 mg dose, CSF levels of CT1812 correspon... more with no evidence of accumulation over 14 days. At the 560 mg dose, CSF levels of CT1812 correspond to estimated brain concentrations equivalent to 95% receptor occupancy. Conclusions: In healthy volunteers, CT1812 was well tolerated with single doses up to 1120 mg and with multiple doses up to 840 mg in healthy young volunteers and 560 mg in healthy elderly volunteers. Multiple dose exposure of CT1812 corresponded to more than 20x the expected minimum therapeutic dose while CSF analysis indicated that brain concentrations exceeded the minimum target expected to improve memory (>80% receptor occupancy). CT1812 is designed to directly test the oligomer hypothesis of AD treatment. Further development will test the ability of CT1812 to improve cognitive ability in AD patients.
Researchers have hypothesized that learning a foreign language could be beneficial for seniors, a... more Researchers have hypothesized that learning a foreign language could be beneficial for seniors, as language learning requires the use of extensive neural networks. We developed and qualitatively evaluated an English training program for older French adults; our principal objective was to determine whether a program integrating technology is feasible for this population. We conducted a 4-month pilot study (16, 2-h sessions) with 14 French participants, (nine women, five men, average age 75). Questionnaires were administered pre- and post-intervention to measure cognitive level and subjective feelings of loneliness or social isolation; however, these scores did not improve significantly. Post-intervention, semi-directive interviews were carried out with participants, and a content/theme analysis was performed. Five main themes were identified from the interviews: Associations with school, attitudes toward English, motivation for learning English, attitudes toward the program's org...
Journal of Clinical and Experimental Neuropsychology, 2016
The K-T cancellation test (K-T) has been validated as a measure of executive functions (EF) but i... more The K-T cancellation test (K-T) has been validated as a measure of executive functions (EF) but its clinical utility has not yet been examined. This study aimed to validate K-T in a memory clinic setting by examining its capacity to discriminate older adults with normal cognition (NC) from those with mild cognitive impairment (MCI) and Alzheimer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease (AD). K-T was administered to 120 NC subjects, 146 patients with MCI, and 93 patients with AD. A one-way analysis of covariance was used to compare the correct cancellations of K-T between the groups. Linear regressions were run to identify significant demographic predictors of K-T for NC subjects and to determine the equation to calculate z scores for all subjects. The area under the curve (AUC), sensitivity (Se), specificity (Sp), and positive (PPV) and negative (NPV) predictive values were assessed to compare the diagnostic performance between K-T and the Mini-Mental State Examination (MMSE) for discrimination between NC subjects and patients with cognitive impairment. After adjusting for age, education, and gender, the groups were significantly different from each other regarding the number of correct cancellations of K-T, F(2, 353) = 116.6, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001, η(2)p = .40. Compared to the NC group (Z = 0, SD = 1), the mean z score was -1.52 for the MCI group and -2.53 for the AD group, suggesting impaired performance for the patient groups. K-T showed a better diagnostic performance for discrimination between the NC subjects and the patients with MCI (AUC = .83; 95% CI [.79, .88]; Se = .79; Sp = .74; PPV = .79; NPV = .74), compared to that of MMSE (AUC = .74, 95% CI [.68, .80]; Se = .68; Sp = .73; PPV = .79; NPV = .64). The K-T cancellation test showed a good diagnostic performance in discriminating cognitively normal older adults from cognitively impaired patients. Our findings support the clinical utility of K-T in geriatric neuropsychological assessment for detection of early cognitive impairment.
Abstract. The ROBADOM project aims at conceiving an assistive robot capable of expressing some ba... more Abstract. The ROBADOM project aims at conceiving an assistive robot capable of expressing some basic emotions and language in order to support the elderly with Mild Cognitive Impairment (MCI), living alone at home. In order to ensure the appropriateness of the design of this kind of robot, technical solutions as well as social, psychological and ethical issues of robot use in the elder care are investigated. This paper presents the system design and some preliminary results from our multi-disciplinary studies. Keywords: assistive robot, elder care, ethical issue, mild cognitive impairment
A variety of technology-based products and services are designed to meet the needs of older adult... more A variety of technology-based products and services are designed to meet the needs of older adults in regard to healthcare, safety and autonomy. The Living Lab is an approach promoting the design and development of innovative technological solutions in a co-creation process which involves users and all other stakeholders. This paper presents the contribution of Living Lab methodology to the development of solutions in the field of gerontechnology by focusing on the case of the LUSAGE laboratory that specifically targets elderly people with cognitive impairment and their caregivers.
Background: Neurofeedback (NF) training, as a method of self-regulation of brain activity, may be... more Background: Neurofeedback (NF) training, as a method of self-regulation of brain activity, may be beneficial in elderly patients with mild cognitive impairment (MCI). In this pilot study, we investigated whether a sensorimotor (SMR)/theta NF training could improve cognitive performance and brain electrical activity in elderly patients with MCI. Methods: Twenty elderly patients with MCI were assigned to 20 consecutive sessions of sensorimotor (SMR)/theta NF training, during 10 weeks, on a basis of two sessions each week. Neuropsychological assessments and questionnaires, as well as electroencephalogram (EEG), were performed and compared between baseline (T0), after the last NF training session at 10 weeks (T1), and 1-month follow-up (T2). Results: Repeated measures ANOVA revealed that from baseline to post-intervention, participants showed significant improvement in the Montreal cognitive assessment (MoCa, F = 4.78; p = 0.012), the delayed recall of the Rey auditory verbal learning test (RAVLT, F = 3.675; p = 0.032), the Forward digit span (F = 13.82; p < 0.0001), the Anxiety Goldberg Scale (F = 4.54; p = 0.015), the Wechsler Adult Intelligence Score-Fourth Edition (WAIS-IV; F = 24.75; p < 0.0001), and the Mac Nair score (F = 4.47; p = 0.016). EEG theta power (F = 4.44; p = 0.016) and alpha power (F = 3.84; p = 0.027) during eyes-closed resting-state significantly increased after the NF training and showed sustained improvement at a 1-month follow-up.
The ROBADOM project aims at conceiving an assistive robot capable of expressing some basic emotio... more The ROBADOM project aims at conceiving an assistive robot capable of expressing some basic emotions and language in order to support the elderly with Mild Cognitive Impairment (MCI), living alone at home. In order to ensure the appropriateness of the design of this kind of robot, technical solutions as well as social, psychological and ethical issues of robot use in the elder care are investigated. This paper presents the system design and some preliminary results from our multi-disciplinary studies.
This study aimed to explore whether a computerized cognitive stimulation program (CCS) induced di... more This study aimed to explore whether a computerized cognitive stimulation program (CCS) induced differential effects in older adults with mild cognitive impairment (MCI) according to the severity of white matter hyperintensities (WMH), which are associated with cognitive impairment and increased risk of progression to Alzheimer's disease because of the damage they cause to cortical and subcortical networks. Patients and methods: Twenty-nine MCI patients with no or little WMH (MCI-non-WMH) and 22 MCI patients with moderate or severe WMH (MCI-WMH) attended a 24-session CCS program (two sessions per week for a duration of 3 months) focused on executive functions, attention, and processing speed. Cognitive and psychosocial assessments were performed at baseline, postintervention, and 3 months after the intervention. Results: Both groups improved on several cognitive measures after the intervention. However, the MCI-non-WMH group improved on a higher number of cognitive measures than the MCI-WMH group. At postintervention assessment, CCS had a more beneficial effect on the MCI-non-WMH group than on the MCI-WMH group with regard to improving categorical fluency (4.6±6.8 vs 0.4±6.4; effect size=0.37; p=0.002). During the 3-month follow-up assessment, significantly higher score improvements were observed in the MCInon-WMH group for the paired-associate learning test (6.4±3 vs 4.7±3.5 points; effect size=0.43; p=0.005) as well as categorical fluency (3.8±7.8 vs −0.7±6 points; effect size=0.55; p=0.0003). Conclusions: These findings suggest that WMH severity was related to cognitive improvement induced by a CCS program and highlight the importance of considering WMH in interventional studies on subjects with MCI.
This study investigated cognitive function in relation to the use of a computer and a touchscreen... more This study investigated cognitive function in relation to the use of a computer and a touchscreen device among older adults attending a memory clinic. The entire sample (n = 323) was categorized into four profiles, according to the frequency of digital device use (either daily or non-daily usage). Results showed that on a daily basis, 26% of the sample used both a computer and a touchscreen device, 26.9% used only a computer, 7.1% used only a touchscreen device, and 39.9% used neither type of digital device. There were significant group differences on age, education, and clinical diagnosis (p < .001). Non-daily users of digital devices had significantly lower performance, compared with daily users of both types of digital device, on measures of global cognitive function, processing speed, short-term memory, and several components of executive function (p < .001). Falling behind with regard to the use of digital devices might reflect underlying poor cognitive capacities.
Mild cognitive impairment (MCI) is associated with a higher risk of dementia and is becoming a to... more Mild cognitive impairment (MCI) is associated with a higher risk of dementia and is becoming a topic of interest for pharmacological and nonpharmacological interventions. With advances in technology, computer-based cognitive exercises are increasingly integrated into traditional cognitive interventions, such as cognitive training. Another type of cognitive intervention involving technology use is cognitive engagement, consisting of involving participants in highly motivational and mentally challenging activities, such as learning to use a form of new digital technology. This study examined the feasibility and acceptability of a computerized cognitive stimulation (CCS) program and a computerized cognitive engagement (CCE) program, and then compared their effects in older adults with MCI. In this randomized study, data from 19 MCI patients were analyzed (n=9 in CCS and n=10 in CCE). The patients attended a group weekly session for a duration of 3 months. Assessments of cognitive and p...
Background and objective There has been a growing interest in using computerized cognitive assess... more Background and objective There has been a growing interest in using computerized cognitive assessment to detect age-related cognitive disorders. We have developed a tablet-based cancellation test (e-CT), previously shown as a reliable measure of executive functions and free of effect of familiarity with computer-based devices in healthy older adults. This study aimed to investigate the influence of demographics and current daily use of computer-based devices in older adults with Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD). We further studied the ability of the e-CT to discriminate MCI and AD patients from older adults with normal cognition (NC). Methods The e-CT was administered to 325 older adults (NC = 112, MCI = 129, AD = 84). Subjects also performed the K-T test, a paper-and-pencil cancellation test from which the e-CT was developed. Multiple linear regression analyses were conducted to assess the contribution of demographics and current daily use of computer-based devices on the e-CT in patient groups. The Receiver Operating Characteristic (ROC) curves and the Area Under the Curve (AUC) were established to compare the efficacy of the e-CT and the K-T test to classify subjects into diagnostic groups.
Uploads
Papers by Ya-Huei Wu