cip- ict- psp: proyecto long lasting memories

Long Lasting Memories: cognitive and physical training using new technologies in mild

impairment. Usefulness and implementation in the community.

M. Franco-Martín , F. González Palau, E. Parra, M. Bernate; R. Losada, Y. Ruiz, A. Solis, T. Cid and C. Turuelo.

INTRAS Foundation, Zamora, SpainINTERDEM Network.

Long Lasting Memories (LLM) 04/22/23

CIP- ICT- PSP: Proyecto LONG LASTING MEMORIES


Partners


BACKGROUND

Despite of the huge advance in the field

of computer-based interventions, few applications have been analyzed in terms of their effectiveness and their usability in healthy elderly population and the recovery of cognitive functions in people with mild cognitive impairment and mild dementia.


BACKGROUND

Long Lasting Memories (LLM) is an integrated ICT platform which combines cognitive exercises with physical activity in the framework of advance technologies.

LLM aims to deliver an effective solution against age-related cognitive decline, and to allow the recovery of higher cognitive functions in people who show cognitive impairment related to Mild Cognitive Impairment and Mild Dementia


LLM Components

Independent Living Component (ILC)

Cognitive Training Component (CTC)

Physical Training Component (PTC)

LLM Platform

Central Management System(CMS)


LLM Integration Architecture

Technical Integration I


LLM Design Idea


CMS – LUI


LLM Components (ILC)

Independent Living Component (ILC)

LLM Platform - ILC


LLM Components (CTC)

Cognitive Training Component (CTC)

LLM Platform - CTC

Software:BrainFitness / GRADIORPresentation Layer: Local User Interface (touch screen)Required Hardware: Regular low-cost personal computer Delivery: Wiring with the rest of the system


COGNITIVE ASSESSMENT AND REHABILITATION THROUGH

COMPUTER


LLM Components (PTC)

Physical Training Component (PTC)

LLM Platform - PTC

Hardware:Wii peripheral devices, such as Wii Remote and Wii Balance Board

Software:FitForAll: Custom developed games that interact with users training of balance (static/dynamic), muscle strength, aerobic endurance and flexibility. (http://kedip.med.auth.gr/FitForAll)


Simple Exergaming Interface


Aerobic exercise & feedback

Δείκτες άσκησης, όπως χρόνος,

απόσταση, ταχύτητα, κ.ά.


The Pilots

Pilots in 5 countries Austria Spain France Greece Cyprus


OBJECTIVES

To examine and analyze preliminary results of the effectiveness and usability of Long Lasting Memories cognitive (Gradior) and physical training applications in Spanish population


• Analysis of all results• Technology Solution• Usability• Health (physical and cognitive results)• Marketability

Pre-Pilot Phase

•Establish Goals•Define Metrics•Develop Monitoring Tools

•System Integration &Localisation

•Train technical staff

•Install Systems•Train Staff

Execute Pilot Tests (3 iterations)

•Recruit and Screen Participants

•Random Assignment

•Train and Monitor Participants

•Technical support

•Quality Control/Auditing

Test Evaluation (3 iterations)

•Collect and Analyse Data

•Post-Pilot Follow-Up Monitoring

•Systems and Process Adjustments

Pilot Test Evaluation

•Medical Data Analysis

•Technology Efficacy Analysis

•Cost Analysis•Analysis of Best Practices

•User Satisfaction Analysis

•Analysis of Impact on Marketability

•Final Report

The PilotsPost Pilot Review and Timeline


DESCRIPTION OF PILOT STUDY

JUN

JUL

AUG

SEP

OCT

NOV

DEC

JAN

FEB

MAR

APR

MAY

JUN

JUL

AUG

SEP

OCT

NOV

DEC

Staff trainning

Screenig 1º inter.

FIRST INTERACTION

Post eval –

Screening 2º inter.

SECOND INTERACTION

Post-ev – screening

3º inter.

THIRD INTERACCION

Post eval. Data analysis and final conclusions

PRE- PILOT PHASE

PILOT PHASE POST PILOT PHASE


Inclusión/Exclusion Criteria

Table 4. Inclusion/Exclusion Criteria

Inclusion Criteria Exclusion CriteriaAge > 60 years Participation in another study at the same time

Fluent language skills of the respective language

SEVERE DEPRESSION OR OTHER RELEVANT PSYCHIATRIC DIAGNOSIS THAT MAKES IT

IMPOSSIBLE TO KEEP UP WITH ALL COMPONENTS OF LLM SEVICE

Signed informed consent SEVERE PHYSICAL ILLNESS OR HANDICAP FOR USING ALL COMPONENTS OF LLM

SERVICE

Agreement of medical doctor Unrecovered clinical relevant neurological diagnosis (e.G. Epilepsy, stroke, brain tumor,...)

Time commitment for the the entire duration of the study

Un-stable medication

MMSE > 15 SEVERE UNCORRECTABLE VISION PROBLEMS (E.G. GREEN/GREY STAR), HEARING AID FOR LESS THAN 3 MONTHS


PARTICIPANTS SUMMARY FIRST AND SECOND INTERATION

LOCATION TYPE # SCREENED

# EXCLUDED

DID NOT ACCEPT NOT ABLE TOTAL

CONTROL

RESIDENTIAL FACILITY

(VALLADOLID)53 6 11

56RESIDENTIAL FACILITY (ZAMORA) 41 9 11

FIRST INTER.

RESIDENTIAL FACITLIY 36 6 1 31

USERS HOME 3 - 1

SECONDINTER.

MEMORY CLINIC 1 32 4 -56MEMORY CLINIC 2 33 3 1

MEMORY CLINIC 3 4 - 1202 28 26


MAIN CAUSES FOR NOT ACCEPTING THE PROGRAM


MATERIALSPretest/Post Test Test

Pretest/Post Test MEC/Minimental Test

Pretest/Post Test Digits WMS (Weschler Memory Scale).

Pretest/Post Test Texts WMS (Weschler Memory Scale).

Pretest/Post Test Verbal Learning Test Revised (HVLT-R)

Pretest/Post Test Trail Making Test (TMT)

Pretest/Post Test Seniors Fitness Test (SFT)

Pretest/Post Test Word Health Organization Quality of Life (WHOQOL-Bref;)

Pretest/Post Test Social Activities Questionnaire

Pretest/Post Test Istrumental Activities of Daily Living (IADL)

Pretest / Post test Geriatric Depression Scale (GDS)

Pretest/Postest Subjective Memory Complaints

Post- Test Usability Questionnaire (Disegned for LLM study)


INTERVENTIONINTERVENTION PILOT PROTOCOL PILOT PROTOCOL

• Cognitive Training Procedure/Duration

- GRADIOR: 40 minutes/ 3-5 times a week Exercises to train perception, attention,

memory, calculus, reasoning and orientation

• Physical Training Procedure/Duration

- FITforAlLL 1 hour session/ 3 times a week Stretching, balance, muscular endurance

and flexibility exercises


HVLT-R: recognition


Memory Weschler Text subscale (WMS)


Geriatric Depression Scale (GDS)


USABILITY RESULTS

73,33 % of the participants perceived LLM platform as beneficial (60%) to very beneficial (13,33 %)for them.

91,1% reported they enjoyed (58,62%) and totally enjoyed (34,48 %) the sessions


USABILITY

All the participants expressed they would be able to use the program alone if they have it at home

All the users agreed they would characterize

LLM software as “warm and friendly” and would recommend the program


EXPECTATIONS MET

70% reported that it met (56,67%) to totally met (13,33%) their expectations and the majority of them indicated they wish to continue using the platform after 12 weeks study.


CONCLUSIONS

• Primary results are promising, indicating that healthy elderly and older adults with mild to moderate impairment could be benefited by LLM cognitive and physical training software.

• Effectiveness of the platform in several cognitive functions. Specially memory (recognition, working memory and immediate recall) can be enhanced by cognitive and physical LLM training.


CONCLUSIONS

• LLM platform could provide a stimulating and usefulness new technology method for cognitive and physical training in elderly population.

• Reviewing aspects of usability have significant implications in the development of new computer-based programs.

• Delineating this aspects can assist in identifying new features to be considerer in LLM and help to refine the application, being this a promising solution for elderly population


CONCLUSION• Most of the participants shown interest in

participating in the study.

• Elderly reacted positively to the use of technology in the treatment.

• Elderly affirmed the program is necessary and beneficial for their health.

• In higher levels of impairment (dementia) patients shown less motivation to participate in the training activities.


www.longlastingmemories.euThank you very much

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cip- ict- psp: proyecto long lasting memories

Documents

llm componentsindependent

llm components ilcindependent

llm general overviewllm

mild cognitive impairment

cognitive exercises

mild impairment

agerelated cognitive

specific user of gradior