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Cognitive strandDaniel Leahy | April 19, 2023

Presentation includes content from Rory Sobolewski and Dr Shona Darcy

Background

The goal of the cognitive strand is to identify and measure behavioural markers which lead to the decline of cognitive function in older people. Behavioural or electrophysiological markers are measurable behaviours or characteristrics of an older person. Knowledge of these markers help the investigators, clinicians or care-givers find ways to modify behaviour or in some way mitigate the problem.

Consequences of Cognitive Decline

The biggest limiting factor to independence in older people is impaired cognitive function and its consequences. Such consequences include:

Accident proneness - falls, burns, bruising and cuts,

Self-neglect - missed medication, not eating properly, failing to keep properly warm, poor hygiene, failure to notice or report medical signs and symptoms,

loss of initiative, diminished repertoire of activities and low mood.

Aging Population

In 1950 European countries had a population of age 65+ of some 45 million; in 1995 the

population of age 65+ had already more than doubled to 101 million; by 2050 Europe will have 173

million people age 65+.

The picture in the US is similar to that of Europe. As the figure below shows, the US population

growth of three age groups for 1975, 2000 and projected for 2025. The age 65+ segment is

increasing almost twice as fast as the rest of the population. (Source: US Census Bureau)

Cognitive Strand Projects

Engineered Alertness

Life mapping

Dear Diary

Cognitive Strand: Objectives and Focus

Dear Diary: a system for speech markers of mood and cognitive function.

Engineering Alertness: a

system to maintain alertness

so as to maintain

independence and avoid

accidents.

Lifemapping: a system for

measuring and augmenting

motivated engagement in

real life activities likely to

maintain or augment brain

function and independence.

Engineering Alertness

Improving attention of the elderly– Self-Alert Training study– Using Galvanic skin response (GSR) as

feedback mechanism.

– Developing experimental procedure for older adults

– Expand monitoring to include respiration and ECG

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Aim of Engineering Alertness

Monitoring alertness and attention – Find appropriate biomarkers of alertness that

can be monitored unobtrusively in the home.– Using these biomarkers to reduce accidents

associated with loss of alertness and lapses in attention.

Life mapping

Monitoring initiative and goal directed behaviour– Monitor physiological signals that are

influenced by changes in cognitive demand

– Sudoku engages cognitive effort– Provide information about different

brain states associated with successful and unsuccessful strategies

Aim of Life mapping

Develop a system that monitors physiological responses to provide feed back to re-enforce effective problem solving strategies

Increasing the level of difficulty of the game provides a training tool for older adults to improve their cognitive skills

Dear Diary

Heidi passage (Reading fixed passage of text) The fluent reader’s brain is free to use higher-level cognitive

skills [4] These higher-level cognitive skills include understanding, synthesizing, and thinking about the material [5] – Acoustic measurements

Fundamental frequency Formant frequencies Perturbation measurements; jitter

(frequency) shimmer (amplitude)– Lexical measurements

Mean pause/utterance duration, number of pauses, length of pauses/utterances, mean/variation energy per second, mean variation vocal pitch

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Analysis

Investigate feature values;– As a function of Age, gender, MMSE (Mini

Mental State Exam), years of education– Best classifier based on MMSE scores

Language analysis– Inspect fluency of read speech– Inspect spontaneous speech, e.g. richness of

language

Common challenges

Ethnographic input– Attitude of elderly users to technology– Attitude of elderly to their cognitive health

References

[1.] Katzman R, Terry R. Normal aging of the nervous system. In: Katzman R, Rowe JW, eds. Principles of geriatric neurology. Philadelphia: F.A. Davis Company, 1992,18-57.

[2.] Von Dras DD, Blumenthal HT. Dementia of the aged: disease or atypical accelerated aging? Biopathological and psychological perspectives.

g Am Geriatr Soc 1992;40:285-94. [3.] Levy R. Aging-associated cognitive decline. Int Psychogeriatr 1994;6:63-8. [4.] Fuchs, et al., 2001. [5] Nathan & Stanovich, 1991.