Authors: Hirt, Julian | Ballhausen, Nicola | Hering, Alexandra | Kliegel, Matthias | Beer, Thomas | Meyer, Gabriele
Article Type: Research Article
Abstract: Background: Using non-pharmacological interventions is a current approach in dementia care to manage responsive behaviors, to maintain functional capacity, and to reduce emotional stress. Novel technologies such as social robot interventions might be useful to engage people with dementia in activities and interactions as well as to improve their cognitive, emotional, and physical status. Objective: Assessing the effects and the quality of reporting of social robot interventions for people with dementia. Methods: In our systematic review, we included quasi-experimental and experimental studies published in English, French, or German, irrespective of publication year. Searching CINAHL, Cochrane Library, MEDLINE, PsycINFO, and Web …of Science Core Collection was supplemented by citation tracking and free web searching. To assess the methodological quality of included studies, we used tools provided by the Joanna Briggs Institute. To assess the reporting of the interventions, we applied CReDECI 2 and TIDieR. Results: We identified sixteen studies published between 2012 and 2018, including two to 415 participants with mostly non-defined type of dementia. Eight studies had an experimental design. The predominant robot types were pet robots (i.e., PARO). Most studies addressed behavioral, emotion-related, and functional outcomes with beneficial, non-beneficial, and mixed results. Predominantly, cognitive outcomes were not improved. Overall, studies were of moderate methodological quality. Conclusion: Heterogeneous populations, intervention characteristics, and measured outcomes make it difficult to generalize the results with regard to clinical practice. The impact of social robot interventions on behavioral, emotion-related, and functional outcomes should therefore be assessed considering the severity of dementia and intervention characteristics. Show more
Keywords: Dementia, robotics, systematic review, technology
DOI: 10.3233/JAD-200347
Citation: Journal of Alzheimer's Disease, vol. 79, no. 2, pp. 773-792, 2021
Authors: Aschwanden, Damaris | Aichele, Stephen | Ghisletta, Paolo | Terracciano, Antonio | Kliegel, Matthias | Sutin, Angelina R. | Brown, Justin | Allemand, Mathias
Article Type: Research Article
Abstract: Background: Efforts to identify important risk factors for cognitive impairment and dementia have to date mostly relied on meta-analytic strategies. A comprehensive empirical evaluation of these risk factors within a single study is currently lacking. Objective: We used a combined methodology of machine learning and semi-parametric survival analysis to estimate the relative importance of 52 predictors in forecasting cognitive impairment and dementia in a large, population-representative sample of older adults. Methods: Participants from the Health and Retirement Study (N = 9,979; aged 50–98 years) were followed for up to 10 years (M = 6.85 for cognitive impairment; M = 7.67 for dementia). Using a …split-sample methodology, we first estimated the relative importance of predictors using machine learning (random forest survival analysis), and we then used semi-parametric survival analysis (Cox proportional hazards) to estimate effect sizes for the most important variables. Results: African Americans and individuals who scored high on emotional distress were at relatively highest risk for developing cognitive impairment and dementia. Sociodemographic (lower education, Hispanic ethnicity) and health variables (worse subjective health, increasing BMI) were comparatively strong predictors for cognitive impairment. Cardiovascular factors (e.g., smoking, physical inactivity) and polygenic scores (with and without APOE ɛ 4) appeared less important than expected. Post-hoc sensitivity analyses underscored the robustness of these results. Conclusions: Higher-order factors (e.g., emotional distress, subjective health), which reflect complex interactions between various aspects of an individual, were more important than narrowly defined factors (e.g., clinical and behavioral indicators) when evaluated concurrently to predict cognitive impairment and dementia. Show more
Keywords: Aging, cognitive impairment, Cox proportional hazard survival analysis, dementia, machine learning, protective factors, random forest survival analysis, risk factors
DOI: 10.3233/JAD-190967
Citation: Journal of Alzheimer's Disease, vol. 75, no. 3, pp. 717-728, 2020
Authors: Alexopoulos, Panagiotis | Skondra, Maria | Kontogianni, Evagellia | Vratsista, Aikaterini | Frounta, Maria | Konstantopoulou, Georgia | Aligianni, Suzana Ioanna | Charalampopoulou, Marina | Lentzari, Iliana | Gourzis, Philippos | Kliegel, Matthias | Economou, Polychronis | Politis, Antonios
Article Type: Research Article
Abstract: Background: Telephone-based neurocognitive instruments embody valuable tools in identifying cognitive impairment in research settings and lately also in clinical contexts due to the pandemic crisis. The accuracy of the Cognitive Telephone Screening Instrument (COGTEL) in detecting mild- (MiND) and major (MaND) neurocognitive disorder has not been studied yet. Objective: Comparison of the utility of COGTEL and COGTEL+, which is enriched with orientation items, with the modified Mini-Mental State Examination (3MS) in detecting MiND and MaND due to Alzheimer’s disease (AD) and assessment of the impact of COGTEL face-to-face-versus telephone administration on individual performance. Methods: The study included 197 cognitively intact …individuals (CI), being at least 45 years old, 95 and 65 patients with MiND and MaND due to AD, respectively. In 20 individuals COGTEL was administered both in face-to-face and telephone sessions. Statistical analyses included proportional odds logistic regression models, stratified repeated random subsampling used to recursive partitioning to training and validation set (70/30 ratio), and an appropriate F-test. Results: All studied instruments were significant predictors of diagnostic outcome, but COGTEL+ and 3MS explained more variance relative to the original COGTEL. Except for the validation regression models including COGTEL in which the average misclassification error slightly exceeded 15%, in all other cases the average misclassification errors (%) were lower than 15%. COGTEL administration modality was not related to systematic over- or underestimation of performance on COGTEL. Conclusion: COGTEL+ is a valuable instrument in detecting MiND and MaND and can be administered in face-to-face or telephone sessions. Show more
Keywords: Mild and major neurocognitive disorder, modified Mini-Mental State Examination, telephone-based neurocognitive testing
DOI: 10.3233/JAD-210477
Citation: Journal of Alzheimer's Disease, vol. 83, no. 1, pp. 259-268, 2021