Technologies Designed to Assist Individuals with Cognitive Impairments
Abstract
:1. Introduction
2. Methodology
- Can IT solutions be used as a home-based alternative therapy?
- Can IT solutions be considered as a reliable assessment that evaluates memory functions?
- What are the advantages of IT solutions compared to clinical devices? Is it more cost-efficient to use IT solutions when compared to clinical devices?
- How can AI be used in healthcare?
3. Evaluation Results
4. Discussion
5. Further Development Opportunities
6. Conclusions
- IT solutions like Virtual Reality, mobile technology, and wearable technology can be used as a home-based alternative therapy.
- These can be used as a new methodology to develop valid tests that assess memory functions.
- Additional to the previous statement, we can infer that these are more cost efficient (lower cost than clinical devices).
- AI can increase the efficiency and accuracy of diagnosis and treatment.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Ref | Year | Population Group | Technology | Target Users | Devices | Type of AT | Objective | Strengths | Limitation |
---|---|---|---|---|---|---|---|---|---|
[8] | 2022 | Elderly with memory disorder, both sexes | Mobile technology | -Elderly with memory disorder | Mobile phone | Visual memory | Game-based psychotherapy for elderly individuals with memory disorder symptoms | -Alternative treatment | --- |
[9] | 2022 | Healthy, mean age: 36.64, both sexes | Virtual Reality | -Healthy people, -Alzheimer’s patients -Other memory disorders | VR headset | Memory assessment and memory training | Memory assessment with a Virtual Reality-based system to check for any associations between performance and age, performance and years of education, and reaction time and age | -It can be used for early detection of cognitive decline. -It can be used as a new methodology to develop valid tests that assess memory functions reliably and efficiently and within ecologically valid contexts | -It must first be validated through a randomized control trial, and checked to see if it can be used in the clinical environment as well |
[10] | 2022 | Major Depressive Disorder, mean age: 25, both sexes | Virtual Reality | -Patients with Major Depressive Disorder | VR headset | Event-based Prospective Memory training | Virtual Reality (VR)-based Working Memory Training (WMT) to improve Event-based Prospective Memory (EBPM) deficits in patients with Major Depressive Disorder (MDD) | -Opportunities for use in therapy, which are limited using traditional methods | -Comparatively small sample so this study cannot confirm the long-term effects of VR |
[11] | 2022 | Healthy, mean age: 21, both sexes | Virtual Reality | -- | VR headset and EEG | Visual working memory | Investigate cueing, memory encoding, maintenance, and retrieval in VR | -Facilitating the understanding of the working memory | -- |
[12] | 2018 | Healthy patients and patients with cognitive decline, younger adults with mean age: 21.65, older adults with mean age: 68, both sexes | Virtual Reality | -Patients with cognitive decline | VR devices: headset and pointing device | Everyday memory | To assess everyday memory performance more accurately | Neuropsychologists can assess everyday memory performance more accurately. -Close to real-life situations | -- |
[13] | 2019 | Dementia, older age, both sexes | Virtual Reality | -Patients diagnosed with dementia and other neurodegenerative diseases, including Alzheimer’s. | VR headset | Improving spatial memory | 3D virtual environment-based serious game for assessing dementia patients with low cost | -Lower cost than clinical devices (e.g., MRI scans). -Interactive, 3D virtual environment | -- |
[14] | 2021 | Stroke patients, mean age: 68.3, both sexes | Virtual Reality | -Older adults, including those who have had strokes | Head-Mounted Display Virtual Reality device and pointing device | Improving cognitive abilities following a stroke | Improving self-reported cybersickness and performance in memory span and speed tasks in stroke patients | -Treatment provided by immersive HMD-VR | -Immersive VR and the experienced content are often associated with a higher risk of simulator sickness due to the strong grade of immersion, which could be a limitation for the use of immersive VR in different settings |
[15] | 2016 | Stroke patients, mean age: 65, both sexes | Virtual Reality | -- | VR headset | Prospective Memory | Improving Prospective Memory (PM) through a Virtual Reality (VR) environment using Constraint-Based Modeling (CBM) and individual feedback | -Adaptive training requires significant clinical input and requires variables to be strictly controlled, which are difficult to control for human investigators and can be replaced with VR | --- |
[16] | 2015 | All people | Mobile technology | -All people | Mobile phone | Memorizing semantic declarative facts | Helping with memorizing semantic declarative facts to aid students | -More entertaining and effective as it is a music-based memory-support tool | -Not finished yet—only a pilot version was tested |
[17] | 2021 | All people | Mobile technology | -All people | Mobile phone | Developing everyday-life memory | A prototype was designed to improve usability, enjoyment, and difficulty of game design to raise awareness of COVID-19 information and provide entertainment | -It was developed for mobile platforms, which are more common than VR devices | -Only English language is available |
[18] | 2017 | Healthy people, 6–12-year-old students, both sexes | Mobile technology | -6–12-year-old students | Mobile phone | Mnemonic | Gamification and mnemonic methods (memory development) to aid children in learning Chinese | -Game is effective in creating an interest | --- |
[19] | 2021 | Patients with dementia | Measurement of eye movement using tangram | -Patients with dementia | Eye tracking device | Short-term memory | Development of a simple puzzle game to measure eye movement to evaluate cognitive function | -Reducing the burden of testing on medical staff and elderly people. -In the case of dementia, the patient’s symptoms can be improved by early detection and medication | -Only available in clinical settings |
[20] | 2019 | Students, male and female, 10–11 years old | Peer-assisted instruction (PAI); iPad-assisted instruction (IAI) | -Students with reading learning disabilities (RLDs) | iPad | AT for improving reading fluency | Understanding students’ reading abilities and improvement requirements | -Implementation of a PAI and IAI combined approach | -Experimented using a single device -Limited number of participants |
[21] | 2017 | Students, male and female, 14–19 years old | A tubular structure material with thermoplastic PVC polymer | -Adolescents with cerebral palsy | --- | AT for assisting adolescents with cerebral palsy to overcome their daily difficulties with studying | Supporting the educational activities of adolescents with cerebral palsy with low cost | -Implemented and validated with educator | -Limited number of participants |
[22] | 2019 | Children, male, 8 years old | -- | -Children with cerebral palsy | NAO robot | AT for assisting children with cerebral palsy to sit, stand, walk, run, and jump independently | Improving the therapeutic process for motor learning (i.e., walking) using a social assistive robot | -SMART-focused (Specific, Measurable, Achievable, Realistic, and Timed) | -Lack of validation with real therapist |
[23] | 2019 | Older adults, male and female, 72–94 years old | Electric calendar | -Older adults with dementia | Tablet | AT for improving cognitive function and behaviors in daily activities | Assessing the effectiveness of using an electric calendar as an assistive technology for older adults with dementia | -Consideration of several aspects such as global cognitive function level, daily activities, appropriate support, and motivation | -Considered only dementia—other cognitive levels should be considered |
[24] | 2019 | Young adults | -- | -People with traumatic brain injury | --- | AT for assisting meal preparation or cooking | Design and development of a cognition context-aware assistive technology | -Focused on user-centred design (UCD) | -Focus on specific disability |
[25] | 2018 | Young adults, 18–27 years old | Wearable technology | -People with intellectual and development disability | Smart watch app | AT for encouraging students’ self-regulation and positive behaviors | Assisting IDD students to improve their behavioural activity using wearable assistive technology | -Consideration of wearable technology | -Consideration of a single device |
[26] | 2018 | All people | Decision support system | -People with decision-making difficulty | -- | AT for supporting people with cognitive disabilities to make their own decisions across life | Assisting brain injury-affected or intellectually disabled people in decision making | -Evidence-based support for decision-making practice | -Lack of automated process |
[27] | 2019 | Children | Kinect V2 sensor | -People with intellectual disabilities (ID) | Lenovo Thinkpad T61 notebook computer Microsoft Windows 7 | AT for assisting children with ID in hand washing independently | Assisting children with intellectual disabilities to improve their hand hygiene skills | -Teaching with video game | -Limited number of participants for experiment |
[28] | 2010 | Male and female, 85+ years old | Cognitive orthosis | People with dementia | COACH | - | Providing AI-based tools to help people with disabilities in their day-to-day life | Hardware that tracks user actions and an AI application that helps decision-making | -It is bound to a plan library and needs improvement in case of unpredicted situations |
[29] | 2016 | - | Super clinician | Any clinical patients | - | - | AI-based assistant to practitioners during clinical assessments and treatments | Increasing efficiency and accuracy in diagnosis and treatment | -There is no good general application yet |
[30] | 2021 | - | Memorz Stash Alzheimer’s Aid | People with Alzheimer’s syndrome | Android | - | An application for mobile devices that may help with memory problems | AI- and non-AI-based app that aims to slow down memory loss and maintain reasoning ability | -Results are not tested -Efficiency is only assumed |
Ref. | Identification of Gaps and Contradictions | Relevant Facts and Theories |
---|---|---|
[8] | The article states that pharmacological treatments for memory disorders are costly and have adverse effects, but it does not provide any evidence or examples to support this claim. Without supporting information, it is difficult to determine if this is a valid statement or a generalization. | Games have been proposed as a potential intervention for elderly individuals with memory disorders based on their strengths. Playing games requires mental concentration, memory, and quick motor reactions, which can stimulate the brain and potentially help improve memory. |
[9] | Limited sample size: The study mentions that the tasks were evaluated on a sample of only 22 healthy participants. While this may be a pilot study, a larger sample size is typically required for more robust and generalizable results. Limited scope of participants: The study focuses on healthy participants, and there is no mention of including individuals with cognitive impairments or specific conditions such as mild cognitive impairment (MCI), Alzheimer’s disease, or dementia. Consequently, the generalizability of the results to clinical populations remains uncertain. | The study highlights that VR has the potential to be used in cognitive rehabilitation interventions for diagnostic and training purposes. |
[10] | A total of 46 MDD patients and 41 healthy controls (HC) were recruited, but the study does not provide information on the demographic characteristics of the participants (e.g., age or gender) or how they were matched between groups. The article does not discuss the specific population characteristics of the MDD patients included in the study (e.g., severity of depression or comorbidities), making it challenging to assess the external validity of the results. | The article mentions that WMT has been reported to improve EBPM, but its specific effect on EBPM in individuals with MDD is still uncertain. |
[11] | The article mentions data collected from 47 participants, but it does not provide information on the characteristics of the participants (e.g., age range, gender distribution, or clinical background). Additional details about the participants would provide a better understanding of the sample and its representativeness. | The article mentions that the data, including behavioral and EEG data (both raw and processed), scripts, and the full task, are available for further investigation. This makes the dataset valuable for researchers interested in studying neural signals during attention cueing, memory encoding, maintenance, and retrieval, as well as those interested in combining VR and EEG. |
[12] | The information presented does not provide sufficient details about the characteristics of the participants involved in the studies. It would be useful to know more about the demographic characteristics, such as age range and gender distribution, and any relevant clinical information (e.g., presence of cognitive impairments) of the participants in each study. This information is important to understand the generalizability of the findings and the potential limitations of the studies. | New method: The Virtual Shop is a fully immersive task designed to assess memory in a more ecologically valid manner compared to traditional neuropsychological assessments. |
[13] | Lack of specific information: The paper mentions the need for utilizing automated techniques in dementia research but does not provide specific details about the automated techniques or their advantages over traditional clinic tests. It would be helpful to have more information on the specific techniques and technologies being referred to. | There is a growing need to utilize automated techniques in dementia research. This is driven by the desire to fully leverage the advantages offered by advanced innovations. Automated techniques have the potential to enhance the efficiency, accessibility, and cost-effectiveness of dementia detection and training methods. |
[14] | The study highlights the potential of HMD-VR therapy for stroke patients, but it does not compare the outcomes or acceptance of HMD-VR to traditional therapy approaches. A comparison with established rehabilitation methods would help assess the relative effectiveness and advantages of HMD-VR as a therapeutic tool for stroke patients. | The background highlights that therapy with Virtual Reality (VR) shows potential as an engaging, effective, and cost-effective approach to improving cognitive abilities following a stroke. This suggests that VR therapy may offer advantages over traditional therapy methods and can be a valuable tool in stroke rehabilitation. |
[15] | The paper does not mention the duration of the study or whether the treatment’s effects were assessed over an extended period. Additionally, it would be valuable to explore the generalizability of the treatment’s effectiveness by considering factors such as the severity of stroke, age, and other demographic variables of the participants. | The researchers have developed a computer-based treatment that utilizes visual imagery to help stroke survivors improve their performance in time- and Event-based Prospective Memory tasks. |
[16] | This research found that the MT1 app has the potential to become more versatile and automated, allowing for widespread use and ease of access as a memory support tool. However, it is not clear how the app can become more versatile and automated, as specific improvements or features are not mentioned. | The study highlights the use of music—specifically the MT1 composition—and its translation into a mobile application as a memory support tool. |
[17] | The paper mentions the aim of targeting users who can benefit from improving their habits and hygiene awareness during the COVID-19 pandemic. However, it does not specify the characteristics or demographics of the intended target audience. Identifying the specific audience, such as age groups, gaming preferences, or specific hygiene concerns, would provide better insight into the intended user base for the prototype. | The paper acknowledges the current rapid growth and impact of the gaming industry, suggesting that it has become one of the most impactful industries globally. This reflects the increasing popularity and influence of gaming as a form of entertainment and interactive media. |
[18] | The article mentions that the developed game can help to develop interest in children to learn the Chinese language based on pre-test and post-test results. However, it does not elaborate on the specific outcomes or improvements observed in the test results. Providing more details on the positive results would strengthen the argument and provide a clearer understanding of the game’s effectiveness. | The study acknowledges that learning the Chinese language can be difficult for children, which can make the learning process boring for them. This highlights the challenge faced by students in acquiring proficiency in a new language. |
[19] | The study mentions that many welfare facilities use check tests to measure the progression of dementia, but it does not provide details about these tests. Without further information, it is unclear how these tests are conducted and what aspects of cognitive function they assess. | The paper highlights that the increasing number of dementia patients is a major social problem in Japan. This fact emphasizes the significance and urgency of addressing dementia-related issues, including early detection and prevention. |
[20] | The paper does not clarify what the “combined approach” refers to. It is not clear whether the combined approach involves simultaneous implementation of PAI and IAI or if it involves alternating between the two approaches. Additional information is needed to understand the specifics of the combined approach used in the study. | The overall findings of the study showed moderate and positive experimental effects on oral reading fluency. This suggests that the combined PAI and IAI approach had a beneficial impact on the oral reading fluency of the participating students with RLDs. |
[21] | The study does not discuss any limitations or challenges encountered during the study. Including information about limitations or challenges faced in the usability evaluation would provide a more comprehensive understanding of the effectiveness and potential areas for improvement of the prototype device. | The concept of assistive technology encompasses various areas of action, including communication, to provide accessible solutions that help individuals overcome daily difficulties. It aims to enhance functional abilities, promote inclusion, and support independent living. |
[22] | The article acknowledges the need for more studies to validate the potential of using social robots in therapeutic interventions for children with motor disabilities like cerebral palsy. However, it does not propose any future research directions or highlight specific areas that require further investigation. | The use of new technologies, such as humanoid robots, in therapeutic processes opens up possibilities for developing new strategies and understanding their impact on rehabilitation. The use of formal methodologies, along with multidisciplinary teams, can increase the potential of using social robots to improve cognitive and motor outcomes in children with cerebral palsy. The study observed that the motivation generated by the interaction with the social assistive robot facilitated persistence in walking and the fulfillment of therapeutic objectives. |
[23] | The study states that participants showed a significant increase in their total Mini-Mental State Examination (MMSE) scores after the intervention period, but it does not specify if this increase was observed in both groups (first and second intervention group) or only in one of them. Clarification is needed to understand the impact of the electric calendar on cognitive function. | Participants who used the electric calendar showed a significant increase in their total MMSE scores after the intervention period, while there was no significant difference in the group without intervention. |
[24] | The article states that COOK is the first cooking assistant in which evidence-based cognitive rehabilitation interventions have been translated into smart technological assistance. However, it does not provide evidence or references to support this claim. | COOK shows promise for rehabilitating clients with cognitive disabilities, enhancing safety in a home environment, and reducing the need for human supervision. |
[25] | The paper does not provide details about the specific features or functionalities of the wearable technology application designed to support students’ learning, participation, and independence. Understanding the specific capabilities of the technology would help evaluate its potential effectiveness. | The findings suggest that wearable technology can support young adults with IDD in inclusive college courses without relying heavily on support staff. |
[26] | The study mentions that at least 5% of people in Australia and the USA have cognitive impairment, but it doesn’t provide clear information about how cognitive impairment is defined and diagnosed. Without a clear understanding of the criteria used, it becomes difficult to determine the scope and applicability of the research program and framework. | Prevalence of cognitive impairment: The paper states that at least 5% of people in Australia and the USA have cognitive impairment and require support for decision-making. This fact highlights the significance and relevance of developing effective support mechanisms for individuals with cognitive disabilities. |
[27] | Lack of information on the Kinect V2 sensor and its application: The paper mentions the use of the Kinect V2 sensor to gamify hand washing, but it does not provide any details about the capabilities or features of the sensor. Additionally, the paper does not explain how the sensor was used or how it contributed to the gamification of hand washing. Without this information, it is difficult to evaluate the appropriateness or effectiveness of the technology in supporting the intervention. | The paper mentions the adoption of a non-concurrent multiple baseline design to demonstrate the relationship between game-based intervention and independent hand washing. This design involves implementing the intervention at different times for each participant, allowing for comparisons and analysis of the intervention’s effects across multiple baselines. |
[28] | The article suggests that using a computerized device like the COACH might improve the situation for individuals with dementia by reducing the need for continuous caregiver supervision. However, it also acknowledges that the COACH issues prerecorded cues of varying detail, suggesting a form of continuous assistance and monitoring. This contradiction raises questions about the actual level of privacy and independence the device provides, and how it addresses the concerns of the affected individuals becoming embarrassed and agitated. | The article proposes the use of a computerized device, specifically the COACH, to improve the situation for individuals with dementia. The device is intended to monitor progress and provide reminders needed to perform daily tasks. This suggests the application of technology to enhance independence and reduce the need for constant caregiver supervision. |
[29] | The study introduces the concept of an integrated AI-based clinician system but does not provide any information or explanation about what this system entails or how it would function. This lack of detail leaves the reader with unanswered questions about the proposed system and its potential benefits or limitations. | The study mentions several AI-assisted activities in clinical psychological practice, including clinical training, treatment, psychological assessment, and clinical decision-making. This indicates that AI can be utilized to support and enhance these areas of practice. |
[30] | No mention of ethical considerations: The article discusses the development of an AI-based application for Alzheimer’s disease but does not address potential ethical considerations associated with data privacy, consent, or the impact of relying solely on technology for the care and support of individuals with Alzheimer’s disease. The ethical implications of developing and using AI in healthcare should be acknowledged and discussed. | The article suggests that the proposed AI-based application has the potential to improve the quality of life for individuals with Alzheimer’s disease by providing support and assistance throughout all stages of the disease. |
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Szabó, P.; Ara, J.; Halmosi, B.; Sik-Lanyi, C.; Guzsvinecz, T. Technologies Designed to Assist Individuals with Cognitive Impairments. Sustainability 2023, 15, 13490. https://doi.org/10.3390/su151813490
Szabó P, Ara J, Halmosi B, Sik-Lanyi C, Guzsvinecz T. Technologies Designed to Assist Individuals with Cognitive Impairments. Sustainability. 2023; 15(18):13490. https://doi.org/10.3390/su151813490
Chicago/Turabian StyleSzabó, Patrícia, Jinat Ara, Bence Halmosi, Cecilia Sik-Lanyi, and Tibor Guzsvinecz. 2023. "Technologies Designed to Assist Individuals with Cognitive Impairments" Sustainability 15, no. 18: 13490. https://doi.org/10.3390/su151813490
APA StyleSzabó, P., Ara, J., Halmosi, B., Sik-Lanyi, C., & Guzsvinecz, T. (2023). Technologies Designed to Assist Individuals with Cognitive Impairments. Sustainability, 15(18), 13490. https://doi.org/10.3390/su151813490