S2‐03‐02: Using technology in designing clinical trials to investigate the efficacy of enhanced social engagement in MCI

Abstract

Past epidemiological studies have demonstrated that larger social networks or more frequent social interactions could have potential protective effects on the incidence of AD. Psychological studies suggest that the task of conversation is highly cognitively stimulating: Conversations require attention, working memory and the organization and control of thought (executive functions), as well as social cognition to understand others' intentions and feelings. Despite the accumulating evidence that increasing social interaction could be a potentially promising intervention tool to improve cognitive and emotional well-being of the elderly, only a few randomized controlled prevention studies using social interaction have been conducted. We developed a randomized controlled behavioral clinical trial to examine whether conversation-based cognitive stimulation has a positive effect on general and domain-specific cognitive functions among older adults with normal cognition or mild cognitive impairment (MCI). Daily face-to-face communications are being conducted through the use of personal computers, webcams, and user-friendly interactive Internet conducted programs to allow participants to be more socially engage while staying at home. The trial protocol was developed forming an inter-disciplinary team of neurologists, neuropsychologists, social psychologists, linguistic scientists, engineers and statisticians. Pilot studies were conducted to develop user-friendly technology interfaces. A standardized conversational interview protocol was developed. Word counts spoken by the interviewer vs. participants during the trial session were monitored using an automated spoken language detection algorithm. A user-friendly Internet communication program using touch-screens and webcams was developed. To monitor daily conversations which might occur outside of the Internet-based conversations, algorithms for automatically extracting spoken language markers were developed, refined, and implemented into a wearable, voice activated digital recorder. To assess the generalizability of subsequent findings, we conducted mass mail-in surveys among community dwelling elderly, assessing demographic characteristics, life style factors and willingness of participating in trials which use technologies and the proposed prevention trial. The results obtained from this pilot study will be used for dose/duration determination in larger prevention studies that examine conversation-based cognitive stimulation as a potential intervention for cognitive decline and incident AD. The technology could improve the feasibility and cost-effective execution of social interaction based preventions.