Home-Based Cognitive Intervention for Healthy Older Adults Through Asking Robots Questions: Randomized Controlled Trial.

Background: Asking questions is common in conversations, and while asking questions, we need to listen carefully to what others say and consider the perspective our questions adopt. However, difficulties persist in verifying the effect of asking questions on older adults' cognitive function due to the lack of a standardized system for conducting experiments at participants' homes. Objective: This study examined the intervention effect of cognitive training moderated by robots on healthy older adults. A focus on the feasibility of the intervention at participants' homes was also maintained. Feasibility was evaluated by considering both the dropout rate during the intervention and the number of questions posed to each participant during the experiment. Methods: We conducted a randomized controlled trial with 81 adults older than 65 years. Participants were recruited through postal invitations and then randomized into 2 groups. The intervention group (n=40) received sessions where participants listened to photo-integrated stories and posed questions to the robots. The control group (n=41) received sessions where participants listened to photo-integrated stories and only thanked the robots for confirming participation. The participants participated in 12 dialogue sessions for 2-3 weeks. Scores of global cognitive functioning tests, recall tests, and verbal fluency tasks measured before and after the intervention were compared between the 2 groups. Results: There was no significant intervention effect on the Telephone Interview for Cognitive Status-Japanese scores, recall tests, and verbal fluency tasks. Additionally, our study successfully concluded with no participant dropouts at follow-up, confirming the feasibility of our approach. Conclusions: There was no statistically significant evidence indicating intervention benefits for cognitive functioning. Although the feasibility of home-based interventions was demonstrated, we identified areas for improvement in the future, such as setting up more efficient session themes. Further research is required to identify the effectiveness of an improved cognitive intervention involving the act of asking questions.

Effect of home-based group conversation intervention using smartphone application on cognitive health and psychological well-being of older adults with subjective cognitive concerns in Japan: a randomized controlled trial protocol.

Background: Social activity is a key component in the prevention of cognitive decline. However, face-to-face social intervention has limited accessibility. To address this issue, we developed the "Photo-Integrated Conversation Moderated by Application" (PICMOA), a home-based group conversation intervention using smartphones. This paper introduces the PICMOA intervention and the protocol of the ongoing randomized controlled trial (RCT), which aims to evaluate the effects of PICMOA on the cognitive functioning and psychological well-being of Japanese community dwelling older adults at the risk of cognitive function decline. Methods: This study uses an RCT design in two parallel group trials with 1:1 allocation. The participants are community dwelling older adults aged 65 years and above, living in an urban city in Japan, with subjective cognitive concerns. In total, 81 participants were allocated to the intervention or control groups. The intervention group receives 30 min of weekly PICMOA sessions at their home for 12 weeks. The PICMOA intervention consists of (1) a photo preparation period before the session and (2) a structured group conversation session talking about the photos that participants took according to a specific theme. The control group receives 30 min of weekly health education videos on a tablet device. The primary outcome is cognitive functioning at pre- and post-phases of the 12-week intervention measured using the Telephone Interview for Cognitive Status in Japanese, semantic and phonemic fluency tests, and the Digit Span Forward and Backward tests. The secondary outcomes are psychological and social aspects including mental status, well-being, loneliness, and social support. Discussion: Interest is growing in internet-based activities for preventing social isolation. However, the effect of remote conversation interventions on cognitive functioning remains unclear. This study addresses this issue and provides a new avenue of social participation for older adults. Clinical trial registration: https://www.umin.ac.jp/ctr/, identifier: UMIN000047247.

Voice Over Body? Older Adults' Reactions to Robot and Voice Assistant Facilitators of Group Conversation.

Intelligent agents have great potential as facilitators of group conversation among older adults. However, little is known about how to design agents for this purpose and user group, especially in terms of agent embodiment. To this end, we conducted a mixed methods study of older adults' reactions to voice and body in a group conversation facilitation agent. Two agent forms with the same underlying artificial intelligence (AI) and voice system were compared: a humanoid robot and a voice assistant. One preliminary study (total n = 24) and one experimental study comparing voice and body morphologies (n = 36) were conducted with older adults and an experienced human facilitator. Findings revealed that the artificiality of the agent, regardless of its form, was beneficial for the socially uncomfortable task of conversation facilitation. Even so, talkative personality types had a poorer experience with the "bodied" robot version. Design implications and supplementary reactions, especially to agent voice, are also discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s12369-022-00925-7.

Scenario-based dialogue system based on pause detection toward daily health monitoring.

Introduction: We have conducted research on building a robot dialogue system to support the independent living of older adults. In order to provide appropriate support for them, it is necessary to obtain as much information, particularly related to their health condition, as possible. As the first step, we have examined a method to allow dialogue to continue for longer periods. Methods: A scenario-based dialogue system utilizing pause detection for turn-taking was built. The practicality of adjusting the system based on the dialogue rhythm of each individual was studied. The system was evaluated through user studies with a total of 20 users, 10 of whom were older adults. Results: The system detected pauses in the user's speech using the sound level of their voice, and predicted the duration and number of pauses based on past dialogue data. Thus, the system initiated the robot's voice-call after the user's predicted speech. Conclusions: Multiple turns of dialogue between robot and older adults are found possible under the system, despite several overlaps of robot's and users' speech observed. The users responded to the robot, including the questions related to health conditions. The feasibility of a scenario-based dialogue system was suggested; however, improvements are required.

Dementia Digital Neuro-biomarker Study from Theta-band EEG Fluctuation Analysis in Facial and Emotional Identification Short-term Memory Oddball Paradigm.

An efficient machine learning (ML) implementation in the so-called 'AI for social good' domain shall contribute to dementia digital neuro-biomarker development for early-onset prognosis of a possible cognitive decline. We report encouraging initial developments of wearable EEG-derived theta-band fluctuations examination and a successive classification embracing a time-series complexity examination with a multifractal detrended fluctuation analysis (MFDFA) in the face or emotion video-clip identification short-term oddball memory tasks. We also report findings from a thirty-five elderly volunteer pilot study that EEG responses to instructed to ignore (inhibited) oddball paradigm stimulation results in more informative MFDFA features, leading to better machine learning classification results. The reported pilot project showcases vital social assistance of artificial intelligence (AI) application for an early-onset dementia prognosis. Clinical Relevance- This introduces a candidate for an objective digital neuro-biomarker from theta-band EEG recorded by a wearable for a plausible replacement of biased 'paper & pencil' tests for a mild cognitive impairment (MCI) evaluation.

A Dialogue-Based System with Photo and Storytelling for Older Adults: Toward Daily Cognitive Training.

As the elderly population grows worldwide, living a healthy and full life as an older adult is becoming a topic of great interest. One key factor and severe challenge to maintaining quality of life in older adults is cognitive decline. Assistive robots for helping older adults have been proposed to solve issues such as social isolation and dependent living. Only a few studies have reported the positive effects of dialogue robots on cognitive function but conversation is being discussed as a promising intervention that includes various cognitive tasks. Existing dialogue robot-related studies have reported on placing dialogue robots in elderly homes and allowing them to interact with residents. However, it is difficult to reproduce these experiments since the participants' characteristics influence experimental conditions, especially at home. Besides, most dialogue systems are not designed to set experimental conditions without on-site support. This study proposes a novel design method that uses a dialogue-based robot system for cognitive training at home. We define challenges and requirements to meet them to realize cognitive function training through daily communication. Those requirements are designed to satisfy detailed conditions such as duration of dialogue, frequency, and starting time without on-site support. Our system displays photos and gives original stories to provide contexts for dialogue that help the robot maintain a conversation for each story. Then the system schedules dialogue sessions along with the participant's plan. The robot moderates the user to ask a question and then responds to the question by changing its facial expression. This question-answering procedure continued for a specific duration (4 min). To verify our design method's effectiveness and implementation, we conducted three user studies by recruiting 35 elderly participants. We performed prototype-, laboratory-, and home-based experiments. Through these experiments, we evaluated current datasets, user experience, and feasibility for home use. We report on and discuss the older adults' attitudes toward the robot and the number of turns during dialogues. We also classify the types of utterances and identify user needs. Herein, we outline the findings of this study, outlining the system's essential characteristics to experiment toward daily cognitive training and explain further feature requests.

Cognitive Intervention Through Photo-Integrated Conversation Moderated by Robots (PICMOR) Program: A Randomized Controlled Trial.

Social interaction might prevent or delay dementia, but little is known about the specific effects of various social activity interventions on cognition. This study conducted a single-site randomized controlled trial (RCT) of Photo-Integrated Conversation Moderated by Robots (PICMOR), a group conversation intervention program for resilience against cognitive decline and dementia. In the RCT, PICMOR was compared to an unstructured group conversation condition. Sixty-five community-living older adults participated in this study. The intervention was provided once a week for 12 weeks. Primary outcome measures were the cognitive functions; process outcome measures included the linguistic characteristics of speech to estimate interaction quality. Baseline and post-intervention data were collected. PICMOR contains two key features: 1) photos taken by the participants are displayed and discussed sequentially; and 2) a robotic moderator manages turn-taking to make sure that participants are allocated the same amount of time. Among the primary outcome measures, one of the subcategories of cognitive functions, verbal fluency significantly improved in the intervention group. Among the process outcome measures, a part of the subcategories of linguistic characteristics of speech, the amount of speech and richness of words, proportion of providing topics, questions, and answers in total utterances were larger for the intervention group. This study demonstrated for the first time the positive effects of a robotic social activity intervention on cognitive function in healthy older adults via RCT. The group conversation generated by PICMOR may improve participants' verbal fluency since participants have more opportunity to provide their own topics, asking and answering questions which results in exploring larger vocabularies. PICMOR is available and accessible to community-living older adults. Clinical Trial Registration: UMIN Clinical Trials Registry, identifier UMIN000036667.