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1.  Naturalistic Assessment of Everyday Activities and Prompting Technologies in Mild Cognitive Impairment 
Older adults with mild cognitive impairment (MCI) often have difficulty performing complex instrumental activities of daily living (IADLs), which are critical to independent living. In this study, amnestic multi-domain MCI (N = 29), amnestic single-domain MCI (N = 18), and healthy older participants (N = 47) completed eight scripted IADLs (e.g., cook oatmeal on the stove) in a smart apartment testbed. We developed and experimented with a graded hierarchy of technology-based prompts to investigate both the amount of prompting and type of prompts required to assist individuals with MCI in completing the activities. When task errors occurred, progressive levels of assistance were provided, starting with the lowest level needed to adjust performance. Results showed that the multi-domain MCI group made more errors and required more prompts than the single-domain MCI and healthy older adult groups. Similar to the other two groups, the multi-domain MCI group responded well to the indirect prompts and did not need a higher level of prompting to get back on track successfully with the tasks. Need for prompting assistance was best predicted by verbal memory abilities in multi-domain amnestic MCI. Participants across groups indicated that they perceived the prompting technology to be very helpful.
PMCID: PMC4144192  PMID: 23351284
Ecological assessment; Instrumental activities of daily living; Aging; Dementia; Smart environment technologies; Rehabilitation
2.  PUCK: An Automated Prompting System for Smart Environments 
Personal and ubiquitous computing  2011;16(7):859-873.
The growth in popularity of smart environments has been quite steep in the last decade and so has the demand for smart health assistance systems. A smart home-based prompting system can enhance these technologies to deliver in-home interventions to users for timely reminders or brief instructions describing the way a task should be done for successful completion. This technology is in high demand given the desire of people who have physical or cognitive limitations to live independently in their homes. In this paper, with the introduction of the “PUCK” prompting system, we take an approach to automate prompting-based interventions without any predefined rule sets or user feedback. Unlike other approaches, we use simple off-the-shelf sensors and learn the timing for prompts based on real data that is collected with volunteer participants in our smart home test bed. The data mining approaches taken to solve this problem come with the challenge of an imbalanced class distribution that occurs naturally in the data. We propose a variant of an existing sampling technique, SMOTE, to deal with the class imbalance problem. To validate the approach, a comparative analysis with Cost Sensitive Learning is performed.
PMCID: PMC4215554  PMID: 25364323
Automated prompting; Prompting systems; Smart environments; Machine learning; Imbalanced class distribution
3.  Wechsler Memory Scale–III Faces test performance in patients with mild cognitive impairment and mild Alzheimer’s disease 
Little is known about the sensitivity of the Wechsler Memory Scale–Third Edition (WMS-III) Faces subtest to memory impairment associated with mild cognitive impairment (MCI). In this study, Faces performance was examined in 24 MCI patients, 46 mild Alzheimer’s disease (AD) patients, and 98 elderly controls. We hypothesized that participants with diagnoses of MCI or AD would be impaired relative to controls on Faces. Analyses showed that AD participants performed significantly worse than MCI and intact participants, although there were no significant differences between MCI and intact participants. Data suggest that brain areas specialized for face recognition memory may be less affected by MCI and mild AD than regions specialized for verbal memory.
PMCID: PMC2829111  PMID: 19037811
Wechsler Memory Scale–Third Edition; Face recognition; Face memory; Mild cognitive impairment; Alzheimer’s disease
4.  Reactions to a Remote-Controlled Video-Communication Robot in Seniors' Homes: A Pilot Study of Feasibility and Acceptance 
Telemedicine Journal and e-Health  2012;18(10):755-759.
Objective: Remote telepresence provided by tele-operated robotics represents a new means for obtaining important health information, improving older adults' social and daily functioning and providing peace of mind to family members and caregivers who live remotely. In this study we tested the feasibility of use and acceptance of a remotely controlled robot with video-communication capability in independently living, cognitively intact older adults. Materials and Methods: A mobile remotely controlled robot with video-communication ability was placed in the homes of eight seniors. The attitudes and preferences of these volunteers and those of family or friends who communicated with them remotely via the device were assessed through survey instruments. Results: Overall experiences were consistently positive, with the exception of one user who subsequently progressed to a diagnosis of mild cognitive impairment. Responses from our participants indicated that in general they appreciated the potential of this technology to enhance their physical health and well-being, social connectedness, and ability to live independently at home. Remote users, who were friends or adult children of the participants, were more likely to test the mobility features and had several suggestions for additional useful applications. Conclusions: Results from the present study showed that a small sample of independently living, cognitively intact older adults and their remote collaterals responded positively to a remote controlled robot with video-communication capabilities. Research is needed to further explore the feasibility and acceptance of this type of technology with a variety of patients and their care contacts.
PMCID: PMC3523242  PMID: 23082794
robotics; tele-operated; aging; technology; video-communication
5.  Recovery of Content and Temporal Order Memory for Performed Activities following Moderate to Severe Traumatic Brain Injury 
Few studies have investigated the complex nature of everyday activity memory following traumatic brain injury (TBI). This study examined recovery of content and temporal order memory for performed activities during the first year in individuals who suffered moderate to severe TBI. TBI and control participants completed eight different cognitive activities at baseline (i.e., acutely following injury for TBI) and then again approximately one year later (follow-up). Participants’ free recall of the activities provided a measure of content memory. Temporal order memory was assessed with a reconstruction task. Self-report and informant-report of everyday memory problems at follow-up was used to examine the relationship between activity memory performances and everyday memory. TBI participants showed significant recovery in both content and temporal order memory for activities during the first year. Despite showing significant recovery, the TBI group’s activity memory performances remained poorer than controls at follow-up. Greater self- and informant-report of everyday memory difficulties was associated with poorer temporal order memory but not content memory for activities. These findings demonstrate recovery in multiple memory processes that support activity memory following moderate to severe TBI. The findings also suggest a stronger link between everyday memory abilities and temporal order memory for activities in comparison to activity memory content in a TBI population.
PMCID: PMC3350309  PMID: 22220505
activity memory; closed head injury; recovery; episodic memory; everyday memory

Results 1-5 (5)