Next steps after ASPAD

Magda Tsolaki, MD, PhDNeuropsychiatrist,

ProfessorAristotle University of Thessaloniki, Greece

Chair of Greek Alzheimer Federation

DISCLOSURES

Grants from Ministry of Education and Health, for Research En-NOHSHS project ASPAD and CBP projects “Psychargos”

FP5, FP6, FP7 European Funding, NIH (MIRAGE) DESCRIPA-ICTUS, ENIR, EDAR, SHARE, CARMEN Long Lasting Memories, Dem@care, AddNeuroMed Rapp program

From pharmaceutical companies, for Lectures and AdvisoryBoards Novartis, Pfizer, Iasis, Coronis, Janssen, Lilly

WITHOUT ICT

ΠεριθάλποντεςCAREGIVERS

Τεχνολογία PATIENTS

HEALTHPROFESSIONALS

3

WITH ICT

ΠεριθάλποντεςCAREGIVERS

ICT PATIENTS

HEALTH PROFESSIONALS

4

Needs unmet in DementiaContribution from Other Scienses

A. DIAGNOSIS

Very comprehensivediagnostic procedure

Simple, easy to use,cheap tests

B. MANAGEMENT

No medication yet todelay, to stop or cure

Computerizedinterventions

A.DIAGNOSTICWORKOUT TODAY

CLINICAL PRAXIS Medical History Neuropsychological Examination NeuroimagingRESEARCH LP-CSF EEG, ERPs PET (amyloid and tau burden) Other sciences?

PREDICTION-EARLY DIAGNOSIS

1. Computerized tests (En-NOHSHS) 2. Virtual Reality (Museum,

PSYCHARGOS) Supermarket-En-NOHSHS)

3. Follow ADL (Dem@Care) 4. Smart houses (Dem@Care)

1. COMPUTERIZED TESTS

(NATIONAL PROGRAM OFCOLLABORATION-EN-

NOHSHS)

COMPUTERIZED TESTS

Cognitive Tests with PC Our new effortsCAMCOG-CAT MindstreamsANAM CNSVSCANTABCogniScreenCALLSCOGDRASCSICOGselftestCogStateCNTBCANS-MCICAMCIMCI ScreenMicroCogTDASCAT

Computerized Cognitive Testing for Older Adults: A review.Zygouris S, Tsolaki M.Am J Alzheimers Dis Other Demen. 2014 Feb 20

Amsterdam for ADL

Cognitive Function testhttp://cft3.foodforthebrain.org/

http://160.40.50.78:8888/ScreeningTest/IntroPage.aspx

Salonica Test for ABC

CNS Vital Signs

Mindstreams

2.VR SUPERMARKET(sen= 82,35%, spe= 95,24%)

(Gardening, washing cloths, Museum)

Healthy

Healthy - Predicted CorrectClassification Rate

(CCR) %Sensitivity %

No Yes

Duration, BoughtUnlisted, CorrectMoney & ROCFT (1& 3)

No 30 392,60 90,91

Yes 1 20

Duration & RBMT1 No 30 388,90 90,91

Yes 3 18

Duration, BoughtUnlisted, CorrectMoney & Trail B

No 27 688,90 81,82

Yes 0 21

•

3. DIADOHOKINETIC (DDK)SPEECH TEST

DDK tests are used by speech-language pathologists forassessment of motor speech impairments Quick and accurate production of rapid, alternating sound

tokens involving different parts of mouse, e.g. “puh-tuk-kuh—puh-tuh-kuh—…”

Our hypothesis and research direction: The DDK test may challenge both motor and cognitive control over

speech production Is the DDK regularity useful in distinguishing between

Control/MCI/AD groups?

DDK REGULARITY ANALYSISEXAMPLES

0 5 10 15 20 25 300

1

2

3

4

5

6

7

8x 10

10

Modulation frequency, Hz

Energy Modulation Spectrum. K=31.8644

1 1.5 2 2.5 30

0.005

0.01

0.015

0.02

0.025

0.03

0.035

0.04

0.045

Modulation F0, Hz

F0 utility func. Max=0.042138 K=9.8176

1 1.5 2 2.5 30

0.002

0.004

0.006

0.008

0.01

0.012

0.014

Modulation F0, Hz

F0 utility func. Max=0.012036 K=2.3936

0 5 10 15 20 25 300

0.5

1

1.5

2

2.5

3

3.5

4x 10

11

Modulation frequency, Hz

Energy Modulation Spectrum. K=10.7455

Good performance Poor performance

Aharon Satt, Alexander Sorin, Orith Toledo-Ronen, OrenBarkan, Ioannis Kompatsiaris, Athina Kokonozi, MagdaTsolaki. Evaluation of Speech-Based Protocol forDetection of Early-Stage Dementia. 14 th AnnualConference of the International Speech CommunicationAssociation. Special Focus: Speech in Life Sciences andHuman Societies.(http://www.interspeech2013.org/)

OUR PUBLICATION

4. DEM@CARE-ADLhttp://www.demcare.eu

ADLOF THE ELDERLY AND

PRODROMAL Alzheimer

5. EN-NOHSHShttp://www.ennoisis.

gr/ennoisis/ An Ambient Intelligence

System (depth camerasand environmentalsensors) for theMonitoring, Empowermentand Disease EvolutionPrediction for Patientswith Μild cognitiveimpairment

FOLLOWING THEMOVEMENTS

Bedroom

Living Room

MasterBedroom Bedroom

Kitchen

Eating

Day centers 4 Day Centers in Thessaloniki 1 for patients with moderate – severe

dementia 2 funded from Ministry of Health and

European Union

1. Five groups of8 excercises

Results after 2 years

Sample (N=41) Mean age=66.8 years (St. D.=8.2) Mean years of education=11,4 years (St. D.=4.6)

16 tests compared (pre-post evaluation) 4 tests with statistical significant differences (p<=0.05)

RAVLT2 (0,021) TEA 1 – A (0.006) TEA 1 – B (0.006) VFT (0.044)

EventPlace | Date

RAPP DEMOSRAPP will develop Robotic Applications (RApps) for two roboticplatforms (NAO and ANG-light) and will test the platform in upto three demo cases targeting:

Technology illiterate peopleMobility assistance and activity monitoringPeople with mild cognitive impairment

29

NAO humanoid robot ANG-light smart rollator

LLM Design Idea

2011

5. TELE-EDUCATIONOF CAREGIVERS

ON LINECAREGIVERS’ SUPPORT

6. Symbiosis

1ο Award. Microsoft Greece. 2o Award. Australia 24 of April,

2012. 3ο Award National Bank of

Greece. PUBLI.

Future Applications

MentALZcare (Symbiosis, Integration) Memory Activator (metabolic syndroms) MindGap (Personilized programs) Renaissance Memory Project (AA Rome) Alz-STEM (Stem cells in AD) LONGEVAD (Longitudinal follow up)

Future Applications

Memento (Integration of services) MyAgeingfalls (prevention of falls) Delight (Life style Management) ENJOiMENT (Multi domain interventions) ARSIS (Promoting active ageing) INA (Early diagnosis and management)

Thank you very much!

Acknowledgments

Bamidis Panagiotis and his team Department of Medical Physics, AUTh

Tsiatsos Thrasyvoulos and his team Department of Informatics, AUTh

Hatjileontiadis Leontios and his team Mitkas Periklis and his team

School of Electrical & Computer Engineering, AUTh

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