this presentation about the hermes...

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Cognitive Care and Guidance for Active Aging – Ref. FP7 216709

Active Ageing through Memory Support and Training Analysis of User Needs

Arjan Geven CURE – Center for Usability Research and Engineering,

Vienna

Cognitive Care and Guidance for Active Aging Arjan Geven | Tagung Lebensqualität im Alter - 19.03.2009 | 2

This presentation

• Ageing and Cognition • About the HERMES Project • User Needs Analysis • Conclusions

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This presentation



Societal Background

• „There will be more older people in absolute as well as relative terms, (..), there will be fewer family carers, and there will be a smaller productive workforce to contribute to the financing (..). Accordingly, the estimated national cost of care will be rapidly increasing“

• Age-related cognitive decline is part of this problem, which is the target of HERMES. HERMES addresses ageing both in terms of independent living and social participation, increasing self-efficacy, perceived control on wellbeing and thereby autonomy and quality of life.

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Age-related Cognitive Decline

• Normal elderly people without specific cognitive impairments – what happens with age? AAMI (Age Associated Memory Impairment) a specific impairment in memory, not affecting other cognitive areas

• Does not have direct effects on the Activities of Daily Living (self-care, hygiene, dressing, etc), but affects normal functioning because it interferes on the remembering of daily information.

• This impairment is often self-reported by the person him/herself and sometimes confirmed by another informant.

• In some cases, patients with Mild Cognitive Impairment (MCI) will also benefit from general memory support


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HERMES Cognitive Care and Guidance for Active Aging

• Project duration: – start: January 1st, 2008 – End: December 31st, 2010

• Project funded under FP7 Call 1 – ICT and Ageing

• Project coordinator: CURE

• Consortium Members: 1. CURE – Center for Usability

Research and Engineering, Austria

2. INGEMA Foundation, Spain 3. IBM Haifa Research Lab,

Israel 4. University of Bradford, UK 5. Athens Information

Technology, Greece 6. TXT E-Solutions, Italy


HERMES Objectives

Episodical Memory

HERMES Past

Prospective Memory

HERMES Future

Cognitive Training

HERMES Training

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HERMES Objective – Episodic Memory (1/2)

• HERMES aims at giving older people who are suffering from age-related cognitive decline control over their episodic memory. Focusing on an interface that reduces the cognitive burden, HERMES provides an extension to episodic memory at points where the user might not remember the particular details of specific events such as the details of drug prescriptions or important personal moments

• The fear of forgetting and a reduced trust in a person‘s own ability reduce the psychological wellbeing of the older person, which can be countered by an assistive memory aid (as long as it is assisting in the right tasks).

Episodical Memory


HERMES Objective – Episodic Memory (2/2)

• Intelligent speech and image processing techniques are employed to index, annotate, and summarize the captured information (semantics extraction, events identification and inferences)

• Application of audiovisual processing tools to support reflective memory (past activity)

• Make captured moments easily retrievable – Interface facilitates reminiscing with

no or very general criteria – Search for particular detail will bring

up context of the moment

Episodical Memory

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Scenario – Episodic Memory Support

Scenario: The user has a conversation with the doctor

The conversation with the doctor is recorded on the mobile device.

At the end of the conversation, the

user stops the recording.

Recording

The mobile device uploads audio records to the home-server and the recorded

data are processed.

Metadata (time, people, keywords) are

extracted.

Arriving home

The user can browse and search through

the stored conversation to find back what was said.

Important audio segments can be

played back.

Remembering


HERMES Objective – Prospective Memory

• Prospective memory is one the areas of cognition that is often affected with aging, the automatic reminders support the user in maintaining a regular day order.

• HERMES’ automated reminders give the user assistance to carry out daily activities and support their prospective memory, when it might fail from time to time. Context-awareness, such as location, time, and situation, allows for reminders to be given where they are most effective.

Prospective Memory

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Scenario – Prospective Memory Support

Free Speech Entry

The user – whenever he or she feels the need to record something – presses a single button (touchscreen) and speaks freely. Time and date are captured and entry in the calendar is made: “don’t forget to buy the scarf in this store next time you’re in the neighbourhood!”

User Reminding The user can search the entries and he can edit them. Reminders are triggered by time or location.

Metadata Extraction

The processing of the entry will happen as soon the user gets home and the device

automatically syncs itself with the server.

Metadata Extraction


HERMES Objective – Cognitive Training

• Personalized training aims to keep the memory fit and reduces the slope of decline. Although large variability exists between people, cognitive decline appears to be strongly related to the amount of exercise one follows.

• The persuasive and game-like design of the exercises stimulates the user to engage in daily training, increasing the amount of training received and increasing performance in the training games as well as everyday memory performance for aging people

• Improve technical quality of the speech recognition by updating accoustic models

Cognitive Training

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Scenario – Cognitive Training

All the appointments for the following day or week are presented. The user has to connect

the right metadata to the right elements. This trains the user to remember specific

events.

Information is revealed progressively when the user is not sure about the appointments. Recorded audio portions are played back, but the score goes down when the user requires

much assistance.

The difficulty level varies with the cognitive

abilities of the user.

i

Incorrect answers are not accepted (to prevent interference).


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User Needs for AAMI

• Questionnaire (n=63 in Spain; n=33 in Austria; some applied to care proffessionals in Greece)

• Focus group: in Spain with 4 participants (University for the elderly)

• Memory assessment: 18 in Spain – Objective memory

performance: WMS-III – Subjective memory

perception: MAC-Q

– Interviews: 15 in Spain, 33 in Austria. Results on: • Health needs • Security needs • Memory needs • Forgetfulness • Problems and emotions • Compensation • Cognitive training • Use of technology

– Cultural probes: 6 in Austria – Diary of forgetfulness: 30 in

Spain


General Findings

• In terms of memory problems, 65 users (67.7%) reported memory problems, 5 (5.2%) described these problems as extreme, and 16 (16.7%) no reported memory problems at all. – The most stated problems were related to forgetting names

(19.8% of the total sample reported it) – followed by forgetting where objects had been left (for

example, glasses, home keys…), reported by 12.5% of the users. • Hearing impairments were reported in 31 (32.3%), while visual

impairments were reportedly present on 70 (72.9%), and mobility impairments on 24 (25%) people. More specifically, 19 (19.8%) reported walking/gait problems.

• Only a small percentage (2.1%) reported problems with activities of daily living (i.e. washing and dressing), and 14 (14.6%) reported some problems when it came to perform usual daily life activities.

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Most appreciated uses for a memory support aid

• A device for shopping list (stated by 46.9% of the sample)

• A device to record previous conversations with the doctor (43.8%)

• device for things to do today (37.5%) • device for previous informal conversations (29.2%). • 67.7% of them would appreciate a device to play some

cognitive games, • 30.2% to register some places of interest for them (e.g.

pharmacies, groceries), and then to remind them where they are.


Device Findings

• The most preferred device from already existing ones in order to receive reminders was: – the mobile phone (preferred by 39.6% of our sample) – followed by the TV screen (9.4%) – or a combination of both (10.4%)

• A great part of our users (41.7%) preferred, when they were alone, to receive information in a combined way of visual and auditory information, rather than just reading the information on a display (19.7%) or just hearing it (5.2%)

• In company of more people, combined visual and auditory information was still preferred (26%) rather than just visual (24%) or just auditory (4.2%).

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Acceptance of a device which reminded them what to do today

• People living alone showed a great reluctance to this device, maybe because it may constitute an attack against their autonomy.

• People living with their partner only, were divided: most were contrary to the device (63% of them), but some accepted a device for this specific use (37%).

• People living with their partner and children were the most oriented for the acceptance of this kind of device.


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Conclusions

The population of the older adults is very heterogeneous in their experience with technology as

well as in their health situation.

Older adults do not want a system that makes them feel dependent

of it. For them, it is very important to keep their cognitive

abilities

Reduced autonomy or minimized cognitive or functional effort

would increase dependency and is directly rejected

Multimodal interaction, Customizeability

Employ pervasive technology aiming at developing non-obtrusive assistive

systems, use a touch-based“appliance” that doesn’t provoke immediate

associations with computers.

Employ cognitive training to reinforce autonomy rather than making dependent on technology. Cognitive games offer to

work with their personal information


Conclusions - The system‘s scenarios

1. Facilitation of episodic memory at home 2. Facilitation of episodic memory on the move 3. Cognitive Training using personalized Informaiton 4. Setting and Retrieving Reminders in the Home and on

the Move 5. Sharing Memories with visitors 6. Facilitation of lexical access to people‘s names 7. Searching for common-use objects in the home

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Conclusions - The system‘s core interface

Multi-touch table interface

Episodic Memory Interface

Cognitive Care and Guidance for Active Aging – Ref. FP7 216709

Thank you for your attention!

Arjan Geven CURE – Center for Usability Research and Engineering, Vienna

Tel: +43(0)1 743 5451 14 Fax: +43 (01 743 5451 30

Mail: [email protected] Web: http://www.cure.at

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