BackgroundOne of the key clinical features of Alzheimer’s disease (AD) is impairment in daily functioning. Patients with mild cognitive impairment (MCI) also commonly have mild problems performing complex tasks. Information and communication technology (ICT), particularly techniques involving imaging and video processing, is of interest in order to improve assessment. The overall aim of this study is to demonstrate that it is possible using a video monitoring system to obtain a quantifiable assessment of instrumental activities of daily living (IADLs) in AD and in MCI.MethodsThe aim of the study is to propose a daily activity scenario (DAS) score that detects functional impairment using ICTs in AD and MCI compared with normal control group (NC). Sixty-four participants over 65 years old were included: 16 AD matched with 10 NC for protocol 1 (P1) and 19 MCI matched with 19 NC for protocol 2 (P2). Each participant was asked to undertake a set of daily tasks in the setting of a “smart home” equipped with two video cameras and everyday objects for use in activities of daily living (8 IADLs for P1 and 11 for P2, plus 4 temporal execution constraints). The DAS score was then computed from quantitative and qualitative parameters collected from video recordings.ResultsIn P1, the DAS score differentiated AD (DASAD,P1 = 0.47, 95% confidence interval [CI] 0.38–0.56) from NC (DASNC,P1 = 0.71, 95% CI 0.68–0.74). In P2, the DAS score differentiated MCI (DASMCI,P2 = 0.11, 95% CI 0.05–0.16) and NC (DASNC,P2 = 0.36, 95% CI 0.26–0.45).ConclusionIn conclusion, this study outlines the interest of a novel tool coming from the ICT world for the assessment of functional impairment in AD and MCI. The derived DAS scores provide a pragmatic, ecological, objective measurement which may improve the prediction of future dementia, be used as an outcome measurement in clinical trials and lead to earlier therapeutic intervention.
Ce papier analyse la stratégie d'unéditeur de logiciel vis-à-vis du piratage. Dans un contexte d'adoption caractérisée par une incertitude sur la qualité (bien d'expérience) et des coûts de piratage hétérogènes, unéditeur peut choisir le prix et la qualité du logiciel distribué ainsi qu'un niveau d'effort ou de surveillance des utilisateurs. Les utilisateurs peuvent choisir de pirater ou d'acheter le logiciel de l'éditeur durant l'une des deux périodes considérées ou de ne pas l'adopter. Entre les deux périodes, un mécanisme de bouche-à-oreille permet de révéler imparfaitement la qualité du logiciel. Dans ce contexte, nous montrons sous quelles conditions une politique de tolérance vis-à-vis du piratage peutêtre profitable pour l'éditeur. Nous envisageons aussi la possibilité pour unéditeur d'annoncer des niveaux de prix et de surveillance futurs qu'il n'appliquerait pas parfaitement durant la deuxième période d'adoption. Une telle politique, faussement permissive en matière de piratage, s'avère encore plus efficace. Néanmoins, seule la politique permissive vis-à-vis du piratage demeure robuste dès lors qu'on augmente le niveau de sophistication des anticipations des utilisateurs quantà l'appréhension de la stratégie de l'éditeur.
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