Conversational System as Assistant Tool in Reminiscence Therapy for People with Early-Stage of Alzheimer’s

Morales-de-Jesús, Víctor Manuel; Gómez-Adorno, Helena; Somodevilla-García, María; Vilariño, Darnes

doi:10.3390/healthcare9081036

Cited by 7 publications

(6 citation statements)

References 36 publications

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“…Such social and conversational LLMs can come in the shape of apps, as potentially voice enacted chat applications. More immersive social interactions might be possible when the LLMs are digitally embodied as virtual avatars (Morales-de-Jesús et al, 2021 ) or even physically embodied as robots (Lima et al, 2022 ).…”

Section: Methodsmentioning

confidence: 99%

Introduction to Large Language Models (LLMs) for dementia care and research

Treder,

Lee,

Tsvetanov

2024

Front. Dement.

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IntroductionDementia is a progressive neurodegenerative disorder that affects cognitive abilities including memory, reasoning, and communication skills, leading to gradual decline in daily activities and social engagement. In light of the recent advent of Large Language Models (LLMs) such as ChatGPT, this paper aims to thoroughly analyse their potential applications and usefulness in dementia care and research.MethodTo this end, we offer an introduction into LLMs, outlining the key features, capabilities, limitations, potential risks, and practical considerations for deployment as easy-to-use software (e.g., smartphone apps). We then explore various domains related to dementia, identifying opportunities for LLMs to enhance understanding, diagnostics, and treatment, with a broader emphasis on improving patient care. For each domain, the specific contributions of LLMs are examined, such as their ability to engage users in meaningful conversations, deliver personalized support, and offer cognitive enrichment. Potential benefits encompass improved social interaction, enhanced cognitive functioning, increased emotional well-being, and reduced caregiver burden. The deployment of LLMs in caregiving frameworks also raises a number of concerns and considerations. These include privacy and safety concerns, the need for empirical validation, user-centered design, adaptation to the user's unique needs, and the integration of multimodal inputs to create more immersive and personalized experiences. Additionally, ethical guidelines and privacy protocols must be established to ensure responsible and ethical deployment of LLMs.ResultsWe report the results on a questionnaire filled in by people with dementia (PwD) and their supporters wherein we surveyed the usefulness of different application scenarios of LLMs as well as the features that LLM-powered apps should have. Both PwD and supporters were largely positive regarding the prospect of LLMs in care, although concerns were raised regarding bias, data privacy and transparency.DiscussionOverall, this review corroborates the promising utilization of LLMs to positively impact dementia care by boosting cognitive abilities, enriching social interaction, and supporting caregivers. The findings underscore the importance of further research and development in this field to fully harness the benefits of LLMs and maximize their potential for improving the lives of individuals living with dementia.

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Section: Methodsmentioning

confidence: 99%

Introduction to Large Language Models (LLMs) for dementia care and research

Treder,

Lee,

Tsvetanov

2024

Front. Dement.

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“… Moon and Park (2020) reported that reminiscence therapy with an app that displays images related to dementia participants’ memories successfully decreased BPSD occurrence in the participants with MMSE scores of 10–19. Morales-De-jesús et al (2021) developed an interactive virtual avatar that performed automated conversational reminiscence therapy. However, they reported that the performance of its dialogues was insufficient for the participants to enjoy the conversation and to improve their cognitive functions.…”

Section: Related Workmentioning

confidence: 99%

“…Reminiscence therapy promotes the activation of memory and increases spontaneous speech through conversations with caregivers or other participants about their own past memories. Spending time to reminisce and talk about the past is expected to stabilize the elderly’s mental condition and thus suppress BPSD ( Butler, 1963 ; Moon and Park, 2020 ; Morales-De-jesús et al, 2021 ). Music therapy promotes memory stimulation and spontaneous vocalization, as in reminiscence therapy, by listening to or singing the elderly person’s favorite songs and talking about those songs with the other participants.…”

Section: Introductionmentioning

confidence: 99%

“…Especially in Japan, where the labor force is decreasing, caregivers do not have enough available time to have adequate conversations with the dementia elderly ( Ministry of Health, Labour and Welfare of Japan, 2015 ). To address this issue, attempts to automate reminiscence therapy using a dialogue system have been reported, but their effectiveness has been limited ( Morales-De-jesús et al, 2021 ). One reason for this difficulty is the inadequate performance of current dialogue systems.…”

Section: Introductionmentioning

confidence: 99%

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Temporary improvement of cognitive and behavioral scales for Dementia elderly by Shiritori word game with a dialogue robot: A pilot study

Sugiyama

Nakamura

2022

Front. Robot. AI

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Communication therapies based on conversations with caregivers, such as reminiscence therapy and music therapy, have been proposed to delay the progression of dementia. Although these therapies have been reported to improve the cognitive and behavioral functions of elderly people suffering from dementia, caregivers do not have enough time to spend on administering such communication therapies, especially in Japan where the workforce of caregivers is inadequate. Consequently, the progression of dementia in the elderly and the accompanying increased burden on caregivers has become a social problem. While the automation of communication therapy using robots and virtual agents has been proposed, the accuracy of both speech recognition and dialogue control is still insufficient to improve the cognitive and behavioral functions of the dementia elderly. In this study, we examine the effect of a Japanese word-chain game (Shiritori game) with an interactive robot and that of music listening on the maintenance and improvement of cognitive and behavioral scales [Mini-Mental State Examination (MMSE) and Dementia Behavior Disturbance scale (DBD)] of the dementia elderly. These activities can provide linguistic and phonetic stimuli, and they are simpler to implement than conventional daily conversation. The results of our Wizard-of-Oz-based experiments show that the cognitive and behavioral function scores of the elderly who periodically played the Shiritori game with an interactive robot were significantly improved over the elderly in a control group. On the other hand, no such effect was observed with the music listening stimuli. Our further experiments showed that, in the Shiritori intervention group, there was a ceiling on the increase in MMSE. The lower the MMSE before participating in the experiment, the greater the increase. Furthermore, greater improvement in DBD was observed when the participants actively played the Shiritori game. Since the Shiritori game is relatively easy to automate, our findings show the potential benefits of automating dementia therapies to maintain cognitive and behavioral functions.

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“…Existen algunas propuestas enfocadas a brindar TR con el uso de tecnología en personas con deterioro cognitivo. Algunas se basan en la tecnología multimedia, como el uso de YouTube para una mayor variedad de elección de materiales para la reminiscencia 23 ; o el uso de un dispositivo portátil de cámara denominado SenseCam, que se lleva alrededor del cuello a través de un cordón, para crear un diario de vida personal o una grabación visual de la vida de la persona usuaria generando información que puede ser muy útil 24 . Otra propuesta se basa en un sistema conversacional que permite la interacción humano-computadora mediante lenguaje natural como herramienta para proporcionar TR de forma satisfactoria y de acuerdo con la información personalizada de la persona con deterioro cognitivo 25 .…”

Section: Introductionunclassified