Our current work focuses on understanding subtle changes in everyday function that occur in healthy older adults as well as those who are experiencing early cognitive decline due to neurodegenerative diseases, like Alzheimer’s disease and cerebrovascular diseases. We draw on our theoretical model for everyday action impairment based on data on populations with functional impairment (Omission-Commission Model). We also are developing interventions for people with dementia based on our early theoretical work. Our current research relies heavily on new technologies, including smartphones and virtual reality, to improve the efficiency of assessments and the delivery and effectiveness of interventions. The overarching goal of our research is to directly improve the everyday lives of older adults.
If you are interested in participating in our ongoing studies, please contact us here to learn more.
Validation of Smartphone-Derived Digital Phenotypes for Cognitive Assessment in Older Adults
Neuropsychological assessment is incredibly important for 1) diagnosing cognitive and age-related disorders like dementia, 2) tracking and predicting cognitive changes over time, 3) informing capacity to live independently, and 4) informing effective intervention strategies. However, traditional assessment methods have drawbacks: they take place in clinic or laboratory settings, which are far removed from the distractions and contextual information of everyday life, and they require travel to and long visits at testing sites. Digital phenotyping is an emerging methodology that relies on passive collection of sensor data right from your smartphone during everyday life to measure activities, behaviors, and mood. It is possible that overarching patterns of de-identified sensor data (for example, how often you unlock your phone screen, how varied your day-to-day movements are) can be tied to underlying cognitive and functional ability and may be useful for detecting early changes associated with cognitive decline. In collaboration with Dr. Ian Barnett from the Department of Biostatistics Epidemiology and Informatics at the University of Pennsylvania and Dr. Chiu Tan from the Department of Computer and Information Science at Temple University, this project will evaluate the validity of a digital phenotyping protocol to characterize cognition and function among diverse older adults across the continuum of cognitive ability level, from healthy aging to mild dementia. The ultimate goal of this project is to develop an ecologically valid, efficient, and sensitive measure of everyday function to be used in clinical and large-scale research settings. We are currently recruiting healthy older adults aged 65 and up and older adults with diagnoses of mild cognitive impairment (MCI) or mild dementia to participate in this study.
Feasibility of the SmartPrompt for Improving Everyday Function in Dementia
People with dementia experience difficulties completing everyday tasks, such as remembering to take medications, leading to secondary health issues, caregiver burden, and high medical care costs. With our collaborator, Chiu Tan in the Department of Computer and Information Science at Temple, this project evaluates the feasibility and usability of a smartphone-based prompting application informed by neuropsychological data and theory. By leveraging the technology capabilities of personal smartphones, the SmartPrompt is designed to promote accurate completion of everyday activities in older adults with dementia. The ultimate goal of this project is to promote aging in place and reduce caregiver burden. We are currently recruiting participants aged 65 and older with diagnoses of mild dementia or MCI to participate in this study.
Assessing Everyday Function in Older Adults with the Virtual Kitchen
Accurate assessment of everyday function in older adults is important for 1) informing capacity to live independently, 2) predicting cognitive decline, and 3) informing effective intervention strategies. However, the current benchmark standard for functional assessment (informant report) is not available for everyone, influenced by informant characteristics, and lacks ecological validity; and traditional performance-based tests require considerable time and training for administration and scoring. In collaboration with Takehiko Yamaguchi from the VR and Data Science Lab at Suwa University of Science in Japan, this project will evaluate the psychometric properties of a novel, non-immersive, tablet-based, virtual reality measure of everyday function for diverse older adults across the continuum of cognitive ability level, from healthy aging to mild dementia. The ultimate goal of this project is to develop a valid, efficient, and sensitive measure of everyday function to be used in clinical and large-scale research settings. We are currently recruiting healthy older adults aged 65 and up and older adults with diagnoses of mild cognitive impairment (MCI) or mild dementia to participate in this study.
Improving Everyday Task Performance through Repeated Practice in Virtual Reality
Cognitive training leads to reliable improvements on the specific task(s) that are repeatedly practiced, but transfer to untrained, functional tasks is limited. Because of both limited transfer and rigid (procedural) learning in AD, novel language-based interventions for dementia have focused on repeated practice with a circumscribed and highly personalized vocabulary to maintain functional communication. Repeated practice of everyday tasks (leveraging intact procedural memory) also has been shown to improve performance of trained tasks in people with AD but is not a feasible intervention, because the effort required to set up tasks, monitor performance, and provide feedback/supervision is far greater than having a caregiver simply complete the task for the patient. In collaboration with Takehiko Yamaguchi from the VR and Data Science Lab at Suwa University of Science in Japan, this project will evaluate the efficacy of a low-cost computer training program that uses non-immersive virtual reality (VR) to enable participants with AD to independently practice meaningful everyday activities (e.g., meal preparation). Results will demonstrate the extent to which training in a virtual context will generalize to real life tasks. We are currently recruiting participants aged 65 and older with diagnoses of mild dementia or MCI to participate in this study.
Mechanisms and Treatment Strategies to Counter Addiction Susceptibility Post TBI
This project is a sub-aim of a large, multidisciplinary study that includes investigators from several departments at Temple University and Temple Medical School, Drexel University, and the Coatesville VA. In collaboration with the Temple Olson Lab, this project evaluates concussed and non-concussed athletes with behavioral testing and brain imaging to determine relations between cerebral white matter integrity, cognitive abilities, addictive behavior, and concussion symptoms.
Translation & Clinical Implementation of a Test of Language & STM in Aphasia (TALSA): TALSA Measures of Verbal STM as Predictors of Mild Cognitive Impairment & Dementia
This collaboration with Nadine Martin and Ingrid Olson examines verbal short-term memory, which is impaired in stroke-related aphasia, in older adults with vascular risk factors in an attempt to develop an integrated framework of risk factors for both stroke and dementia.
Peri-Operative Cognitive Function in Older Adults Undergoing Cardiac Surgery
Smartwatch Derived Digital Phenotypes in Older Adults
Funding provided from Labfront
Brain structures that regulate and control the autonomic nervous system (i.e., locus coeruleus) have been identified as the earliest affected regions of neurodegenerative disorders, including Alzheimer’s disease. Thus, passive measurement of autonomic functions, including day-to-day variability of physical activity, sleep, and heart rate may offer a highly sensitive measure of early cognitive difficulties with numerous advantages (e.g., relatively inexpensive, non-invasive, portable, discrete, not affected by education, culture, or test anxiety, etc.). The aim of this proposal is to validate continuous measures of autonomic function against standard clinical tests of cognitive abilities, performance-based and questionnaire measures of everyday function, brain imaging measures of cerebrovascular integrity (white matter hyperintensities), and brain health (volume and function of locus coeruleus). 500 older adults (55+) who are cognitively healthy, have mild cognitive impairment (MCI), or mild Alzheimer’s dementia (AD) will be recruited from a parent study that includes standard cognitive testing, comprehensive assessment of everyday function, and structural/functional neuroimaging. Participants will be asked to wear the Garmin vivosmart 4 watch while completing study tasks and/or for four weeks to measure variation in day-to-day heart rate, steps, sleep, and accelerometer derived physical activity. Partial correlations/regressions adjusting for age, sex, and level of intellectual function will investigate the relation between autonomic measures and clinical variables (cognition, everyday function, mood, and neuroimaging). Strong relations between physiological variables and clinical measures would provide preliminary support for using smart watches to help monitor cognitive function and characterize neuropsychological health in a variety of older adults. We are recruiting older adults aged 55 and older.
Naturalistic Eye Movements as Clinical Markers of Everyday Cognition in Older Adults
Loss of independence in activities of daily living (ADLs), such as meal preparation, is a core diagnostic criterion of Alzheimer’s disease and related dementias (ADRD) and is associated with increased costs of care and decreased quality of life, but even mild, age-associated changes in cognition negatively influence the performance of everyday tasks. Studies of individuals with dementia posit two possible distinct cognitive mechanisms for functional difficulties: impaired cognitive control and degraded task schema knowledge. However, the primary mechanisms contributing to functional changes in older adults with milder cognitive decline remain poorly understood, in part due to a lack of sensitive methods for studying everyday functioning in individuals without dementia. Eye tracking and virtual reality (VR) have emerged as potential sensitive and scalable methods for studying such changes. The proposed study will recruit a racially diverse sample of older adults to examine the relation between eye fixations during a VR task of everyday functioning and clinical measures of real-world everyday functioning and cognitive abilities. We predict that inefficiencies in eye fixations during completion of the VR task are associated with (1) inefficient reaching movements in the VR task and (2) real-world functional difficulties, and (3) patterns of inefficient eye movements reflect distinct cognitive mechanisms for functional difficulties. Results of the proposed study will help develop a highly sensitive, scalable assessment for cognitive skills most critical for everyday functioning in a diverse aging population and 2) identify the cognitive mechanisms underlying mild functional difficulties to inform future development of targeted interventions. We are currently recruiting healthy older adults aged 65 and up and older adults with diagnoses of mild cognitive impairment (MCI) or mild dementia to participate in this study.