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Finding critical features for predicting quality of life in tablet-based serious games for dementia

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Abstract

While the number of dementia cases is steadily increasing, as of today no medication has been developed to cure its underlying causes. Instead, the focus in treatment has shifted to improve quality of life (QoL) for people with dementia (PwD). To this end, some non-pharmacological treatments such as exercising, socializing, and playing games have received increasing attention. PflegeTab is a tablet-based application developed for this purpose. It includes a number of services such as cognitive training games, everyday activity training games, emotional applications, and a biographical picture album. In the present paper, we explore the possibility of QoL prediction for PwD using data collected while nursing home residents played games in PflegeTab (\(N = 81\)). Using features generated from the data and applying linear discriminant analysis for classification, our approach obtained an average accuracy of 74.80% on predicting QoL ratings when measured by Monte Carlo cross-validation. Furthermore, this paper investigates which features were dominant for the classification (prominent features were e.g. time needed for task completion) and briefly discusses how the results might be utilized for managing general QoL of PwD.

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References

  1. 2016 Alzheimer’s disease facts and figures (2016) Alzheimer’s Dement J Alzheimer’s Assoc 12(4): 459–509 https://doi.org/10.1016/j.jalz.2016.03.001

  2. Asselbergs J, Ruwaard J, Ejdys M, Schrader N, Sijbrandij M, Riper H (2016) Mobile phone-based unobtrusive ecological momentary assessment of day-to-day mood: an explorative study mobile phone-based unobtrusive ecological momentary assessment of day-to-day mood: an explorative study. J Med Internet Res 18(3):e72. https://doi.org/10.2196/jmir.5505

    Article  Google Scholar 

  3. Bahar-Fuchs CL, Woods B (2013) Cognitive training and cognitive rehabilitation for mild to moderate alzheimer’s disease and vascular dementia. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD003260.pub2

    Article  Google Scholar 

  4. Ballard CG, Mohan RN, Patel A, Graham C (1994) Anxiety disorder in dementia. Irish J Psychol Med 113:108–109. https://doi.org/10.1017/S0790966700014750

    Article  Google Scholar 

  5. Barofsky I (2012) Can quality or quality-of-life be defined? Qual Life Res 21(4):625–631. https://doi.org/10.1007/s11136-011-9961-0

    Article  Google Scholar 

  6. Benveniste S, Jouvelot P, Péquignot R (2010) The MINWii project: renarcissization of patients suffering from Alzheimer’s disease through video game-based music therapy. In: Entertainment computing—ICEC 2010. Springer, Berlin, pp. 79–90. https://doi.org/10.1007/978-3-642-15399-0_8

  7. Biswas J, Tolstikov A, Jayachandran M, Foo V, Wai AAP, Phua C et al (2010) Health and wellness monitoring through wearable and ambient sensors: exemplars from home-based care of elderly with mild dementia. Ann Telecommun 659:505–521. https://doi.org/10.1007/s12243-010-0176-0

    Article  Google Scholar 

  8. Bobillier Chaumon M-E, Michel C, Tarpin Bernard F, Croisile B (2014) Can ICT improve the quality of life of elderly adults living in residential home care units? From actual impacts to hidden artefacts. Behav Inf Technol 33(6):574–590. https://doi.org/10.1080/0144929X.2013.832382

    Article  Google Scholar 

  9. Bouchard B, Imbeault F, Bouzouane A, Menelas B-AJ (2012) Developing serious games specifically adapted to people suffering from Alzheimer. In: Ma M, Oliveira MF, Hauge JB, Duin H, Thoben K-D (eds) Serious games development and applications. Springer, Berlin, pp 243–254

    Chapter  Google Scholar 

  10. Boulay M, Benveniste S, Boespflug S, Jouvelot P, Rigaud A-S (2011) A pilot usability study of MINWii, a music therapy game for demented patients. Technol Health Care 19(4):233–246. https://doi.org/10.3233/THC-2011-0628

    Article  Google Scholar 

  11. Bouman AIE, Ettema TP, Wetzels RB, van Beek APA, de Lange J, Dröes RM (2011) Evaluation of qualidem: a dementia-specific quality of life instrument for persons with dementia in residential settings; scalability and reliability of subscales in four dutch field surveys. Int J Geriatr Psychiatry 26(7):711–722. https://doi.org/10.1002/gps.2585

    Article  Google Scholar 

  12. Brod M, Stewart AL, Sands L, Walton P (1999) Conceptualization and measurement of quality of life in dementia: the dementia quality of life instrument (DQoL). Gerontologist 39(1):25–36. https://doi.org/10.1093/geront/39.1.25

    Article  Google Scholar 

  13. Chandrashekar G, Sahin F (2014) A survey on feature selection methods. Comput Electr Eng 40(1):16–28. https://doi.org/10.1016/j.compeleceng.2013.11.024

    Article  Google Scholar 

  14. Cotelli M, Manenti R, Zanetti O (2012) Reminiscence therapy in dementia: a review. Maturitas 72(3):203–205. https://doi.org/10.1016/j.maturitas.2012.04.008

    Article  Google Scholar 

  15. Croisile B, Tarpin-Bernard F, Noir M (2002) Expérience d’un site internet d’entraînement cognitif destiné aux seniors. Rev Natl Neurol 3(1):2S126

    Google Scholar 

  16. Cutler C, Hicks B, Innes A (2016) Does digital gaming enable healthy aging for community-dwelling people with dementia? Games Culture 11(1–2):104–129. https://doi.org/10.1177/1555412015600580

    Article  Google Scholar 

  17. Demiris G, Hensel BK (2008) Technologies for an aging society: a systematic review of “smart home” applications. Yearbook Med Inf 17:33–40. https://doi.org/10.1055/s-0038-1638580

    Article  Google Scholar 

  18. de Ridder D, Schreurs K (2001) Developing interventions for chronically ill patients: Is coping a helpful concept? Clin Psychol Rev 21(2):205–240. https://doi.org/10.1016/S0272-7358(99)00046-X

    Article  Google Scholar 

  19. Douglas S, James I, Ballard C (2004) Non-pharmacological interventions in dementia. Adv Psychiatr Treat 103:171–177. https://doi.org/10.1192/apt.10.3.171

    Article  Google Scholar 

  20. Ettema TP, Dröes R-M, de Lange J, Mellenbergh GJ, Ribbe MW (2007) QUALIDEM: development and evaluation of a dementia specific quality of life instrument—validation. Int J Geriatric Psychiatry 22(5):424–430. https://doi.org/10.1002/gps.1692

    Article  Google Scholar 

  21. Ettema TP, Dröes RM, De Lange J, Ooms ME, Mellenbergh GJ, Ribbe MW (2005) The concept of quality of life in dementia in the different stages of the disease. Int Psychogeriatr 17(3):353–370. https://doi.org/10.1017/S1041610205002073

    Article  Google Scholar 

  22. Ezekiel M, Fox KA (1959) Methods of correlation and regression analysis: linear and curvilinear. Wiley, New York

    MATH  Google Scholar 

  23. Finkel S, Silva JCE, Cohen G, Miller S, Sartorius N (1997) Behavioral and psychological signs and symptoms of dementia: a consensus statement on current knowledge and implications for research and treatment. Int J Geriatr Psychiatry 12(11):1060–1061. https://doi.org/10.1002/(SICI)1099-1166(199711)12:11<1060::AID-GPS658>3.0.CO;2-M

    Article  Google Scholar 

  24. Folstein MF, Folstein SE, McHugh PR (1975) mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198. https://doi.org/10.1016/0022-3956(75)90026-6

    Article  Google Scholar 

  25. Gao Y, Bianchi-Berthouze N, Meng H (2012) What does touch tell us about emotions in touchscreen-based gameplay? ACM Trans Comput Hum Interact (TOCHI) 19(4):31:1–31:30. https://doi.org/10.1145/2395131.2395138

    Article  Google Scholar 

  26. Gräske J, Fischer T, Kuhlmey A, Wolf-Ostermann K (2012) Quality of life in dementia care—differences in quality of life measurements performed by residents with dementia and by nursing staff. Aging Mental Health 16(7):819–827. https://doi.org/10.1080/13607863.2012.667782

    Article  Google Scholar 

  27. Guyon I, Elisseeff A (2003) An introduction to variable and feature selection. J Mach Learn Res 3:1157–1182. https://doi.org/10.1162/153244303322753616

    Article  MATH  Google Scholar 

  28. Hitch D, Swan J, Pattison R, Stefaniak R (2017) Use of touchscreen tablet technology by people with dementia in homes: a scoping review. J Rehabilit Assist Technol Eng 4:1–8. https://doi.org/10.1177/2055668317733382

    Article  Google Scholar 

  29. Huang HC, Chen YT, Chen PY, Hu SHL, Liu F, Kuo YL, Chiu HY (2015) Reminiscence therapy improves cognitive functions and reduces depressive symptoms in elderly people with dementia: a meta-analysis of randomized controlled trials. J Am Med Dir Assoc 16(12):1087–1094

    Article  Google Scholar 

  30. Imbeault F, Bouchard B, Bouzouane A (2011) Serious games in cognitive training for Alzheimer’s patients. In: 2011 IEEE 1st international conference on serious games and applications for health (SeGAH). IEEE, pp 1–8. https://doi.org/10.1109/SeGAH.2011.6165447

  31. Jain A, Zongker D (1997) Feature selection: evaluation, application, and small sample performance. IEEE Trans Pattern Anal Mach Intell 19(2):153–158. https://doi.org/10.1109/34.574797

    Article  Google Scholar 

  32. Joddrell P, Astell JA (2016) Studies involving people with dementia and touchscreen technology: a literature review. JMIR Rehabil Assist Technol 3(2):e10. https://doi.org/10.2196/rehab.5788

    Article  Google Scholar 

  33. Kira K, Rendell LA (1992) The feature selection problem: traditional methods and a new algorithm. In: Proceedings of the tenth national conference on artificial intelligence. AAAI Press, pp 129–134. http://dl.acm.org/citation.cfm?id=1867135.1867155

  34. Lee H, Choi YS, Lee S, Park IP (2012) Towards unobtrusive emotion recognition for affective social communication. In: 2012 IEEE consumer communications and networking conference (CCNC). IEEE, pp 260–264. https://doi.org/10.1109/CCNC.2012.6181098

  35. LiKamWa R, Liu Y, Lane ND, Zhong L (2013) Moodscope: building a mood sensor from smartphone usage patterns. In: Proceedings of the 11th annual international conference on mobile systems, applications, and services. ACM, New York, pp 389–402. https://doi.org/10.1145/2462456.2464449

  36. Lim FS, Wallace T, Luszcz MA, Reynolds KJ (2013) Usability of tablet computers by people with early-stage dementia. Gerontology 59(2):174–182. https://doi.org/10.1159/000343986

    Article  Google Scholar 

  37. Lin Q, Zhang D, Huang X, Ni H, Zhou X (2012) Detecting wandering behavior based on GPS traces for elders with dementia. In: 2012 12th international conference on control automation robotics vision (ICARCV). IEEE, pp 672–677. https://doi.org/10.1109/ICARCV.2012.6485238

  38. Loi SM, Mazur A, Huppert D, Hoy B, Swan J, Lautenschlager NT (2017) A pilot study using “apps” as a novel strategy for the management of challenging behaviors seen in people living in residential care. Int Psychogeriatr 29(4):637–643. https://doi.org/10.1017/S1041610216002039

    Article  Google Scholar 

  39. Lyketsos CG, Steinberg M, Tschanz JT, Norton MC, Steffens DC, Breitner JC (2000) Mental and behavioral disturbances in dementia: findings from the cache county study on memory in aging. Am J Psychiatry 157(5):708–714. https://doi.org/10.1176/appi.ajp.157.5.708

    Article  Google Scholar 

  40. Matthews F, Stephan B, Robinson L, Jagger C, Barnes L, Arthur A et al (2016) A two decade dementia incidence comparison from the cognitive function and ageing studies I and II. Nat Commun 7:11398. https://doi.org/10.1038/ncomms11398

    Article  Google Scholar 

  41. McCallum S (2012) Gamification and serious games for personalized health. Stud Health Technol Inform 177:85–96. https://doi.org/10.3233/978-1-61499-069-7-85

    Article  Google Scholar 

  42. McCallum S, Boletsis C (2013) Dementia games: a literature review of dementia-related serious games. In: Ma M, Oliveira MF, Petersen S, Hauge JB (eds) Serious games development and applications. Springer, Berlin, pp 15–27. https://doi.org/10.1007/978-3-642-40790-1_2

    Chapter  Google Scholar 

  43. Mottelson A, Hornbæk K (2016) An affect detection technique using mobile commodity sensors in the wild. In: Proceedings of the 2016 ACM international joint conference on pervasive and ubiquitous computing. ACM, New York, pp 781–792. https://doi.org/10.1145/2971648.2971654

  44. Nordheim J, O’Sullivan J, Gellert P, Arndt S, Kuhlmey A, Antons J (2017) Tablet-based intervention for nursing home residents with dementia: a cluster RCT. Innov Aging 1(suppl 1):1370. https://doi.org/10.1093/geroni/igx004.5041

    Article  Google Scholar 

  45. Nugent C, Donnelly M, Mason S, Passmore P, McClean S, Scotney B, Craig D (2010) A mobile multimedia technology to aid those with Alzheimer’s disease. IEEE MultiMed 17:42–51. https://doi.org/10.1109/MMUL.2010.25

    Article  Google Scholar 

  46. O’Neill SA, Mason S, Parente G, Donnelly MP, Nugent CD, McClean S et al (2011) Video reminders as cognitive prosthetics for people with dementia. Ageing Int 36(2):267–282. https://doi.org/10.1007/s12126-010-9089-5

    Article  Google Scholar 

  47. Padala K, Padala P, Malloy T, Geske J, Dubbert P, Dennis R et al (2012) Wii-Fit for improving gait and balance in an assisted living facility: a pilot study. J Aging Res. https://doi.org/10.1155/2012/597573

    Article  Google Scholar 

  48. Picard RR, Cook RD (1984) Cross-validation of regression models. J Am Stat Assoc 79(387):575–583. https://doi.org/10.1080/01621459.1984.10478083

    Article  MathSciNet  MATH  Google Scholar 

  49. Politou E, Alepis E, Patsakis C (2017) A survey on mobile affective computing. Comput Sci Rev 25:79–100. https://doi.org/10.1016/j.cosrev.2017.07.002

    Article  Google Scholar 

  50. Prince M, Wimo A, Guerchet M, Ali G-C , Wu, Y-T , Prina M (2015) World Alzheimer report 2015—the global impact of dementia: an analysis of prevalence, incidence, cost and trends. Alzheimer’s Dis Int. https://www.alz.co.uk/research/world-report-2015/

  51. Ready RE, Ott BR (2003) Quality of life measures for dementia. Health Qual Life Outcomes 1(1):11. https://doi.org/10.1186/1477-7525-1-11

    Article  Google Scholar 

  52. Rowe M, Lane S, Phipps C (2007) CareWatch: a home monitoring system for use in homes of persons with cognitive impairment. Top Geriatr Rehabil 23(1):3–8. https://doi.org/10.1097/00013614-200701000-00003

    Article  Google Scholar 

  53. Schalock RL (2000) Three decades of quality of life. Focus Autism Other Dev Disabil 15(2):116–127. https://doi.org/10.1177/108835760001500207

    Article  Google Scholar 

  54. Selai CE, Trimble MR, Rossor MN, Harvey RJ (2001) Assessing quality of life in dementia: preliminary psychometric testing of the quality of life assessment schedule (QOLAS). Neuropsychol Rehabil 11(3–4):219–243. https://doi.org/10.1080/09602010042000033

    Article  Google Scholar 

  55. Shah S, Teja JN, Bhattacharya S (2015) Towards affective touch interaction: predicting mobile user emotion from finger strokes. J Interact Sci 3(1):6. https://doi.org/10.1186/s40166-015-0013-z

    Article  Google Scholar 

  56. Sposaro F, Danielson J, Tyson G (2010) iWander: an android application for dementia patients. In: 2010 annual international conference of the IEEE engineering in medicine and biology. IEEE, pp 3875–3878. https://doi.org/10.1109/IEMBS.2010.5627669

  57. Tárraga L, Boada M, Modinos G, Espinosa A, Diego S, Morera A et al (2006) A randomised pilot study to assess the efficacy of an interactive, multimedia tool of cognitive stimulation in Alzheimer’s disease. J Neurol Neurosurg Psychiatry 77(10):1116–1121. https://doi.org/10.1136/jnnp.2005.086074

    Article  Google Scholar 

  58. Tsuji A, Kuwahara N, Narumoto J, Yoshitomi Y, Morimoto K (2013) Improvement of the QOL of elderly people utilizing ICT. In: The 27th annual conference of the Japanese Society for Artificial Intelligence, 3C1, pp 1–4. https://doi.org/10.11517/pjsai.JSAI2013.0_3C1IOS1b4

  59. Tyack C, Camic PM, Heron MJ, Hulbert S (2017) Viewing art on a tablet computer: a well-being intervention for people with dementia and their caregivers. J Appl Gerontol 36(7):864–894. https://doi.org/10.1177/0733464815617287

    Article  Google Scholar 

  60. Upton D, Bray J, Jones T, Upton P (2013) The use of touch screen technology by people with dementia and their careers in care home settings. J Dement Care 21:16–17

    Google Scholar 

  61. Verdugo MA, Schalock RL, Keith KD, Stancliffe RJ (2005) Quality of life and its measurement: important principles and guidelines. J Intellect Disabil Res 49(10):707–717. https://doi.org/10.1111/j.1365-2788.2005.00739.x

    Article  Google Scholar 

  62. Vernooij-Dassen M, Vasse E, Zuidema S, Cohen-Mansfield J, Moyle W (2010) Psychosocial interventions for dementia patients in long-term care. Int Psychogeriatr 22(7):1121–1128. https://doi.org/10.1017/S1041610210001365

    Article  Google Scholar 

  63. Versijpt J (2014) Effectiveness and cost-effectiveness of the pharmacological treatment of Alzheimer’s disease and vascular dementia. J Alzheimers Dis 42(s3):S19–S25. https://doi.org/10.3233/JAD-132639

    Article  Google Scholar 

  64. Wilkinson P (2016) A brief history of serious games. In: Dörner R, Göbel S, Kickmeier-Rust M, Masuch M, Zweig K (eds) Entertainment computing and serious games. Springer, Cham, pp 17–41. https://doi.org/10.1007/978-3-319-46152-6_2

    Chapter  Google Scholar 

  65. Wu Y-T, Beiser A, Breteler M, Fratiglioni L, Helmer C, Hendrie H et al (2017) The changing prevalence and incidence of dementia over time–current evidence. Nat Rev Neurol 13(6):327–339. https://doi.org/10.1038/nrneurol.2017.63

    Article  Google Scholar 

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Acknowledgements

This research was conducted as part of PflegeTab research project (https://pflegetab.qu.tu-berlin.de) funded by The National Association of Statutory Health Insurance Funds (GKV-Spitzenverband).

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  1. Jeehoon Cha and Jan-Niklas Voigt-Antons contributed equally to this publication.

Authors and Affiliations

  1. Quality and Usability Lab, Technische Universität Berlin, Berlin, Germany

    Jeehoon Cha, Jan-Niklas Voigt-Antons, Carola Trahms & Sebastian Möller

  2. Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité - Universitätsmedizin Berlin, Berlin, Germany

    Julie Lorraine O’Sullivan, Paul Gellert, Adelheid Kuhlmey & Johanna Nordheim

  3. German Research Center for Artificial Intelligence (DFKI), Berlin, Germany

    Jan-Niklas Voigt-Antons & Sebastian Möller

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  1. Jeehoon Cha
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Cha, J., Voigt-Antons, JN., Trahms, C. et al. Finding critical features for predicting quality of life in tablet-based serious games for dementia. Qual User Exp 4, 6 (2019). https://doi.org/10.1007/s41233-019-0028-2

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