Zsoldos Isabella, Trân Eléonore, Fournier Hippolyte, Tarpin-Bernard Franck, Fruitet Joan, Fouillen Mélodie, Bailly Gérard, Elisei Frédéric, Bouchot Béatrice, Constant Patrick, Ringeval Fabien, Koenig Olivier, Chainay Hanna
Laboratoire d'Étude des Mécanismes Cognitifs, Université Lumière Lyon 2, Lyon, France.
SBT Humans Matter, Lyon, France.
JMIR Rehabil Assist Technol. 2024 Jun 20;11:e48129. doi: 10.2196/48129.
Impaired cognitive function is observed in many pathologies, including neurodegenerative diseases such as Alzheimer disease. At present, the pharmaceutical treatments available to counter cognitive decline have only modest effects, with significant side effects. A nonpharmacological treatment that has received considerable attention is computerized cognitive training (CCT), which aims to maintain or improve cognitive functioning through repeated practice in standardized exercises. CCT allows for more regular and thorough training of cognitive functions directly at home, which represents a significant opportunity to prevent and fight cognitive decline. However, the presence of assistance during training seems to be an important parameter to improve patients' motivation and adherence to treatment. To compensate for the absence of a therapist during at-home CCT, a relevant option could be to include a virtual assistant to accompany patients throughout their training.
The objective of this exploratory study was to evaluate the interest of including a virtual assistant to accompany patients during CCT. We investigated the relationship between various individual factors (eg, age, psycho-affective functioning, personality, personal motivations, and cognitive skills) and the appreciation and usefulness of a virtual assistant during CCT. This study is part of the THERADIA (Thérapies Digitales Augmentées par l'Intelligence Artificielle) project, which aims to develop an empathetic virtual assistant.
A total of 104 participants were recruited, including 52 (50%) young adults (mean age 21.2, range 18 to 27, SD 2.9 years) and 52 (50%) older adults (mean age 67.9, range 60 to 79, SD 5.1 years). All participants were invited to the laboratory to answer several questionnaires and perform 1 CCT session, which consisted of 4 cognitive exercises supervised by a virtual assistant animated by a human pilot via the Wizard of Oz method. The participants evaluated the virtual assistant and CCT at the end of the session.
Analyses were performed using the Bayesian framework. The results suggest that the virtual assistant was appreciated and perceived as useful during CCT in both age groups. However, older adults rated the assistant and CCT more positively overall than young adults. Certain characteristics of users, especially their current affective state (ie, arousal, intrinsic relevance, goal conduciveness, and anxiety state), appeared to be related to their evaluation of the session.
This study provides, for the first time, insight into how young and older adults perceive a virtual assistant during CCT. The results suggest that such an assistant could have a beneficial influence on users' motivation, provided that it can handle different situations, particularly their emotional state. The next step of our project will be to evaluate our device with patients experiencing mild cognitive impairment and to test its effectiveness in long-term cognitive training.
在许多病症中都观察到认知功能受损，包括神经退行性疾病，如阿尔茨海默病。目前，用于对抗认知衰退的药物治疗效果有限，且有显著副作用。一种受到广泛关注的非药物治疗方法是计算机化认知训练（CCT），其旨在通过标准化练习中的重复训练来维持或改善认知功能。CCT允许直接在家中更规律、更全面地训练认知功能，这为预防和对抗认知衰退提供了重要契机。然而，训练期间的辅助似乎是提高患者治疗积极性和依从性的一个重要因素。为弥补在家进行CCT时缺乏治疗师的不足，一个相关的选择可能是引入虚拟助手全程陪伴患者训练。
本探索性研究的目的是评估在CCT期间引入虚拟助手陪伴患者的可行性。我们调查了各种个体因素（如年龄、心理情感功能、个性、个人动机和认知技能）与CCT期间对虚拟助手的评价及其实用性之间的关系。本研究是THERADIA（人工智能增强数字疗法）项目的一部分，该项目旨在开发一个具有同理心的虚拟助手。
共招募了104名参与者，其中52名（50%）为年轻人（平均年龄21.2岁，范围18至27岁，标准差2.9岁），52名（50%）为老年人（平均年龄67.9岁，范围60至79岁，标准差5.1岁）。所有参与者均被邀请到实验室回答几份问卷并进行1次CCT训练，该训练包括4项认知练习，由一名真人操控的虚拟助手通过奥兹巫师方法进行监督。参与者在训练结束时对虚拟助手和CCT进行了评价。
使用贝叶斯框架进行分析。结果表明，两个年龄组在CCT期间都对虚拟助手表示赞赏并认为其有用。然而，总体而言，老年人对虚拟助手和CCT的评价比年轻人更积极。用户的某些特征，尤其是他们当前的情感状态（即唤醒、内在相关性、目标导向性和焦虑状态），似乎与他们对训练的评价有关。
本研究首次深入了解了年轻人和老年人在CCT期间如何看待虚拟助手。结果表明，只要虚拟助手能够应对不同情况，特别是用户的情绪状态，它可能会对用户的积极性产生有益影响。我们项目的下一步将是对患有轻度认知障碍的患者进行设备评估，并测试其在长期认知训练中的有效性。
