Unai Diaz-Orueta

Mobile technologies and technological advances in behavioral assessment have found their way in common healthcare practices. However, there are still few studies about videogame-based interventions to support concrete psychological treatments. While the market for self-help mobile apps is continuously increasing, in most cases, they are a mere digitalization of texts contained in self-help books and do not take advantage of the interactive and playful potential of devices on which they are offered. Nevertheless, a number of health games have been developed for children and adults for a variety of therapeutic purposes. The current chapter provides an overview of the state-of-the-art serious games currently available as psychological interventions across popular delivery formats (virtual reality environments, online and PC videogames). Where available, evidence about their efficacy is reported. These serious games have the potential to complement traditional psychological interventions and improve psychological wellbeing for people of all ages.

Progressive introduction of Assistive Technologies in our society, as a result of several years of European funding, has provided many researchers and companies with opportunities to developed new information and communication technologies aimed to overcome the digital divide of those at a greater risk of being left behind, as it can be the case of older people and people with disabilities. The great speed of evolvement of this type of technologies has accelerated the need of adapting the European and country specific legal frameworks in order to ensure the right of access but also the protection of privacy, dignity and integrity of those potential vulnerable users. This chapter addresses the consideration of major ethical principles and the practical implications of these principles when faced with technologies directed to older people in vulnerable conditions such as dementia and in the major domain of their privacy and intimacy, such as their own homes. We present explanatory examples on how these ethical issues can be addressed in the particular case of developing ICTs for older people with dementia at their homes, present examples of good practices performed in the past, and conclude with some remarks that may direct future research in the area.

In recent years, it has been assumed that brain may be trained as a muscle (use-it-or-lose-it hypothesis) so the higher amount of cognitively stimulating activities we are involved at, the better the cognitive status will be when we reach the old age. Though this assumption needs to be properly verified with additional scientific evidence, there has been an increasing number of studies on cognitive intervention (training, stimulation, rehabilitation) that have obtained diverse results with regards to their efficacy in maintaining cognitive function over time and transfer their gains to older people's daily life activities and challenges. The current chapter revises latest years of research on cognitive tests and interventions, and incorporates the added value of the latest developments in computerized and virtual-reality based assessment and training tools, to respectively measure and improve cognitive status in older populations. Moreover, key recommendations on how existing tools could be improved will be provided.

24,83-38,20 points, respectively. About 20% e 46% of the early and moderate individuals, respectively, were under the BBS cutoff. On the AWS, 13,33% and 33,3% of the early and moderate AD were under the cutoff score. From all the individuals, about 16%, 2 from early and 8 from the moderate AD group, were under AWS and BBS cutoff scores.Conclusions:Gait apraxia and balance disorders might be presented in AD individuals, and seems to be more frequent in the moderate stage. Gait apraxia can be misinterpreted as simply balance disorders. Gait apraxia assessment, such as balance, requires high subjectivity dosages. Gait apraxia diagnosis would be easier if the sensibility index of the AWS could be improved. Despite this is just a conjecture, it seems that frontal involvement has great relation to gait apraxia presence and severity.

This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contac

Background: Dementia research prioritisation allows for the systematic allocation of investment in dementia research by governments, funding agencies and the private sector. There is currently a lack of information available in Ireland regarding priority areas for dementia research. To address this gap, a dementia research prioritisation exercise was undertaken, consisting of an online survey of professionals in the dementia field and workshops for people living with dementia and family carers. Methods: (1) An anonymous online survey of professionals, based on an existing WHO global survey: The global survey was adapted to an Irish context and participants were asked to score 65 thematic research avenues under 5 criteria; (2) A mixed-methods exercise for people living with dementia and family carers: This involved two facilitated workshops where participants voted on the research themes they felt were important to them and should be addressed through research. Results: Eight of the ...

In the past two decades, the traditional nosology of attention-deficit/hyperactivity disorder (ADHD) has been criticized for having insufficient discriminant validity. In line with current trends, in the present study, we combined a data-driven approach with the advantages of virtual reality aiming to identify novel behavioral profiles of ADHD based on ecological and performance-based measures of inattention, impulsivity, and hyperactivity. One hundred and ten Spanish-speaking participants (6–16 years) with ADHD (medication-naïve, n = 57) and typically developing participants (n = 53) completed AULA, a continuous performance test embedded in virtual reality. We performed hybrid hierarchical k-means clustering methods over the whole sample on the normalized t-scores of AULA main indices. A five-cluster structure was the most optimal solution. We did not replicate ADHD subtypes. Instead, we identified two clusters sharing clinical scores on attention indices, susceptibility to distrac...

In the past two decades, the traditional subtypes of Attention-Deficit/Hyperactivity Disorder (ADHD) have been criticized for having substantial variability in symptom manifestation, clinical course, and treatment response. In the present study, we questioned whether an objective and ecological assessment of attentional control, impulsivity, and hyperactivity, the core symptom domains on which ADHD diagnosis is currently based, could yield similar phenotypic profiles to those defined by DSM-5 criteria. 110 Spanish-speaking children and adolescents (6–16 years) with ADHD (n = 57) and typically developing (n = 53) completed AULA, a continuous performance test embedded in virtual reality. We found that ADHD-Combined and ADHD-Inattentive subtypes exhibited the same performance profile. Then, we applied hybrid hierarchical k-means clustering algorithms to AULA’s main outcome measures. A five-cluster structure was the most optimal solution based on several validation indices. We identifie...

Supplemental material, Supplemental_Tables_1,_2_and_3_correctedclean for Health Related Quality of Life and Cognitive Decline in Older Populations: Preliminary Results From NeuroDemeNPsia Study by Iban Onandia-Hinchado and Unai Diaz-Orueta in Journal of Applied Gerontology

Attention is one of the most basic cognitive processes and is a prerequisite for the use of more complex functions, since it is not possible to evaluate perception or memory processes without keeping in mind attention issues (Amador, Forns, & Kirchner, 2006). The ability to maintain an appropriate level of attention is basic for education and learning, especially during childhood and school age. With the aim of studying attention separately from other cognitive functions, the so-called continuous performance tests (CPT) were created. The first series of CPTs were developed by Rosvold, Mirsky, Sarason, Bransome, and Beck (1956) to study vigilance in adults with acquired brain injury (Riccio, Reynolds, & Lowe, 2001), more specifically, persons with seizures (Amador, Forns, & Kirchner, 2006). Nowadays, CPTs are still one of the most widely used measures for the assessment of attention and processing speed. Briefly, it can be said that a CPT is a group of paradigms to evaluate attention...

A proliferation of tests exists for the assessment of auditory-verbal memory processes. However, from a clinical practice perspective, the situation is less clear when it comes to the ready availability of reliable and valid tests for the evaluation of visual/visuo-spatial memory processes. While, at face value, there appear to be a wide range of available tests of visual/visuo-spatial memory, utilizing different types of materials and assessment strategies, a number of criticisms have been, and arguably should be, leveled at the majority of these tests. The criticisms that have been directed toward what are typically considered to be visual/visuo-spatial memory tests, such as (1) the potential for verbal mediation, (2) over-abstraction of stimuli, (3) the requirement of a drawing response, and (4) the lack of sensitivity to unilateral brain lesions, mean that, in reality, the number of readily available valid tests of visual/visuo-spatial memory is, at best, limited. This article o...

e-Coaching approaches have recently received a lot of attention, as technology led healthy ageing solutions depend on empowering older people’s motivation. While the beneficial impact of physical activity for older populations is indisputable, this work aims at presenting first designing considerations to be followed if increased adherence to physical activity through an e-coaching system were to be aimed for older adults. The work plan kicks-off on the basis of an existing exergame platform, especially designed and widely tested for older adults (webFitForAll) which is forced to align with notion of behavior change techniques (BCTs) that have been developed for physical activity enhancement. New advances in micro-projector technologies provide extra opportunities for tweaking the accessibility burden while augmenting and blending the real with the coaching environment. Quite reasonably, these are not easy tasks to follow and success depends much on multi-disciplinary approaches encompassing new ideas from co-creation and co-design with the actual users.

Attention-deficit/hyperactivity disorder (ADHD) is a chronic mental health disorder with distinct behavioral manifestations in childhood, adolescence, and adulthood. Neuropsychological evaluation has increasingly become part of the protocol to the understanding and appropriate diagnosis of this pathology, but lack of ecological validity of ordinary psycho-educational batteries has open the door to other type of tools, such as computerized and Virtual Reality tests. With the aim to overcome the absence of ecological validity of many computerized tests of attention, AULA test (a VR environment which simulates a real classroom environment and demands the patient to complete different tasks presented on both a visual and auditory basis) was developed. The current study describes the main features of the AULA test, and analyzes the performance of the Spanish normative sample of 1272 children from 6 to 16 years old from the perspective of the influence of ecological distractors present in...

“In geriatric mental health, then, we are detectives trying to gather as many clues as possible to help us crack these complex cases.” The world population continues to age and with this demographic shift comes an accompanying growth in the number of older adults with mental health needs. This quote from the authors, Laura Dunn, MD, and Erin Cassidy-Eagle, PhD, reveals that meeting the mental health needs of older adults is anything but simple and requires specialized skills and tools to assess and treat this population. The goal of this book is to disseminate practical tools, resources, and information to work with older adults in a way that is accessible to a broader audience of care and service providers, distinguishing it from other volumes with a more technical focus and narrowed to physician and mental health practitioners. The book walks through chapters with a very defined structure of presenting a clinical case at the beginning without providing all the clues or outcomes, requiring the reader to assume the role of “detective” as the case unfolds. The clinical presentation starts with a chief complaint, followed by a case vignette and then the main relevant information around the topic of that particular chapter. Then, the case presented initially is later reintroduced with a new perspective based on all the information learned through the chapter. Finally, the reader is given key points about the most relevant aspects of the chapter, as well as resources that can be found both in the community and online to seek assistance for the conditions discussed. Topics covered in this book include, for example, depression, anxiety, pain, sleep disorders, bipolar disorder, post-traumatic stress disorder, neurocognitive issues (e.g., dementia), grief, and special populations (e.g., LGBT) of older adults. In this review, I will focus on several chapters that are representative of the overall book rather than walk through each chapter. I conclude with recommendations for readership and use in academic settings. Chapter 4 covers the topic of anxiety disorders in later life. As with other chapters, the authors present an intriguing case study. This example is followed by a discussion of treatment using a unique commentary section which provides the perspective of the treatment team. This structure allows the reader to take part and gain insight into the actual discussions held within the patient’s treatment team and significantly increases the reader’s engagement and involvement. After a first part focused on symptoms and diagnostic criteria, the chapter enters into pharmacological and psychoeducational treatments in a very detailed way and provides a comprehensive introduction to the structure of a treatment agreement between the clinician and the patient. The authors provide specific templates on how to develop this type of agreement and pay special attention to the ways that the clinician may communicate with the patient with anxiety in a way that is unusual to find in clinical literature. In other words, while you can normally read a lot about “what” to do, this chapter focuses on “how” to do it. Chapter 6, another representative chapter, focuses on pain and the underlying psychological factors that affect the expression of pain in older adults. There is an extensive section on differential diagnosis of chronic pain from other conditions and the authors encourage readers to consider additional factors that may affect the expression of pain. While the authors appropriately discuss pharmacological treatment for pain, they also encourage readers to escape from the trap of a pure biomedical model when dealing with older adults with pain symptoms. As the authors state, “Patients receive suboptimal care and have suboptimal pain treatment outcomes when psychological factors are not addressed.” The remainder of the chapter offers detailed clinical guidance and tips on how to treat pain better, assessment and referral tips for older adults with pain (i.e., which conditions should be screened when an older adult refers to pain), and suggestions on how to enhance patients’ receptivity for psychological treatment of pain. The chapter ends with a brief mention of evidence-based treatments and references and links for reader follow-up. Chapters 16 and 17 depart from the earlier structure of the book and focus on inpatient settings, such as intensive care units. After a precise account of the steps to follow for an appropriate evaluation and differential diagnosis in inpatient settings, there is a detailed description of contributing factors 970501 JAGXXX10.1177/0733464820970501Journal of Applied GerontologyBook Review book-review2020

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition characterised by the core symptoms of inattention, impulsivity and hyperactivity. Similar to many other neuropsychiatric conditions, ADHD is associated with very high levels of sleep disturbance. However, it is not clear whether such sleep disturbances are precursors to, or symptoms of, ADHD. Neither is it clear through which mechanisms sleep and ADHD are linked. One possible link is via modulation of circadian rhythms. In this chapter we overview the evidence that ADHD is associated with alterations in circadian processes, manifesting as later chronotype and delayed sleep phase in ADHD, and examine some mechanisms that may lead to such changes. We also interrogate how the circadian clock may be a substrate for therapeutic intervention in ADHD (chronotherapy) and highlight important new questions to be addressed to move the field forward.

The linear regression-based Reliable Change Index (RCI) is widely used to identify memory impairments through longitudinal assessment. However, the minimum sample size required for estimates to be reliable has never been specified. Using the Alzheimer’s Disease Neuroimaging Initiative data as true parameters, we run simulations for samples of size 10 to 1000 and analyzed the percentage of times the estimates are significant, their coverage rate, and the accuracy of the models including both the True Positive Rate (TPR) and the True Negative Rate (TNR). We compared the linear RCI with a logistic RCI for discrete, bounded scores. We found that the logistic RCI is more accurate than the linear RCI overall, with the linear RCI approximating the logistic RCI for samples of size 200 or greater. We provide an R code for researchers and clinicians to calculate the logistic RCI with samples smaller than 200.

A detailed neuropsychological assessment plays an important role in the diagnostic process of Mild Cognitive Impairment (MCI). However, available brief cognitive screening tests for this clinical population are administered and interpreted based mainly, or exclusively, on total achievement scores. This score-based approach can lead to erroneous clinical interpretations unless we also pay attention to the test taking behavior or to the type of errors committed during test performance. The goal of the current study is to perform a rapid review of the literature regarding cognitive screening tools for dementia in primary and secondary care; this will include revisiting previously published systematic reviews on screening tools for dementia, extensive database search, and analysis of individual references cited in selected studies. A subset of representative screening tools for dementia was identified that covers as many cognitive functions as possible. How these screening tools overlap...

Lisdexanfetamine (LDX) is the drug for attention deficit hyperactivity disorder (ADHD) undergoing the largest research volume in the latest years. However, no studies certify its usefulness for the improvement of cognitive functioning in ADHD. To evaluate the efficacy of LDX in the behavioral and cognitive improvement of a group of patients with ADHD. Such efficacy was measured by means of the administration of AULA Nesplora virtual reality test before the prescription of pharmacological treatment and right after the treatment with LDX. The sample comprised 85 patients between 6 and 16 years, with clinical diagnosis of ADHD, who attended treatment in a neuropediatrics consultation. All patients started pharmacological treatment with the proper dose of LDX after the clinical interview and the first administration of AULA test. After an average treatment of 7.5 months, AULA was administered again and the treatment progress based on cognitive and motor symptomatology was assessed. Resu...

Supplemental material, sj-pdf-1-jad-10.1177_1087054720978556 for A Systematic Review of Sleep and Circadian Rhythms in Children with Attention Deficit Hyperactivity Disorder by Upasana Bondopadhyay, Unai Diaz-Orueta and Andrew N. Coogan in Journal of Attention Disorders

Our work exhibits how previous projects on the Active and Healthy Ageing field have advanced to the conception of CAPTAIN, a radically new approach towards increased end-user acceptance. The goal is to create intuitive technology that does not require specific skills for interaction and blends in with real life. CAPTAIN will be co-designed by all types of stakeholders, including older adults, involved in all stages, from the initial design to delivery of the final system.

This work demonstrates the process of mapping real participants from the co-creation session in the user personas. The personas development that were used in co-creation sessions with older adults is presented. This paper provides also insights into how the ongoing user acceptance evaluation research has created a feedback loop into the development and enhancement of personas. The feedback collected improved the real users versus persona distribution while at the same time could provide early enough insights for the market research and drive the exploitation map.

The virtual school environment has been developed and validated by the Computational Neuropsychology and Simulation (CNS) Laboratory of Dr. Thomas Parsons. The overarching goal of the virtual school project is to provide neuropsychological, affective, and social cognitive assessments that are more meaningful for the lives of children. These previously developed and validated virtual reality (VR) simulations of various contexts within the school environment (e.g., classroom, hallway, playground) can be combined and harnessed to gain ecologically valid assessments of children in real-world situations. The virtual school environment generates synthetic surroundings, including a virtual classroom, hallway, and playground via a 360-degree immersive experience. Furthermore, the computational design and administration of the virtual school environment platform allows for simultaneous recording of the child’s behavioral and physiological responses. Virtual environments can be used to offer ...

... The strength of this notation relies on its expressive power, and on its easy-to-use graphical syntax. ... By using this mapping when the user inserts the channel value in his user interface, the Activity Management assigns that value to the proper step input slot. ... 3] Convention on the ...

... los Pinos, 27-bajo, 20018 Donostia-San Sebastián, Spain {udiaz,ilaskibar,cbuiza}@fmatia.net 2 University of Warwick, WMG, Internation Digital Laboratory, Coventry CV4 7AL, UK {S.Badiyani,Hardik.Raja,Vinesh.Raja}@warwick.ac ... 2 User Centered Design and Virtual Personas ...

... Gorka Epelde, Visual Interaction Communication Technologies, Paseo Mikeletegi, Donostia-San Sebastian, Spain. Xabier Valencia, Visual Interaction Communication Technologies, Paseo Mikeletegi, Donostia-San Sebastian, Spain. 2011 Article. Bibliometrics. ...

ABSTRACT The complexity of new information technologies (IT) may limit the access of elderly people to the information society, exacerbating what is known as “the digital divide,” as they appear to be too challenging for elderly citizens regardless of the integrity of their cognitive status. This study is an attempt to clarify how some cognitive functions (such as attention or verbal memory) may determine the interaction of cognitively impaired elderly people with technology. Twenty participants ranging from mild cognitive impairment to moderate Alzheimer’s disease were assessed by means of a neuropsychological and functional battery and were asked to follow simple commands from an avatar appearing on a TV by means of a remote control, such as asking the participant to confirm their presence or to respond Yes/No to a proposal to see a TV program. The number of correct answers and command repetitions required for the user to respond were registered. The results show that participants with a better cognitive and functional state in specific tests show a significantly better performance in the TV task. The derived conclusion is that neuropsychological assessment may be used as a useful complementary tool for assistive technology developers in the adaptation of IT to the elderly with different cognitive and functional profiles. Further studies with larger samples are required to determine to what extent cognitive functions can actually predict older users’ interaction with technology.

One of the challenges that Ambient Intelligent (AmI) faces is the provision of a usable interaction concept to its users, especially for those with less technical background. In this paper, we describe a new approach to integrate interactive services provided by an AmI environment with the television set, which is one of the most used interaction client in the home

This study presents a systematic review on existing cognitive screening tools for mild cognitive impairment and dementia in populations with low education and literacy levels. Cochrane Library, PubMed and LILACS databases were examined for studies including adults aged 50 years old or older with low educational level. 61 articles were included. Despite its frequent use, studies on Mini-Mental State Examination (MMSE) revealed that educational level biased the score obtained, regardless of other factors. Separately, the Informant Questionnaire on Cognitive Decline in the Elderly, the Fototest, or the Eurotest, appear to minimize the effect of education and literacy. MMSE is unreliable for individuals with low literacy. Tasks involving reading, writing, arithmetics, drawing, praxis, visuospatial, and visuoconstructive skills have a greater educational bias than naming, orientation, or memory. An adequate determination of educational level and validation of instruments in populations w...

Attention-deficit/hyperactivity disorder (ADHD) is a chronic mental health disorder with distinct behavioral manifestations in childhood, adolescence, and adulthood. Neuropsychological evaluation has increasingly become part of the protocol to the understanding and appropriate diagnosis of this pathology, but lack of ecological validity of ordinary psycho-educational batteries has open the door to other type of tools, such as computerized and Virtual Reality tests. With the aim to overcome the absence of ecological validity of many computerized tests of attention, AULA test (a VR environment which simulates a real classroom environment and demands the patient to complete different tasks presented on both a visual and auditory basis) was developed. The current study describes the main features of the AULA test, and analyzes the performance of the Spanish normative sample of 1272 children from 6 to 16 years old from the perspective of the influence of ecological distractors present in...

The human memory is a complex cognitive system whose close relationship with executive functions implies that, in many occasions, a mnemonic deficit comprises difficulties to operate with correctly stored contents. Traditional memory tests, more focused in the information storage than in its processing, may be poorly sensitive both to subjects' daily life functioning and to changes originated by rehabilitation programs. In memory assessment, there is plenty evidence with regards to the need of improving it by means of tests which offer a higher ecological validity, with information that may be presented in various sensorial modalities and produced in a simultaneous way. Virtual reality reproduces three-dimensional environments with which the patient interacts in a dynamic way, with a sense of immersion in the environment similar to the presence and exposure to a real environment, and in which presentation of such stimuli, distractors and other variables may be systematically con...