Association France Alzheimer

Diagnostic criteria for apathy in neurocognitive disorders (DCA-NCD) have recently been updated. We investigated whether validated scales measuring apathy severity capture the three dimensions of the DCA-NCD (diminished initiative, diminished interest, diminished emotional expression). Degree of mapping ("not at all", "weakly", or "strongly") between items on two commonly used apathy scales, the Neuropsychiatric Inventory-Clinician (NPI-C) apathy and Apathy Evaluation Scale (AES), with the DCA-NCD overall and its 3 dimensions was evaluated by survey. Survey participants, either experts (n=12, DCA-NCD authors) or scientific community members (n=19), rated mapping for each item and mean scores were calculated. Interrater reliability between expert and scientific community members was assessed using Cohen's kappa. According to experts, 9 of 11 (81.8%) NPI-C apathy items and 6 of 18 (33.3%) AES items mapped strongly onto the DCA-NCD overall. For the scientific community group, 10 of 11 (90.9%) NPI-C apathy items and 7 of 18 (38.8%) AES items mapped strongly onto the DCA-NCD overall. The overall mean mapping scores were higher for the NPI-C apathy compared to the AES for both expert (t (11) =3.13, p=.01) and scientific community (t (17) =3.77, p=.002) groups. There was moderate agreement between the two groups on overall mapping for the NPI-C apathy (kappa= 0.74 (0.57, 1.00)) and AES (kappa= 0.63 (0.35, 1.00)). More NPI-C apathy than AES items mapped strongly and uniquely onto the DCA-NCD and its dimensions. The NPI-C apathy may better capture the DCA-NCD and its dimensions compared with the AES.

Apathy is present in many brain disorders, but it is also prevalent to varying degrees in healthy people. While many tools have been developed to assess levels of apathy in pathology, no standardized measure of apathy in healthy people exists. Therefore, this study aimed to validate the French version of the Apathy Motivation Index (f-AMI). The results of 729 participants were analyzed using an exploratory factorial analysis. Preliminary analyses suggested that the three domains of apathy extracted in the original AMI scale-behavioral activation (BA), social motivation (SM), and emotional sensitivity (ES)-could be found also in the f-AMI. A further exploratory analysis showed that a higher number of factors could be extracted, particularly for women. Specifically, both social and emotional factors could be divided into two sub-factors: (1) social motivation toward strangers or toward an acquaintance and (2) self-directed emotional sensitivity directed toward others. Regarding construct validity, the scores of f-AMI were correlated with the French Dimensional Apathy Scale results. Concerning the divergent validity, emotional sensitivity in apathy is different from depression, anhedonia, and fatigue levels. These results suggest that the f-AMI can be used to assess levels of apathy in healthy adults.

IntroductionThe use of teleconsultations for mental health has drastically increased since 2020 due to the Covid19 pandemic. In the present paper, we aimed to analyze the advantages and disadvantages of teleconsultations for mental health compared to face-to-face consultations, and to provide recommendations in this domain. MethodsThe recommendations were gathered using a Delphi methodology. The expert panel (N = 21) included professionals from the health and ICT domains. They answered questions via two rounds of web surveys, and then discussed the results in a plenary meeting. Some of the questions were also shared with non-experts (N = 104). ResultsBoth the experts and the non-experts with teleconsultation experience reported a general satisfaction concerning teleconsultations. A SWOT analysis revealed several strengths and opportunities of teleconsultations for mental health, but also several weaknesses and threats. The experts provided a set of practical recommendations for the preparation and organization of teleconsultations for mental health. DiscussionTeleconsultations for mental health have the potential to allow access to care for patients in remote and isolated areas. Thus, their use will unlikely be discontinued after the end of the pandemic. In this context, we suggest that the collaboration among clinicians, researchers, and interface designers is crucial to improve usability and user experience for both clinicians and patients. The importance of teaching teleconsultation skills and informing the public on the features of teleconsultations (e.g., data privacy/security) is also highlighted.

Abstract BackgroundMany aspects of language and speech seem affected with increased dementia risk. Recently speech analysis has become mature enough to provide completely automatically extracted fine‐grained features highly sensitive to early cognitive and affective changes.MethodSeveral studies were performed during which over 150 speech samples of patients at different stages (controls, Mild Cognitive Impairment, Dementia) were collected at the clinic as well as remotely (over the phone and video‐conference system). Subsamples of patients with apathy and depression were included. The spoken features extracted from the recordings were compared against data from classical assessment tools and manual annotations.ResultComparison to reference measures show firstly, highly accuracies in demonstrating speech differences based on clinical diagnosis (up to 90%) and secondly, significant correlations between automatically extracted and manually annotated measures (r = 0.9).ConclusionSpeech and language features represent a promising biomarker candidate as they can be automatically and remotely extracted even over the telephone. With the help of advanced machine learning and different computational techniques the most significant markers can be identified as early indicator for screening.

Abstract BackgroundThe presence of neurocognitive disorders (NCD) must be detected at an early stage of the disease progression and monitored by clinicians overtime, in order to provide early individualized interventions. Today, a reliable diagnosis requires a heavy set of neuropsychological tests, often coupled with biomarker evidence. There is growing interest in finding objective, fast to administer, and reliable behavioral markers that could complement classical clinical assessment and help detecting early changes in cognitive performance. Serious games have been proposed as promising tools to screen cognitive deficits in people with NCD [1]. In this study, we investigated the interest of employing a battery of mini‐games developed by CoBTeK lab to distinguish elderly patients with mild NCD from patients without cognitive decline.MethodsIn the context of an ongoing project, we recruited 20 subjects with mild NCD (14 females; age: M=75.5, SD=5.7; MMSE, M=26.1; SD=2.2) and 10 subjects with subjective cognitive decline ‐ SCD (9 females; age: M=71.0, SD=7.6; MMSE, M=29.2, SD=1.2) at the Nice Memory Center. Participants played four mini‐games on a tablet, each game assessing a different cognitive function: selective and sustained attention, episodic memory, inhibitory control, and sensitivity to reward. We collected different data including scores, responses, response times, and videos (focused on hand gestures).ResultsPreliminary data analysis focused on one mini‐game (assessing sensitivity to reward) suggests that participants with mild NCD had an almost significantly lower sensitivity to reward. Once the data analysis is complete for the 4 mini‐games, and the final sample size of 50 participants is reached (by the end of June 2021), we plan to integrate all the collected data into a predictive behavior model compliant with model checking techniques.ConclusionsConverging with previous findings, these very preliminary results suggest that mini‐games could be interesting to differentiate patients with mild NCD from subjects without cognitive impairment. Predictive behavior model based on mini‐games may in the next future help clinicians identify individuals that meet the profile of NCD. Reference: Robert P et al. (2014) Recommendations for the use of Serious Games in people with Alzheimer’s Disease, related disorders and frailty. Front Aging Neurosci. 6:54. doi:10.3389/fnagi.2014.00054

Abstract BackgroundApathy, a reduction in goal‐directed activities in the domains of behavior, cognition, emotion and social interaction, is one of the most common behavioral symptoms in Neurocognitive Disorders (NCD)[1]. Current apathy assessment strongly relies on self‐reports or clinical scales, which are subjective and dependent on the information provided by patients and caregivers. For this reason, growing attention is devoted to defining more objective, measurable and non‐invasive apathy proxies. In the present study we investigated the interest of recording action kinematics in a short reach and grasp protocol[2] for the assessment of apathy social component, characterized by a reduction of the willingness to interact with others.Methods19 subjects with Mild NCD (6M, age=75,7±6,3y, MMSE=26,0±3,0) were recruited at the Nice Memory Center. Based on the Apathy Motivation Index (social motivation subscale[3]), subjects were classified as socially apathetic (N=9) vs non‐apathetic (N=10). SensRing, a novel ring‐shaped wearable sensor[4], was placed on their dominant hand’s index finger. Subjects were asked to reach and grasp a can to place it into a cup (individual condition) and pass it to a partner (social condition). Several parameters were extracted, including movement velocity, acceleration, jerk (representing the smoothness of the movement) and execution time.ResultsNon‐apathetic participants showed a significantly lower peak velocity (p=0,009) and a lower jerk (p=0,038) in the social vs individual condition when moving the can to the final position, suggesting a more careful approach in placing the object in the partner’s hand vs a cup. Non‐apathetic participants showed no significant differences between conditions in any of the extracted parameters.ConclusionPrevious studies showed the interest of recording patients’ level of weekly motor activity for apathy assessment. Here, for the first time, we showed that a 5‐minutes reach and grasp protocol may be able to show differences between socially apathetic and non‐apathetic subjects with Mild NCD, thus providing a tool easily usable in the clinical practice. Future studies with a bigger sample are needed to better characterize these findings. [1] Manera et al., 2019, doi.org/10.1002/gps.5125. [2] Becchio et al., 2008, doi.org/10.1016/j.concog.2007.03.003. [3] Ang et al., 2017, doi:10.1371/journal.pone.0169938. [4] Rovini et al., 2020, EMBC‐2020.

Deux ouvrages viennent de sortir et s’adressent aux aides médico-psychologiques. Ces professionnelles s’occupent soit des personnes âgées, soit des personnes handicapées. Le premier livre (Assistant de soins en gérontologie) est l’œuvre de deux gériatres, les docteurs Jean Pierre Aquino et Benoît Lavallard et d’une psychologue Judith Mollard. Ils ont coordonné les contributions de collaborateurs de diverses disciplines (diététique, musique, économie, psychomotricité, professions sociales), o...