Papers by Alexandra Konig
Rapid relaxation installations in order to reduce stress appear more and more in public or work p... more Rapid relaxation installations in order to reduce stress appear more and more in public or work places. However, the effects of such devices on physiological and psychological parameters have not been scientifically tested yet. This pilot study (N=40) evaluates the variations of vocal speech and facial emotions parameters in 3-minute videos of participant recorded just before and after relaxation, on four different groups, three of them using a different rapid (15 minutes) sensorial immersion relaxation devices and a control group using no device. Vocal speech parameters included sound duration, pause mean duration, sound duration ratio, mean vocal frequency (F0), standard deviation of F0, minimum and maximum of F0, jitter and shimmer. Facial emotion analysis included neutral, happy, sad, surprised, angry, disgusted, scared, contempt, valence and arousal. The objective of this study is to evaluate different parameters of the automated vocal and facial emotions analysis that could be...
2017 IEEE International Conference on Data Mining Workshops (ICDMW), 2017
The standard dementia screening tool Mini Mental State Examination (MMSE) and the standard dement... more The standard dementia screening tool Mini Mental State Examination (MMSE) and the standard dementia staging tool Clinical Dementia Rating Scale (CDR) are prominent methods for answering questions whether a person might have dementia and about the dementia severity respectively. These methods are time consuming and require well-educated personnel to administer. Conversely, cognitive tests, such as the Semantic Verbal Fluency (SVF), demand little time. With this as a starting point, we investigate the relation between SVF results and MMSE/CDR-SOB scores. We use regression models to predict scores based on persons' SVF performance. Over a set of 179 patients with different degree of dementia, we achieve a mean absolute error of of 2.2 for MMSE (range 0-30) and 1.7 for CDR-SOB (range 0-18). True and predicted scores agree with a Cohen's κ of 0.76 for MMSE and 0.52 for CDR-SOB. We conclude that our approach has potential to serve as a cheap dementia screening, possibly even in non-clinical settings.
Background: One of the key clinical features of Alzheimer's disease (AD) is impairment in daily f... more Background: One of the key clinical features of Alzheimer's disease (AD) is impairment in daily functioning. Patients with mild cognitive impairment (MCI) also commonly have mild problems performing complex tasks. Information and communication technology (ICT), particularly techniques involving imaging and video processing, is of interest in order to improve assessment. The overall aim of this study is to demonstrate that it is possible using a video monitoring system to obtain a quantifiable assessment of instrumental activities of daily living (IADLs) in AD and in MCI. Methods: The aim of the study is to propose a daily activity scenario (DAS) score that detects functional impairment using ICTs in AD and MCI compared with normal control group (NC). Sixty-four participants over 65 years old were included: 16 AD matched with 10 NC for protocol 1 (P1) and 19 MCI matched with 19 NC for protocol 2 (P2). Each participant was asked to undertake a set of daily tasks in the setting of a "smart home" equipped with two video cameras and everyday objects for use in activities of daily living (8 IADLs for P1 and 11 for P2, plus 4 temporal execution constraints). The DAS score was then computed from quantitative and qualitative parameters collected from video recordings. Results: In P1, the DAS score differentiated AD (DAS AD,P1 = 0.47, 95% confidence interval [CI] 0.38-0.56) from NC (DAS NC,P1 = 0.71, 95% CI 0.68-0.74). In P2, the DAS score differentiated MCI (DAS MCI,P2 = 0.11, 95% CI 0.05-0.16) and NC (DAS NC,P2 = 0.36, 95% CI 0.26-0.45). Conclusion: In conclusion, this study outlines the interest of a novel tool coming from the ICT world for the assessment of functional impairment in AD and MCI. The derived DAS scores provide a pragmatic, ecological, objective measurement which may improve the prediction of future dementia, be used as an outcome measurement in clinical trials and lead to earlier therapeutic intervention.
Detection of activities of daily living impairment in Alzheimer’s disease and mild cognitive impa... more Detection of activities of daily living impairment in Alzheimer’s disease and mild cognitive impairment using information and communication technology Guillaume Sacco1–3
Gerontechnology, 2016
15.s.875.00 Purpose: world population is aging and the number of seniors in need of care is expec... more 15.s.875.00 Purpose: world population is aging and the number of seniors in need of care is expected to surpass the number of young people capable of providing it. It is then quintessential to develop instruments to support doctors at the task of diagnosing and monitoring the health status of seniors 1-3. Methods to assess autonomy and functional abilities of seniors currently rely on rating scales 4. The subjective character of these scales and their dependence on human observations tend to jeopardize the timely diagnosis of deteriorations in cognitive health. We propose a probabilistic model (PM) to objectively classify a person's performance in executive functions into three classes of cognitive status: Alzheimer's disease (AD), mild cognitive impairment (MCI) and healthy control (HC); and into different levels of autonomy: good, intermediate or poor. Material & Methods: the proposed PM relies on Naive Bayes model for classification and takes as input automatically extrac...
The Semantic Verbal Fluency Task is a common neuropsychological assessment for cognitive disorder... more The Semantic Verbal Fluency Task is a common neuropsychological assessment for cognitive disorders: patients are prompted to name as many words from a semantic category as possible in a time interval; the count of correctly named concepts is assessed. Patients often organise their retrieval around semantically related clusters. The definition of clusters is usually based on handmade taxonomies and the patient's performance is manually evaluated. In order to overcome limitations of such an approach, we propose a statistical method using distributional semantics. Based on transcribed speech samples from 100 French elderly, 53 diagnosed with Mild Cognitive Impairment and 47 healthy, we used distributional semantic models to cluster words in each sample and compare performance with a taxonomic baseline approach in a realistic classification task. The distributional models outperform the baseline. Comparing different linguistic corpora as basis for the models, our results indicate th...
Interspeech 2014, 2014
We provide evidence to the potential use of simple spoken tasks for automatic assessment of very ... more We provide evidence to the potential use of simple spoken tasks for automatic assessment of very early dementia. Timely detection of dementia is required for effective psychological treatment and to enable patients to participate in new drug therapy research. The technology enables automatic, cheap, remote and wide-scale screening of dementia, typically a costly and complex procedure. It can aid clinicians in the diagnosis of very early dementia, as well as assessing the disease progression. We describe the spoken tasks, and their respective languageindependent vocal feature extraction, followed by classification accuracy evaluation. We use recordings from over 60 persons, diagnosed as healthy-control (CTRL) / mildcognitive-impairment (MCI) / early-stage-Alzheimer-disease and early-mixed-dementia (AD). We present a new data regularization technique to overcome data sparseness due to the limited data set size. Next, we present a comprehensive statistical analysis, showing that the suggested classifier generalizes, and revealing the role and the statistical importance of the different spoken tasks and their respective vocal features. We demonstrate classification accuracy of about 80% for CTRL vs. MCI and MCI vs. AD, and 87% for CTRL vs. AD, all shown to generalize. This provides an evidence for potential use for automatic detection of very early dementia.
Proceedings of the Seventh Workshop on Computational Linguistics and Clinical Psychology: Improving Access, 2021
Effective management of dementia hinges on timely detection and precise diagnosis of the underlyi... more Effective management of dementia hinges on timely detection and precise diagnosis of the underlying cause of the syndrome at an early mild cognitive impairment (MCI) stage. Verbal fluency tasks are among the most often applied tests for early dementia detection due to their efficiency and ease of use. In these tasks, participants are asked to produce as many words as possible belonging to either a semantic category (SVF task) or a phonemic category (PVF task). Even though both SVF and PVF share neurocognitive function profiles, the PVF is typically believed to be less sensitive to measure MCI-related cognitive impairment and recent research on finegrained automatic evaluation of VF tasks has mainly focused on the SVF. Contrary to this belief, we show that by applying state-of-theart semantic and phonemic distance metrics in automatic analysis of PVF word productions, in-depth conclusions about production strategy of MCI patients are possible. Our results reveal a dissociation between semantically-and phonemically-guided search processes in the PVF. Specifically, we show that subjects with MCI rely less on semantic-and more on phonemic processes to guide their word production as compared to healthy controls (HC). We further show that semantic similarity-based features improve automatic MCI versus HC classification by 29% over previous approaches for the PVF. As such, these results point towards the yet underexplored utility of the PVF for indepth assessment of cognition in MCI.
The American Journal of Geriatric Psychiatry, 2019
Highlights The present paper aimed at collecting recommendations on non-pharmacological treatme... more Highlights The present paper aimed at collecting recommendations on non-pharmacological treatment (NPT) for apathy and on the role of new Information and Communication Technologies (ICT) in this domain. Based on the experts' opinion, NPT should be tailored to deficits, clinical objectives, and preferences of each patient. ICT may help to improve treatment personalization, increase motivation, and aid remote treatment delivery. Further structured research is needed to determine NTP efficacy.
Dementia and Geriatric Cognitive Disorders, 2018
Background: Semantic verbal fluency (SVF) tests are routinely used in screening for mild cognitiv... more Background: Semantic verbal fluency (SVF) tests are routinely used in screening for mild cognitive impairment (MCI). In this task, participants name as many items as possible of a semantic category under a time constraint. Clinicians measure task performance manually by summing the number of correct words and errors. More fine-grained variables add valuable information to clinical assessment, but are time-consuming. Therefore, the aim of this study is to investigate whether automatic analysis of the SVF could provide these as accurate as manual and thus, support qualitative screening of neurocognitive impairment. Methods: SVF data were collected from 95 older people with MCI (n = 47), Alzheimer’s or related dementias (ADRD; n = 24), and healthy controls (HC; n = 24). All data were annotated manually and automatically with clusters and switches. The obtained metrics were validated using a classifier to distinguish HC, MCI, and ADRD. Results: Automatically extracted clusters and switc...
Sensors (Basel, Switzerland), Jan 29, 2017
Visual activity recognition plays a fundamental role in several research fields as a way to extra... more Visual activity recognition plays a fundamental role in several research fields as a way to extract semantic meaning of images and videos. Prior work has mostly focused on classification tasks, where a label is given for a video clip. However, real life scenarios require a method to browse a continuous video flow, automatically identify relevant temporal segments and classify them accordingly to target activities. This paper proposes a knowledge-driven event recognition framework to address this problem. The novelty of the method lies in the combination of a constraint-based ontology language for event modeling with robust algorithms to detect, track and re-identify people using color-depth sensing (Kinect(®) sensor). This combination enables to model and recognize longer and more complex events and to incorporate domain knowledge and 3D information into the same models. Moreover, the ontology-driven approach enables human understanding of system decisions and facilitates knowledge ...
Aging clinical and experimental research, Jan 27, 2017
The present study explores the differences in gait parameters in elderly subjects with or without... more The present study explores the differences in gait parameters in elderly subjects with or without cognitive impairment measured by means of ambulatory actigraphy while performing a single and a dual task. Sixty-nine participants of which 23 individuals were diagnosed with Alzheimer's disease (AD), 24 individuals with mild cognitive impairment (MCI), and 22 healthy controls performed a single and dual walking task while wearing a wrist-worn accelerometer. Objective measures of gait features such as walking speed, cadence (i.e., number of steps per minute), and step variance (i.e., variance in time between two consecutive steps) were derived and analyzed. While differences in several gait parameters, namely walking speed, were found between MCI and AD patients, no differences between healthy elderly and MCI patients were found. Walking speed seems to be a gait-related feature that differs significantly between MCI and AD patients and thus could be used as an additional measurement...
Soins Gérontologie, 2016
Neuropsychiatric disorders and technological solutions. Innovative new tools today allow better c... more Neuropsychiatric disorders and technological solutions. Innovative new tools today allow better clinical evaluation. Indeed, new information and communication technology is particularly interesting for the screening, monitoring and management of neuropsychiatric disorders of the elderly. A personalised approach to patients can further enhance their adherence and involvement.
Journal of Alzheimer's disease : JAD, Jan 30, 2016
The use of Serious exerGames (SeG) as enriched environments (EE), which promotes cognitive simula... more The use of Serious exerGames (SeG) as enriched environments (EE), which promotes cognitive simulation with physical activity in a positive emotional context, has been proposed to represent a powerful method to slow down the decline due to neurodegenerative diseases (ND), such as Alzheimer's disease (AD). However, so far, no SeG targeting EE has been tested in ND subjects. This study aimed at evaluating the usability and short-term training effects of X-Torp, an action SeG designed for elderly ND subjects with mild cognitive impairment (MCI) and AD. X-Torp is a SeG played using the Microsoft® Kinect™. 10 ND subjects and 8 healthy elderly controls (HEC) were enrolled in a 1-month program with three training sessions per week. Usability was evaluated through game time, game performance, the aerobic intensity level reached, perceived emotions, and perceived usability. All participants successfully completed the training program. ND subjects played less and had a lower game performan...
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, 2015
Background: To evaluate the interest of using automatic speech analyses for the assessment of mil... more Background: To evaluate the interest of using automatic speech analyses for the assessment of mild cognitive impairment (MCI) and early-stage Alzheimer's disease (AD). Methods: Healthy elderly control (HC) subjects and patients with MCI or AD were recorded while performing several short cognitive vocal tasks. The voice recordings were processed, and the first vocal markers were extracted using speech signal processing techniques. Second, the vocal markers were tested to assess their "power" to distinguish among HC, MCI, and AD. The second step included training automatic classifiers for detecting MCI and AD, using machine learning methods and testing the detection accuracy. Results: The classification accuracy of automatic audio analyses were as follows: between HCs and those with MCI, 79% 6 5%; between HCs and those with AD, 87% 6 3%; and between those with MCI and those with AD, 80% 6 5%, demonstrating its assessment utility. Conclusion: Automatic speech analyses could be an additional objective assessment tool for elderly with cognitive decline.
Alzheimer's & Dementia, 2014
2013 10th IEEE International Conference on Advanced Video and Signal Based Surveillance, 2013
Population aging has been motivating academic research and industry to develop technologies for t... more Population aging has been motivating academic research and industry to develop technologies for the improvement of older people's quality of life, medical diagnosis, and support on frailty cases. Most of available research prototypes for older people monitoring focus on fall detection or gait analysis and rely on wearable, environmental, or video sensors. We present an evaluation of a research prototype of a video monitoring system for event recognition of older people. The prototype accuracy is evaluated for the recognition of physical tasks (e.g., Up and Go test) and instrumental activities of daily living (e.g., watching TV, writing a check) of participants of a clinical protocol for Alzheimer's disease study (29 participants). The prototype uses as input a 2D RGB camera, and its performance is compared to the use of a RGB-D camera. The experimentation results show the proposed approach has a competitive performance to the use of a RGB-D camera, even outperforming it on event recognition precision. The use of a 2D-camera is advantageous, as the camera field of view can be much larger and cover an entire room where at least a couple of RGB-D cameras would be necessary.
Journal of Alzheimer's disease : JAD, 2015
Over the last few years, the use of new technologies for the support of elderly people and in par... more Over the last few years, the use of new technologies for the support of elderly people and in particular dementia patients received increasing interest. We investigated the use of a video monitoring system for automatic event recognition for the assessment of instrumental activities of daily living (IADL) in dementia patients. Participants (19 healthy subjects (HC) and 19 mild cognitive impairment (MCI) patients) had to carry out a standardized scenario consisting of several IADLs such as making a phone call while they were recorded by 2D video cameras. After the recording session, data was processed by a platform of video signal analysis in order to extract kinematic parameters detecting activities undertaken by the participant. We compared our automated activity quality prediction as well as cognitive health prediction with direct observation annotation and neuropsychological assessment scores. With a sensitivity of 85.31% and a precision of 75.90%, the overall activities were cor...
Frontiers in Aging Neuroscience, 2014
Alzheimer's disease and other related disorders (ADRD) represent a major challenge for health car... more Alzheimer's disease and other related disorders (ADRD) represent a major challenge for health care systems within the aging population. It is therefore important to develop better instruments to assess the disease severity and progression, as well as to improve its treatment, stimulation, and rehabilitation. This is the underlying idea for the development of Serious Games (SG). These are digital applications specially adapted for purposes other than entertaining; such as rehabilitation, training and education. Recently, there has been an increase of interest in the use of SG targeting patients with ADRD. However, this field is completely uncharted, and the clinical, ethical, economic and research impact of the employment of SG in these target populations has never been systematically addressed. The aim of this paper is to systematically analyze the Strengths, Weaknesses, Opportunities, and Threats (SWOT) of employing SG with patients with ADRD in order to provide practical recommendations for the development and use of SG in these populations. These analyses and recommendations were gathered, commented on and validated during a 2-round workshop in the context of the 2013 Clinical Trial of Alzheimer's Disease (CTAD) conference, and endorsed by stakeholders in the field. The results revealed that SG may offer very useful tools for professionals involved in the care of patients suffering from ADRD. However, more interdisciplinary work should be done in order to create SG specifically targeting these populations. Furthermore, in order to acquire more academic and professional credibility and acceptance, it will be necessary to invest more in research targeting efficacy and feasibility. Finally, the emerging ethical challenges should be considered a priority.
Clinical Interventions in Aging, 2012
Background: One of the key clinical features of Alzheimer's disease (AD) is impairment in daily f... more Background: One of the key clinical features of Alzheimer's disease (AD) is impairment in daily functioning. Patients with mild cognitive impairment (MCI) also commonly have mild problems performing complex tasks. Information and communication technology (ICT), particularly techniques involving imaging and video processing, is of interest in order to improve assessment. The overall aim of this study is to demonstrate that it is possible using a video monitoring system to obtain a quantifiable assessment of instrumental activities of daily living (IADLs) in AD and in MCI. Methods: The aim of the study is to propose a daily activity scenario (DAS) score that detects functional impairment using ICTs in AD and MCI compared with normal control group (NC). Sixty-four participants over 65 years old were included: 16 AD matched with 10 NC for protocol 1 (P1) and 19 MCI matched with 19 NC for protocol 2 (P2). Each participant was asked to undertake a set of daily tasks in the setting of a "smart home" equipped with two video cameras and everyday objects for use in activities of daily living (8 IADLs for P1 and 11 for P2, plus 4 temporal execution constraints). The DAS score was then computed from quantitative and qualitative parameters collected from video recordings. Results: In P1, the DAS score differentiated AD (DAS AD,P1 = 0.47, 95% confidence interval [CI] 0.38-0.56) from NC (DAS NC,P1 = 0.71, 95% CI 0.68-0.74). In P2, the DAS score differentiated MCI (DAS MCI,P2 = 0.11, 95% CI 0.05-0.16) and NC (DAS NC,P2 = 0.36, 95% CI 0.26-0.45). Conclusion: In conclusion, this study outlines the interest of a novel tool coming from the ICT world for the assessment of functional impairment in AD and MCI. The derived DAS scores provide a pragmatic, ecological, objective measurement which may improve the prediction of future dementia, be used as an outcome measurement in clinical trials and lead to earlier therapeutic intervention.
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Papers by Alexandra Konig