Conversational Engagement as a Means to Delay Alzheimer's Disease Onset

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DESCRIPTION (provided by applicant): Faced with an aging population and a growing number of sufferers of dementia, it is critical to find effective means to delay the onset of dementia, and more generally to find ways to slow the process of cognitive decline. Psychological studies suggest that the task of conversation is highly cognitively stimulating. Conversations require attention, working memory and the organization and control of thought (executive functions), as well as social cognition to understand others' intentions and feelings. We examine whether conversation-based cognitive stimulations will have positive effects on general, and domain-specific cognitive functions among the elderly who currently report relatively low levels of social engagement and interaction (the potentially high risk group for getting AD). Face-to-face communication will be conducted through the use of personal computers, webcams, and user-friendly simple interactive Internet programs (i.e., Skype) to allow participants to have social engagement while staying at their home and also for the cost effective execution of the study. In order to take into account daily conversations that may occur outside of the internet-based conversations, we will utilize a wearable, voice activated digital recorder called the MicroDot Audio Recorder (MAR), which unobtrusively records the amount of time spent talking by the participants. The aims of this pilot study include: Aim 1. We will assess the normative levels of social engagement among persons aged 75 and older, and the types and frequencies of social engagement and other characteristics associated with the likelihood of participating in trials using modern technologies and the proposed prevention trial. We will use the results to assess the generalizability of our subsequent findings. Aim 2. Among those interviewed in Aim 1, we will recruit 80 subjects with Clinical Dementia Rating Scale (CDR) = 0 and 80 subjects with CDR = 0.5 from the lower end of the social engagement frequencies. Each CDR group (CDR = 0 and 0.5) will be represented in the experimental and control sub-groups. The trial group will be exposed to either 4 weeks or 8 weeks of daily conversational sessions with interviewers through Skype. Aim 3. Development of algorithms for automatically extracting spoken language markers (an exploratory study). The results obtained from this pilot study will be used for hypothesis generation, dose/duration determination, power calculations, and refinement of control variables for use in future prevention studies that examine conversation-based cognitive stimulation as a potential protective means against cognitive decline and the incidence of AD among the elderly with limited opportunities of social engagement. PUBLIC HEALTH RELEVANCE: Faced with an aging population and a growing number of people with Alzheimer's Disease (AD), developing a preventive strategy against AD is one of the most important and urgent issues in public health. The proposed study examines conversational engagement as a means to improve cognitive functions among the elderly aged 75 and older with limited opportunities of social engagement. The project is of high public health significance in that few effective, low-cost interventions exist for this vulnerable population.