A facial expression-based personalization engine (FPE) for monitoring and modulating real-time effective engagement in cognitive training in older adults at risk for AD/ADRD

摘要 如何确保在无人监督的情况下坚持计算机化认知训练（例如，在家里，自我- 在有患阿尔茨海默病（AD）或AD相关痴呆（AD/ADRD）风险的老年人中， 替补演员R61/R33的目标是完善和测试一种新的基于面部表情的个性化 FPE引擎，用于监控和调节实时有效参与，最终目标是增强 在有AD/ADRD风险的老年人中长期坚持无监督的认知训练。在这里，有效 敬业度被定义为某人积极参与并以显著的 训练时的注意力和乐趣，解决坚持和认知增益/可塑性之间的平衡 从训练中。基于以前的工作，包括我们的工作，我们假设：（1）精神疲劳揭示在 面部表情将反映受训者的有效参与程度，这可以通过调整 任务的新奇;（2）我们提出的FPE将确保有效地参与认知训练，通过监测 学员的面部表情和调节训练的反应，促进学员的长期坚持， 训练和认知可塑性。在R61（Y1-Y2）中，我们将生成用于监视和调制真实的的FPE。 通过完善我们已建立的应用程序，在有AD/ADRD风险的老年人中进行认知训练 使用阶段I设计的编程接口。在R33（Y3-Y 5）中，我们将进行第二阶段干预疗效 一项研究比较了培训与非监督认知培训之间的有效参与和坚持 在有AD/ADRD风险的老年人中进行与不进行FPE的计划。我们将处理 这两个阶段（a）确保R33（R61里程碑）的拟议FPE准备就绪，（B）评估和 进一步修订FPE，用于未来的实施测试（R33里程碑）。影响：拟议的FPE可能有助于 监测和改善老年人在无监督认知的情况下的有效参与和依从性 训练在当前的应用中，我们将在一个名为处理速度的认知训练项目中测试FPE 训练然而，在未来的研究中，这种FPE可能会嵌入到任何计算机化的认知训练中，以帮助 解决与遵守有关的问题。

ABSTRACT How to ensure adherence to computerized cognitive training in unsupervised circumstances (e.g., at-home, self- administered) in older adults at risk for Alzheimer’s disease (AD) or AD related dementia (AD/ADRD) is understudied. The objective of the R61/R33 is to refine and test a novel facial expression-based personalization engine (FPE) for monitoring and modulating real-time effective engagement, with an ultimate goal of enhancing long-term adherence in unsupervised cognitive training in older adults at risk for AD/ADRD. Here, Effective engagement is defined as the extent to which someone is actively engaged and performing with significant attention and enjoyment while training, addressing a balance between adherence and cognitive gains/plasticity from the training. Based on previous work, including ours, we hypothesize that (1) mental fatigue revealed in facial expressions will reflect a trainee’s degree of effective engagement, which can be modified by modulating task novelty; (2) our proposed FPE will ensure the effective engagement in cognitive training by monitoring trainee facial expressions and modulating training in response, promoting the trainee’s long-term adherence to the training and cognitive plasticity. In R61 (Y1-Y2), we will generate the FPE for monitoring and modulating real- time engagement in cognitive trainings in older adults at risk for AD/ADRD by refining our established application programming interface using a Stage I design. In R33 (Y3-Y5), we will conduct a Stage II intervention efficacy study comparing effective engagement and adherence in unsupervised cognitive training between training programs with vs. without FPE in older adults at risk for AD/ADRD. We will address milestones proposed in both stages to (a) ensure the readiness of the proposed FPE for R33 (R61 milestone) and (b) evaluate and further revision of FPE for future implementation test (R33 milestone). Impact: the proposed FPE may assist in monitoring and improving effective engagement and adherence in older adults with unsupervised cognitive training. In the current application, we will test FPE in a cognitive training program called speed of processing training. However, such FPE may be embedded to any computerized cognitive training in future studies to help address adherence related issues.