According to the World Alzheimer Report (Prince, The Global Impact of Dementia: an Analysis of Prevalence, Incidence, Cost and Trends, 2015), 46.8 million people worldwide are nowadays living with dementia. And this number is estimated to approximate 131.5 million by 2050, with an increasing burden on society and families. The lack of medical treatments able to stop or slow down the course of the disease has moved the focus of interest toward the nonpharmacological approach and psychosocial therapies for people with/at risk of dementia, as in the Mild Cognitive Impairment (MCI) condition. The purpose of the present study is to test an individualized home-based multidimensional program aimed at enhancing the continuum of care for MCI and outpatients with dementia in early stage using technology. The proposed study is a single blind randomized controlled trial (RCT) involving 30 subjects with MCI and Alzheimer’s disease (AD) randomly assigned to the intervention group (Ability group), who will receive the “Ability Program”, or to the active control group (ACG), who will receive “Treatment As Usual” (TAU). The protocol provides for three steps of assessment: at the baseline (T_0), after treatment, (T_1) and at follow-up (T_2) with a multidimensional evaluation battery including cognitive functioning, behavioral, functional, and quality of life measures. The Ability Program lasts 6 weeks, comprises tablet-delivered cognitive (5 days/week) and physical activities (7 days/week) combined with a set of devices for the measurement and monitoring from remote of vital and physical health parameters. The TAU equally lasts 6 weeks and includes paper and pencil cognitive activities (5 days/week), with clinician’s prescription to perform physical exercise every day and to monitor selected vital parameters. Results of this study will inform on the efficacy of a technology-enhanced home care service to preserve cognitive and motor levels of functioning in MCI and AD, in order to slow down their loss of autonomy in daily life. The expected outcome is to ensure the continuity of care from clinical practice to the patient’s home, enabling also cost effectiveness and the empowerment of patient and caregiver in the care process, positively impacting on their quality of life. ClinicalTrials.gov ID: NCT02746484 (registration date: 12/apr/2016 – retrospectively registered).

The Mind-Reading ability through the eyes is an important component of the affective Theory of Mind (ToM), which allows people to infer the other’s mental state from the eye gaze. The aim of the present study was to investigate to which extent age-associated structural brain changes impact this ability and to determine if this association is related to executive functions in elderly subjects. For this purpose, Magnetic Resonance Imaging was used to determine both gray matter and white matter areas associated with aging. The resulting areas have been included in a subsequent correlation analysis to detect the brain regions whose structure was associated with the Mind-Reading ability through the eyes, assessed with the Italian version of the “Reading the Mind in the Eyes” (RME) test, in a sample of 36 healthy subjects ranging from 24 to 79 years of age. The analysis resulted in three important findings: 1) the performance to the RME test is relatively stable across the decades 20-70 (despite a slight decrease of this ability with aging) and independent from executive functions; 2) structural brain imaging demonstrated the involvement of a great number of cortical ToM areas for the execution of the RME test: the bilateral precentral gyrus, the bilateral posterior insula, the left superior temporal gyrus and the left inferior frontal gyrus, which also showed a significant volume decrease with age; 3) an age and task-related decline in white matter connectivity on left fronto-temporal portion of the brain. Our results confirm the age-related structural modifications of the brain and show that these changes have an influence on the Mind-Reading ability through the eyes.

The assessment of executive functions poses researchers with several challenges related to both the complexity of the construct of executive functions itself and/or the methodological difficulties related to its evaluation. The main objective of the current study was to evaluate a 360° version of an ecologically valid assessment called the Picture Interpretation Test (PIT). Participants included 19 patients with Parkinson’s disease (PD) and 19 healthy controls. All participants endorsed globally positive experiences of the PIT 360°. Furthermore, findings indicated that patients with PD took longer to correctly interpret the PIT 360° scene and tended to significantly focus on details of the 360° scene instead of the most informative elements. The time needed for a correct interpretation of the presented scene also correlated significantly with performance in conventional paper and pencil tests of executive functions for patients with PD. Classification analysis indicated the potential of the PIT 360° for distinguishing between patients with PD and healthy controls. Overall, these data provide preliminary evidence in support of the PIT 360° for evaluating executive functions.

Due to the lack of pharmacological treatment for dementia, timely detection of subjects at risk can be of seminal importance for preemptive rehabilitation interventions. The aim of the study was to determine the usability of the smart aging serious game (SASG), a virtual reality platform, in assessing the cognitive profile of an amnestic mild cognitive impairment (aMCI) population, its validity in discriminating aMCI from healthy controls (HC), and in detecting hippocampal degeneration, a biomarker of clinical progression towards dementia. Thirty-six aMCI and 107 HC subjects were recruited and administered the SASG together with a neuropsychological evaluation. All aMCI and 30 HC subjects performed also an MRI for hippocampal volume measurement. Results showed good usability of the SASG despite the low familiarity with technology in both groups. ROC curve analyses showed similar discriminating abilities for SASG and gold standard tests, and a greater discrimination ability compared to non-specific neuropsychological tests. Finally, linear regression analysis revealed that the SASG outperformed the Montreal cognitive assessment test (MoCA) in the ability to detect neuronal degeneration in the hippocampus on the right side. These data show that SASG is an ecological task, that can be considered a digital biomarker providing objective and clinically meaningful data about the cognitive profile of aMCI subjects.

This study tested the efficacy of digital-health home intervention for people within the Alzheimer’s disease (AD)-continuum.Thirty people within the AD continuum were randomly assigned to a telereh... People in the Alzheimer’s Disease continuum facing chronic cognitive disabilities represent an emergency for the healthcare system given the substantial need for long-term rehabilitation;This study...

The aim of the study was to explore cognitive and affective dimensions of ToM using the computerized Yoni task in participants with amnestic Mild Cognitive Impairment (aMCI=16), early stage of Parkinson’s Disease (PD=14), and healthy controls (HC=18) Results demonstrated that the Yoni task was effective in discriminating between groups in 1^th order cognitive dimension (MCI<PD=HC, p_corr<.05), and in 2^nd order cognitive and affective dimensions (MCI<HC, p_corr <.05), highlighting a reduced ToM performance also in people with PD (MCI<PD<HC, p_corr <.05). Thus, the Yoni task represents a sensitive tool for detecting different dimensions of ToM impairment, across different clinical conditions.