Detection of activities of daily living impairment in Alzheimer’s disease and mild cognitive impairment using information and communication technology
Identifieur interne : 001038 ( Ncbi/Merge ); précédent : 001037; suivant : 001039Detection of activities of daily living impairment in Alzheimer’s disease and mild cognitive impairment using information and communication technology
Auteurs : Guillaume Sacco [France] ; Véronique Joumier [France] ; Nelly Darmon [France] ; Arnaud Dechamps [France, Indonésie] ; Alexandre Derreumaux [France] ; Ji-Hyun Lee [France] ; Julie Piano [France] ; Nathalie Bordone [France] ; Alexandra Konig [France, Pays-Bas] ; Bernard Teboul [France] ; Renaud David [France] ; Olivier Guerin [France] ; François Bremond [France] ; Philippe Robert [France]Source :
- Clinical Interventions in Aging [ 1176-9092 ] ; 2012.
Abstract
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.
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.
In P1, the DAS score differentiated AD (DASAD,P1 = 0.47, 95% confidence interval [CI] 0.38–0.56) from NC (DASNC,P1 = 0.71, 95% CI 0.68–0.74). In P2, the DAS score differentiated MCI (DASMCI,P2 = 0.11, 95% CI 0.05–0.16) and NC (DASNC,P2 = 0.36, 95% CI 0.26–0.45).
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.
Url:
DOI: 10.2147/CIA.S36297
PubMed: 23271900
PubMed Central: 3526878
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Jakarta</wicri:regionArea><wicri:noRegion>Jakarta</wicri:noRegion></affiliation></author><author><name sortKey="Derreumaux, Alexandre" sort="Derreumaux, Alexandre" uniqKey="Derreumaux A" first="Alexandre" last="Derreumaux">Alexandre Derreumaux</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af3-cia-7-539">Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, 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id="af2-cia-7-539">Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Guerin, Olivier" sort="Guerin, Olivier" uniqKey="Guerin O" first="Olivier" last="Guerin">Olivier Guerin</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af3-cia-7-539">Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Bremond, Francois" sort="Bremond, Francois" uniqKey="Bremond F" first="François" last="Bremond">François Bremond</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af4-cia-7-539">Equipe Stars, Institut National de Recherche en Informatique et en Automatique (INRIA), Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Equipe Stars, Institut National de Recherche en Informatique et en Automatique (INRIA), Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Robert, Philippe" sort="Robert, Philippe" uniqKey="Robert P" first="Philippe" last="Robert">Philippe Robert</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-cia-7-539">Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23271900</idno><idno type="pmc">3526878</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526878</idno><idno type="RBID">PMC:3526878</idno><idno type="doi">10.2147/CIA.S36297</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">000711</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000711</idno><idno type="wicri:Area/Pmc/Curation">000708</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000708</idno><idno type="wicri:Area/Pmc/Checkpoint">000630</idno><idno 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Recherche, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af3-cia-7-539">Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Joumier, Veronique" sort="Joumier, Veronique" uniqKey="Joumier V" first="Véronique" last="Joumier">Véronique Joumier</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af4-cia-7-539">Equipe Stars, Institut National de Recherche en Informatique et en Automatique (INRIA), Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Equipe Stars, Institut National de Recherche en Informatique et en Automatique (INRIA), Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Darmon, Nelly" sort="Darmon, Nelly" uniqKey="Darmon N" first="Nelly" last="Darmon">Nelly Darmon</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Dechamps, Arnaud" sort="Dechamps, Arnaud" uniqKey="Dechamps A" first="Arnaud" last="Dechamps">Arnaud Dechamps</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af5-cia-7-539">University of Pancasila, Department of Psychology, Jakarta, Indonesia</nlm:aff><country xml:lang="fr">Indonésie</country><wicri:regionArea>University of Pancasila, Department of Psychology, Jakarta</wicri:regionArea><wicri:noRegion>Jakarta</wicri:noRegion></affiliation></author><author><name sortKey="Derreumaux, Alexandre" sort="Derreumaux, Alexandre" uniqKey="Derreumaux A" first="Alexandre" last="Derreumaux">Alexandre Derreumaux</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af3-cia-7-539">Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Ji Hyun" sort="Lee, Ji Hyun" uniqKey="Lee J" first="Ji-Hyun" last="Lee">Ji-Hyun Lee</name><affiliation wicri:level="1"><nlm:aff id="af2-cia-7-539">Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Piano, Julie" sort="Piano, Julie" uniqKey="Piano J" first="Julie" last="Piano">Julie Piano</name><affiliation wicri:level="1"><nlm:aff id="af2-cia-7-539">Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Bordone, Nathalie" sort="Bordone, Nathalie" uniqKey="Bordone N" first="Nathalie" last="Bordone">Nathalie Bordone</name><affiliation wicri:level="1"><nlm:aff id="af2-cia-7-539">Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Konig, Alexandra" sort="Konig, Alexandra" uniqKey="Konig A" first="Alexandra" last="Konig">Alexandra Konig</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af6-cia-7-539">University of Maastricht, Faculty of Psychology and Neuropsychology, Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>University of Maastricht, Faculty of Psychology and Neuropsychology, Department of Psychiatry and Neuropsychology, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Teboul, Bernard" sort="Teboul, Bernard" uniqKey="Teboul B" first="Bernard" last="Teboul">Bernard Teboul</name><affiliation wicri:level="1"><nlm:aff id="af3-cia-7-539">Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="David, Renaud" sort="David, Renaud" uniqKey="David R" first="Renaud" last="David">Renaud David</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-cia-7-539">Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Guerin, Olivier" sort="Guerin, Olivier" uniqKey="Guerin O" first="Olivier" last="Guerin">Olivier Guerin</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af3-cia-7-539">Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Bremond, Francois" sort="Bremond, Francois" uniqKey="Bremond F" first="François" last="Bremond">François Bremond</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af4-cia-7-539">Equipe Stars, Institut National de Recherche en Informatique et en Automatique (INRIA), Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Equipe Stars, Institut National de Recherche en Informatique et en Automatique (INRIA), Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author><author><name sortKey="Robert, Philippe" sort="Robert, Philippe" uniqKey="Robert P" first="Philippe" last="Robert">Philippe Robert</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-7-539">EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-cia-7-539">Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis</wicri:regionArea><wicri:noRegion>Sophia-Antipolis</wicri:noRegion><wicri:noRegion>Sophia-Antipolis</wicri:noRegion></affiliation></author></analytic><series><title level="j">Clinical Interventions in Aging</title><idno type="ISSN">1176-9092</idno><idno type="eISSN">1178-1998</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>In P1, the DAS score differentiated AD (DAS<sub>AD,P1</sub> = 0.47, 95% confidence interval [CI] 0.38–0.56) from NC (DAS<sub>NC,P1</sub> = 0.71, 95% CI 0.68–0.74). In P2, the DAS score differentiated MCI (DAS<sub>MCI,P2</sub> = 0.11, 95% CI 0.05–0.16) and NC (DAS<sub>NC,P2</sub> = 0.36, 95% CI 0.26–0.45).</p></sec><sec><title>Conclusion</title><p>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. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Interv Aging</journal-id><journal-id journal-id-type="iso-abbrev">Clin Interv Aging</journal-id><journal-title-group><journal-title>Clinical Interventions in Aging</journal-title></journal-title-group><issn pub-type="ppub">1176-9092</issn><issn pub-type="epub">1178-1998</issn><publisher><publisher-name>Dove Medical Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23271900</article-id><article-id pub-id-type="pmc">3526878</article-id><article-id pub-id-type="doi">10.2147/CIA.S36297</article-id><article-id pub-id-type="publisher-id">cia-7-539</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Research</subject></subj-group></article-categories><title-group><article-title>Detection of activities of daily living impairment in Alzheimer’s disease and mild cognitive impairment using information and communication technology</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Sacco</surname><given-names>Guillaume</given-names></name><xref ref-type="aff" rid="af1-cia-7-539">1</xref><xref ref-type="aff" rid="af2-cia-7-539">2</xref><xref ref-type="aff" rid="af3-cia-7-539">3</xref><xref ref-type="corresp" rid="c1-cia-7-539"></xref></contrib><contrib contrib-type="author"><name><surname>Joumier</surname><given-names>Véronique</given-names></name><xref ref-type="aff" rid="af1-cia-7-539">1</xref><xref ref-type="aff" rid="af4-cia-7-539">4</xref></contrib><contrib contrib-type="author"><name><surname>Darmon</surname><given-names>Nelly</given-names></name><xref ref-type="aff" rid="af1-cia-7-539">1</xref></contrib><contrib contrib-type="author"><name><surname>Dechamps</surname><given-names>Arnaud</given-names></name><xref ref-type="aff" rid="af1-cia-7-539">1</xref><xref ref-type="aff" rid="af5-cia-7-539">5</xref></contrib><contrib contrib-type="author"><name><surname>Derreumaux</surname><given-names>Alexandre</given-names></name><xref ref-type="aff" rid="af1-cia-7-539">1</xref><xref ref-type="aff" rid="af3-cia-7-539">3</xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Ji-Hyun</given-names></name><xref ref-type="aff" rid="af2-cia-7-539">2</xref></contrib><contrib contrib-type="author"><name><surname>Piano</surname><given-names>Julie</given-names></name><xref ref-type="aff" rid="af2-cia-7-539">2</xref></contrib><contrib contrib-type="author"><name><surname>Bordone</surname><given-names>Nathalie</given-names></name><xref ref-type="aff" rid="af2-cia-7-539">2</xref></contrib><contrib contrib-type="author"><name><surname>Konig</surname><given-names>Alexandra</given-names></name><xref ref-type="aff" rid="af1-cia-7-539">1</xref><xref ref-type="aff" rid="af6-cia-7-539">6</xref></contrib><contrib contrib-type="author"><name><surname>Teboul</surname><given-names>Bernard</given-names></name><xref ref-type="aff" rid="af3-cia-7-539">3</xref></contrib><contrib contrib-type="author"><name><surname>David</surname><given-names>Renaud</given-names></name><xref ref-type="aff" rid="af1-cia-7-539">1</xref><xref ref-type="aff" rid="af2-cia-7-539">2</xref></contrib><contrib contrib-type="author"><name><surname>Guerin</surname><given-names>Olivier</given-names></name><xref ref-type="aff" rid="af1-cia-7-539">1</xref><xref ref-type="aff" rid="af3-cia-7-539">3</xref></contrib><contrib contrib-type="author"><name><surname>Bremond</surname><given-names>François</given-names></name><xref ref-type="aff" rid="af1-cia-7-539">1</xref><xref ref-type="aff" rid="af4-cia-7-539">4</xref></contrib><contrib contrib-type="author"><name><surname>Robert</surname><given-names>Philippe</given-names></name><xref ref-type="aff" rid="af1-cia-7-539">1</xref><xref ref-type="aff" rid="af2-cia-7-539">2</xref></contrib></contrib-group><aff id="af1-cia-7-539"><label>1</label>EA CoBTeK, Université de Nice Sophia-Antipolis, Sophia-Antipolis, France</aff><aff id="af2-cia-7-539"><label>2</label>Centre Mémoire de Ressource et de Recherche, CHU de Nice, Sophia-Antipolis, France</aff><aff id="af3-cia-7-539"><label>3</label>Plateforme Patient du Centre d’Innovation et d’Usage en Santé, CHU de Nice, Sophia-Antipolis, France</aff><aff id="af4-cia-7-539"><label>4</label>Equipe Stars, Institut National de Recherche en Informatique et en Automatique (INRIA), Sophia-Antipolis, France</aff><aff id="af5-cia-7-539"><label>5</label>University of Pancasila, Department of Psychology, Jakarta, Indonesia</aff><aff id="af6-cia-7-539"><label>6</label>University of Maastricht, Faculty of Psychology and Neuropsychology, Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands</aff><author-notes><corresp id="c1-cia-7-539">Correspondence: Guillaume Sacco, Centre Mémoire de Ressources et de Recherche, Hôpital de Cimiez, 4 Avenue Reine Victoria, Pavillon Mossa, 06000 Nice, France, Tel +33 609733254, Email <email>sacco.g@chu-nice.fr</email></corresp></author-notes><pub-date pub-type="collection"><year>2012</year></pub-date><pmc-comment>Dove Press titles changed from ppub to collections in 2009.
Fake ppub written to satisfy Coll Date Type=ppub</pmc-comment>
<pub-date pub-type="ppub"><year>2012</year></pub-date><pub-date pub-type="epub"><day>04</day><month>12</month><year>2012</year></pub-date><volume>7</volume><fpage>539</fpage><lpage>549</lpage><permissions><copyright-statement>© 2012 Sacco et al, publisher and licensee Dove Medical Press Ltd.</copyright-statement><copyright-year>2012</copyright-year><license><license-p>This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>In P1, the DAS score differentiated AD (DAS<sub>AD,P1</sub> = 0.47, 95% confidence interval [CI] 0.38–0.56) from NC (DAS<sub>NC,P1</sub> = 0.71, 95% CI 0.68–0.74). In P2, the DAS score differentiated MCI (DAS<sub>MCI,P2</sub> = 0.11, 95% CI 0.05–0.16) and NC (DAS<sub>NC,P2</sub> = 0.36, 95% CI 0.26–0.45).</p></sec><sec><title>Conclusion</title><p>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.</p></sec></abstract><kwd-group><kwd>functional impairment</kwd><kwd>ICT</kwd><kwd>IADL</kwd><kwd>MCI</kwd></kwd-group></article-meta></front><floats-group><fig id="f1-cia-7-539" position="float"><label>Figure 1</label><caption><p>DAS<sub>.,P1</sub> scores for AD patients and NC participants for protocol 1 (P1). The first line (<bold>A</bold>) represents the ratio of efficacy for the two groups (Grey dots for NC and Black dots for AD). Then the next lines (<bold>B–E</bold>) show the evolution of the index from ratio of efficacy (index 0) to DAS<sub>.,P1</sub> score (index 4) including omission (<bold>B</bold>), repetition (<bold>C</bold>), order error (<bold>D</bold>), and bad completion at the first attempt (<bold>E</bold>). Measurements represented for each participant <italic>j</italic>: (A) R<sub>Eff</sub> = Index<sub>0,P1</sub>(j) (Percentage of time spent in the room to behave directed to perform a listed activities). (B)
<inline-formula><mml:math id="mm2"><mml:mrow><mml:msub><mml:mrow><mml:mrow><mml:mtext>Index</mml:mtext></mml:mrow></mml:mrow><mml:mrow><mml:mtext>1</mml:mtext><mml:mo>,</mml:mo><mml:mtext>P1</mml:mtext></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo>=</mml:mo><mml:mo stretchy="false">[</mml:mo><mml:msub><mml:mrow><mml:mtext>R</mml:mtext></mml:mrow><mml:mrow><mml:mtext>Eff</mml:mtext></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo stretchy="false">]</mml:mo><mml:mo>×</mml:mo><mml:msubsup><mml:mo>∏</mml:mo><mml:mrow><mml:mtext>i</mml:mtext><mml:mo>=</mml:mo><mml:mn>1</mml:mn></mml:mrow><mml:mn>4</mml:mn></mml:msubsup><mml:mrow><mml:msubsup><mml:mrow><mml:mi>k</mml:mi></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mrow><mml:mi>P</mml:mi><mml:mn>1</mml:mn></mml:mrow></mml:mrow><mml:mrow><mml:msub><mml:mrow><mml:mtext>a</mml:mtext></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mi>F</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:msubsup></mml:mrow></mml:mrow></mml:math></inline-formula> (impact of omission mistakes on the R<sub>Eff</sub>). (C)
<inline-formula><mml:math id="mm3"><mml:mrow><mml:msub><mml:mrow><mml:mrow><mml:mtext>Index</mml:mtext></mml:mrow></mml:mrow><mml:mrow><mml:mn>2</mml:mn><mml:mo>,</mml:mo><mml:mtext>P1</mml:mtext></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo>=</mml:mo><mml:mo stretchy="false">[</mml:mo><mml:msub><mml:mrow><mml:mtext>R</mml:mtext></mml:mrow><mml:mrow><mml:mtext>Eff</mml:mtext></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo stretchy="false">]</mml:mo><mml:mo>×</mml:mo><mml:msubsup><mml:mo>∏</mml:mo><mml:mrow><mml:mtext>i</mml:mtext><mml:mo>=</mml:mo><mml:mn>1</mml:mn></mml:mrow><mml:mn>4</mml:mn></mml:msubsup><mml:mrow><mml:msubsup><mml:mrow><mml:mi>k</mml:mi></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mi>P</mml:mi><mml:mn>1</mml:mn></mml:mrow><mml:mrow><mml:msub><mml:mrow><mml:mtext>a</mml:mtext></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mi>F</mml:mi><mml:mn>1</mml:mn></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:msubsup></mml:mrow></mml:mrow></mml:math></inline-formula> (cumulative impact of omission and repetition mistakes on the R<sub>Eff</sub>). (D)
<inline-formula><mml:math id="mm4"><mml:mrow><mml:msub><mml:mrow><mml:mrow><mml:mtext>Index</mml:mtext></mml:mrow></mml:mrow><mml:mrow><mml:mn>3</mml:mn><mml:mo>,</mml:mo><mml:mtext>P1</mml:mtext></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo>=</mml:mo><mml:mo stretchy="false">[</mml:mo><mml:msub><mml:mrow><mml:mtext>R</mml:mtext></mml:mrow><mml:mrow><mml:mtext>Eff</mml:mtext></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo stretchy="false">]</mml:mo><mml:mo>×</mml:mo><mml:msubsup><mml:mo>∏</mml:mo><mml:mrow><mml:mtext>i</mml:mtext><mml:mo>=</mml:mo><mml:mn>1</mml:mn></mml:mrow><mml:mn>2</mml:mn></mml:msubsup><mml:mrow><mml:msubsup><mml:mrow><mml:mi>k</mml:mi></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mrow><mml:mi>P</mml:mi><mml:mn>2</mml:mn></mml:mrow></mml:mrow><mml:mrow><mml:msub><mml:mrow><mml:mtext>a</mml:mtext></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mrow><mml:mi>F</mml:mi><mml:mn>2</mml:mn></mml:mrow></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mi>j</mml:mi><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:msubsup></mml:mrow></mml:mrow></mml:math></inline-formula> (cumulative impact of omission, repetition, and order mistakes on the R<sub>Eff</sub>). (E) Final DAS score
<inline-formula><mml:math id="mm5"><mml:mrow><mml:msub><mml:mrow><mml:mtext>S</mml:mtext></mml:mrow><mml:mrow><mml:mtext>j</mml:mtext><mml:mo>,</mml:mo><mml:mtext>P</mml:mtext><mml:mn>1</mml:mn></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:msub><mml:mrow><mml:mtext>k</mml:mtext></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mtext>P</mml:mtext><mml:mn>1</mml:mn><mml:mo>,</mml:mo></mml:mrow></mml:msub><mml:mi> </mml:mi><mml:msub><mml:mrow><mml:mtext>k</mml:mtext></mml:mrow><mml:mrow><mml:mn>2</mml:mn><mml:mo>,</mml:mo><mml:mtext>P</mml:mtext><mml:mn>1</mml:mn><mml:mo>,</mml:mo></mml:mrow></mml:msub><mml:mi> </mml:mi><mml:msub><mml:mrow><mml:mtext>k</mml:mtext></mml:mrow><mml:mrow><mml:mn>3</mml:mn><mml:mo>,</mml:mo><mml:mtext>P1</mml:mtext><mml:mo>,</mml:mo></mml:mrow></mml:msub><mml:mi> </mml:mi><mml:msub><mml:mrow><mml:mtext>k</mml:mtext></mml:mrow><mml:mrow><mml:mn>4</mml:mn><mml:mo>,</mml:mo><mml:mtext>P1</mml:mtext><mml:mo>,</mml:mo></mml:mrow></mml:msub><mml:mo stretchy="false">)</mml:mo><mml:mi> </mml:mi><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo>=</mml:mo><mml:mo stretchy="false">[</mml:mo><mml:msub><mml:mrow><mml:mtext>R</mml:mtext></mml:mrow><mml:mrow><mml:mtext>Eff</mml:mtext></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo stretchy="false">]</mml:mo><mml:mo>×</mml:mo><mml:msubsup><mml:mo>∏</mml:mo><mml:mrow><mml:mtext>i</mml:mtext><mml:mo>=</mml:mo><mml:mn>1</mml:mn></mml:mrow><mml:mn>4</mml:mn></mml:msubsup><mml:mrow><mml:msubsup><mml:mrow><mml:mi>k</mml:mi></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mi>P</mml:mi><mml:mn>1</mml:mn></mml:mrow><mml:mrow><mml:msub><mml:mrow><mml:mtext>a</mml:mtext></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mi>F</mml:mi><mml:mn>1</mml:mn></mml:mrow></mml:msub><mml:mi> </mml:mi><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:msubsup></mml:mrow></mml:mrow></mml:math></inline-formula> (cumulative impact of omission, repetition, order mistakes, and bad completion at the first attempt on the R<sub>Eff</sub>).</p></caption><graphic xlink:href="cia-7-539f1"></graphic></fig><fig id="f2-cia-7-539" position="float"><label>Figure 2</label><caption><p>Performance evaluation of the assessment methodology to classify observation data as AD group or NC group. (<bold>A</bold>) Specificity and sensitivity in function of the cutoff point of DAS<sub>.,P1</sub>() scores. (<bold>B</bold>) Receiver operating curve associated with protocol 1.</p><p><bold>Abbreviations:</bold> AD, Alzheimer’s disease; DAS, daily activity scenario; NC, normal control.</p></caption><graphic xlink:href="cia-7-539f2"></graphic></fig><fig id="f3-cia-7-539" position="float"><label>Figure 3</label><caption><p>DAS<sub>.,P2</sub> scores for MCI patients and NC participants for protocol 2 (P2). The first line (<bold>A</bold>) represents the ratio of efficacy for the two groups (Grey dots for NC and Black dots for MCI). Then the next lines (<bold>B–E</bold>) show the evolution of the index from ratio of efficacy (index 0) to DAS<sub>.,P2</sub> score (index 4) including omission (B), repetition (C), bad achievement of activities (D), and planning errors (E). Measurements represented for each participant <italic>j</italic>: (A) R<sub>Eff</sub> = Index<sub>0,P2</sub> (j) (Percentage of time spent in the room to behave directed to perform a listed activities). (B)
<inline-formula><mml:math id="mm6"><mml:mrow><mml:msub><mml:mrow><mml:mrow><mml:mtext>Index</mml:mtext></mml:mrow></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mtext>P</mml:mtext><mml:mn>2</mml:mn></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo>=</mml:mo><mml:mo stretchy="false">[</mml:mo><mml:msub><mml:mrow><mml:mtext>R</mml:mtext></mml:mrow><mml:mrow><mml:mtext>Eff</mml:mtext></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo stretchy="false">]</mml:mo><mml:mo>×</mml:mo><mml:msubsup><mml:mrow><mml:mi>k</mml:mi></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mrow><mml:mi>P</mml:mi><mml:mn>2</mml:mn></mml:mrow></mml:mrow><mml:mrow><mml:msub><mml:mrow><mml:mi>α</mml:mi></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mi>F</mml:mi><mml:mn>2</mml:mn></mml:mrow></mml:msub><mml:mi> </mml:mi><mml:mo stretchy="false">(</mml:mo><mml:mi>j</mml:mi><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:msubsup></mml:mrow></mml:math></inline-formula> (impact of omission mistakes on the R<sub>Eff</sub>). (C)
<inline-formula><mml:math id="mm7"><mml:mrow><mml:msub><mml:mrow><mml:mrow><mml:mtext>Index</mml:mtext></mml:mrow></mml:mrow><mml:mrow><mml:mn>2</mml:mn><mml:mo>,</mml:mo><mml:mtext>P</mml:mtext><mml:mn>2</mml:mn></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo>=</mml:mo><mml:mo stretchy="false">[</mml:mo><mml:msub><mml:mrow><mml:mtext>R</mml:mtext></mml:mrow><mml:mrow><mml:mtext>Eff</mml:mtext></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo stretchy="false">]</mml:mo><mml:mo>×</mml:mo><mml:msubsup><mml:mo>∏</mml:mo><mml:mrow><mml:mtext>i</mml:mtext><mml:mo>=</mml:mo><mml:mn>1</mml:mn></mml:mrow><mml:mn>2</mml:mn></mml:msubsup><mml:mrow><mml:msubsup><mml:mrow><mml:mi>k</mml:mi></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mrow><mml:mi>P</mml:mi><mml:mn>2</mml:mn></mml:mrow></mml:mrow><mml:mrow><mml:msub><mml:mrow><mml:mi>a</mml:mi></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mi>F</mml:mi><mml:mn>2</mml:mn></mml:mrow></mml:msub><mml:mi> </mml:mi><mml:mo stretchy="false">(</mml:mo><mml:mi>j</mml:mi><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:msubsup></mml:mrow></mml:mrow></mml:math></inline-formula> (cumulative impact of omission and repetition (excluding repetition of leisure activities) mistakes on the R<sub>Eff</sub>). (D)
<inline-formula><mml:math id="mm8"><mml:mrow><mml:msub><mml:mrow><mml:mrow><mml:mtext>Index</mml:mtext></mml:mrow></mml:mrow><mml:mrow><mml:mn>3</mml:mn><mml:mo>,</mml:mo><mml:mtext>P</mml:mtext><mml:mn>2</mml:mn></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo>=</mml:mo><mml:mo stretchy="false">[</mml:mo><mml:msub><mml:mrow><mml:mtext>R</mml:mtext></mml:mrow><mml:mrow><mml:mtext>Eff</mml:mtext></mml:mrow></mml:msub><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo stretchy="false">]</mml:mo><mml:mo>×</mml:mo><mml:msubsup><mml:mo>∏</mml:mo><mml:mrow><mml:mtext>i</mml:mtext><mml:mo>=</mml:mo><mml:mn>1</mml:mn></mml:mrow><mml:mn>3</mml:mn></mml:msubsup><mml:mrow><mml:msubsup><mml:mrow><mml:mi>k</mml:mi></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mrow><mml:mi>P</mml:mi><mml:mn>2</mml:mn></mml:mrow></mml:mrow><mml:mrow><mml:msub><mml:mrow><mml:mi>a</mml:mi></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mi>F</mml:mi><mml:mn>2</mml:mn></mml:mrow></mml:msub><mml:mi> </mml:mi><mml:mo stretchy="false">(</mml:mo><mml:mi>j</mml:mi><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:msubsup></mml:mrow></mml:mrow></mml:math></inline-formula> (cumulative impact of omission, repetition (excluding repetition of leisure activities) mistakes and bad achievement of activities on the R<sub>Eff</sub>). (E) Final DAS score
<inline-formula><mml:math id="mm9"><mml:mrow><mml:msub><mml:mrow><mml:mtext>S</mml:mtext></mml:mrow><mml:mrow><mml:mtext>j</mml:mtext><mml:mo>,</mml:mo><mml:mtext>P</mml:mtext><mml:mn>2</mml:mn></mml:mrow></mml:msub><mml:mi> </mml:mi><mml:mo stretchy="false">(</mml:mo><mml:msub><mml:mrow><mml:mtext>k</mml:mtext></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mtext>P</mml:mtext><mml:mn>2</mml:mn><mml:mo>,</mml:mo></mml:mrow></mml:msub><mml:mi> </mml:mi><mml:msub><mml:mrow><mml:mtext>k</mml:mtext></mml:mrow><mml:mrow><mml:mn>2</mml:mn><mml:mo>,</mml:mo><mml:mtext>P</mml:mtext><mml:mn>2</mml:mn><mml:mo>,</mml:mo></mml:mrow></mml:msub><mml:mi> </mml:mi><mml:msub><mml:mrow><mml:mtext>k</mml:mtext></mml:mrow><mml:mrow><mml:mn>3</mml:mn><mml:mo>,</mml:mo><mml:mtext>P</mml:mtext><mml:mn>2</mml:mn><mml:mo>,</mml:mo></mml:mrow></mml:msub><mml:mi> </mml:mi><mml:msub><mml:mrow><mml:mtext>k</mml:mtext></mml:mrow><mml:mrow><mml:mn>4</mml:mn><mml:mo>,</mml:mo><mml:mtext>P</mml:mtext><mml:mn>2</mml:mn><mml:mo>,</mml:mo></mml:mrow></mml:msub><mml:mo stretchy="false">)</mml:mo><mml:mi> </mml:mi><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo>=</mml:mo><mml:mo stretchy="false">[</mml:mo><mml:mtext>REff</mml:mtext><mml:mo stretchy="false">(</mml:mo><mml:mtext>j</mml:mtext><mml:mo stretchy="false">)</mml:mo><mml:mo stretchy="false">]</mml:mo><mml:mo>×</mml:mo><mml:msubsup><mml:mo>∏</mml:mo><mml:mrow><mml:mtext>i</mml:mtext><mml:mo>=</mml:mo><mml:mn>1</mml:mn></mml:mrow><mml:mn>4</mml:mn></mml:msubsup><mml:mrow><mml:msubsup><mml:mrow><mml:mi>k</mml:mi></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mrow><mml:mi>P</mml:mi><mml:mn>2</mml:mn></mml:mrow></mml:mrow><mml:mrow><mml:msub><mml:mrow><mml:mtext>a</mml:mtext></mml:mrow><mml:mrow><mml:mn>1</mml:mn><mml:mo>,</mml:mo><mml:mrow><mml:mi>F</mml:mi><mml:mn>2</mml:mn></mml:mrow></mml:mrow></mml:msub><mml:mi> </mml:mi><mml:mo stretchy="false">(</mml:mo><mml:mi>j</mml:mi><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:msubsup></mml:mrow></mml:mrow></mml:math></inline-formula> (cumulative impact of omission, repetition (excluding repetition of leisure activities) mistakes, bad achievements of activities, and planification mistakes on the R<sub>Eff</sub>).</p></caption><graphic xlink:href="cia-7-539f3"></graphic></fig><fig id="f4-cia-7-539" position="float"><label>Figure 4</label><caption><p>Performance evaluation of the assessment methodology to classify observation data as MCI group or NC group. (<bold>A</bold>) Specificity and sensitivity in function of the cutoff point of DAS<sub>.,P2</sub>() scores. (<bold>B</bold>) Receiver operating curve associated with the protocol 2.</p><p><bold>Abbreviations:</bold> DAS, daily activity scenario; MCI, mild cognitive impairment; NC, normal control.</p></caption><graphic xlink:href="cia-7-539f4"></graphic></fig><table-wrap id="t1-cia-7-539" position="float"><label>Table 1</label><caption><p>Daily activity scenarios characteristics in protocols 1 (P1) and 2 (P2)</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th align="left" valign="top" rowspan="1" colspan="1">Daily activity scenario associated with the protocol 1 (P1)</th><th align="left" valign="top" rowspan="1" colspan="1">Daily activity scenario associated with the protocol 2 (P2)</th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Activities</td><td align="left" valign="top" rowspan="1" colspan="1">“Your task is to perform this list of activities in the order given within a time frame of 20 minutes”
<list list-type="bullet"><list-item><p>Walk to the reading table and read something for 2 mn</p></list-item><list-item><p>Walk to the coffee corner where the kettle is and boil some water</p></list-item><list-item><p>Walk to the phone and compose this number: xxxxxx</p></list-item><list-item><p>Take the watering can and water the plant.</p></list-item><list-item><p>Walk to the television and turn it on with the remote control</p></list-item><list-item><p>Walk to the reading table, take the playing cards and classify them by color (reds with reds, blacks with blacks)</p></list-item><list-item><p>Take the green “ABCD” folder on the desk with the A, B, C, D sheets in it. Match the A, B, C, D sheets from the folder to the relevant folders dispersed all over the room; A with A, etc … Put the “ABCD” folder back on the desk</p></list-item><list-item><p>Leave the room</p></list-item></list></td><td align="left" valign="top" rowspan="1" colspan="1">“Your task is to perform this list of 10 activities in a logical manner within 15 min. These 15 minutes represent a typical morning period of everyday life”
<list list-type="bullet"><list-item><p>Read the newspaper</p></list-item><list-item><p>Water the plant</p></list-item><list-item><p>Answer the phone</p></list-item><list-item><p>Call the taxi</p></list-item><list-item><p>Prepare today’s medication</p></list-item><list-item><p>Make the check for the Electricity Company</p></list-item><list-item><p>Leave the room when you have finished all activities</p></list-item><list-item><p>Watch the TV</p></list-item><list-item><p>Prepare a hot tea</p></list-item><list-item><p>Write a shopping list for lunch</p></list-item></list></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Constraints</td><td align="left" valign="top" rowspan="1" colspan="1">Participant has to perform the activities in the given order</td><td align="left" valign="top" rowspan="1" colspan="1"><list list-type="order"><list-item><p>watch the TV before the phone call</p></list-item><list-item><p>water the plant just before leaving the room</p></list-item><list-item><p>call the taxi, which will arrive in 10 minutes and ask the driver to drive you to the market</p></list-item></list></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Duration</td><td align="left" valign="top" rowspan="1" colspan="1">20 minutes</td><td align="left" valign="top" rowspan="1" colspan="1">15 minutes</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Parameters extracted from video used to compute DAS<sub>.,n</sub> scores</td><td align="left" valign="top" rowspan="1" colspan="1"><list list-type="simple"><list-item><p>– RE<sub>ff</sub> € R<sub>[0,1]</sub></p></list-item><list-item><p>– Number of activities omitted, a<sub>1,P1</sub> € [1,7]</p></list-item><list-item><p>– Total number of repetitions, a<sub>2,P1</sub> € N</p></list-item><list-item><p>– Order error, a<sub>3,P1</sub> € {0,1} with a<sub>3,1</sub> = 1 if order error was done</p></list-item><list-item><p>– Total number of attempts before completing a given activity, a<sub>4,P1</sub> € N</p></list-item></list></td><td align="left" valign="top" rowspan="1" colspan="1"><list list-type="simple"><list-item><p>– RE<sub>ff</sub> € R<sub>[0,1]</sub></p></list-item><list-item><p>– Number of activities omitted, a<sub>1,P2</sub> € [0,10]</p></list-item><list-item><p>– Total number of repetitions excluding the leisure activities (“watching TV”, and “reading”), a<sub>2,P2</sub> € N</p></list-item><list-item><p>– Number of activities performed but not achieved, a<sub>3,P2</sub> € [0,10]</p></list-item><list-item><p>– Respect of temporal execution constraints, a<sub>4,P2</sub> € {0,1} with a<sub>4,P2</sub> = 1 if more than two or three temporal constraints were not respected</p></list-item></list></td></tr></tbody></table></table-wrap><table-wrap id="t2-cia-7-539" position="float"><label>Table 2</label><caption><p>Observable criteria used to annotate video sequences of the protocol 2 (P2)</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1">Activity</th><th colspan="2" align="left" valign="top" rowspan="1">Activity period</th><th align="left" valign="top" rowspan="1" colspan="1">Achievement</th></tr><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th colspan="2" align="left" valign="top" rowspan="1"><hr></hr></th><th align="left" valign="top" rowspan="1" colspan="1"></th></tr><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th align="left" valign="top" rowspan="1" colspan="1">Start</th><th align="left" valign="top" rowspan="1" colspan="1">End</th><th align="left" valign="top" rowspan="1" colspan="1"></th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Read the newspaper</td><td align="left" valign="top" rowspan="1" colspan="1">Taking for the first time the newspaper</td><td align="left" valign="top" rowspan="1" colspan="1">Putting on the table the last newspaper taken</td><td align="left" valign="top" rowspan="1" colspan="1">Opening a newspaper taken to read the content</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Water the plant</td><td align="left" valign="top" rowspan="1" colspan="1">Taking the watering can</td><td align="left" valign="top" rowspan="1" colspan="1">Putting the watering can on the table</td><td align="left" valign="top" rowspan="1" colspan="1">Making the gesture of watering the plant</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Answer the phone</td><td align="left" valign="top" rowspan="1" colspan="1">Taking the handset in the hand</td><td align="left" valign="top" rowspan="1" colspan="1">Putting the handset on the phone base</td><td align="left" valign="top" rowspan="1" colspan="1">Speaking on the phone</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Call the taxi</td><td align="left" valign="top" rowspan="1" colspan="1">Taking the handset in the hand</td><td align="left" valign="top" rowspan="1" colspan="1">Putting the handset on the phone base</td><td align="left" valign="top" rowspan="1" colspan="1">Dialing the correct phone number and speaking on the phone</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Prepare the medication for today</td><td align="left" valign="top" rowspan="1" colspan="1">Taking the pillbox located inside a basket with the medication prescription inside</td><td align="left" valign="top" rowspan="1" colspan="1">Putting the pillbox inside the basket</td><td align="left" valign="top" rowspan="1" colspan="1">Correct use of medication prescription (both dose and timetable)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Make the check for the Electricity Company</td><td align="left" valign="top" rowspan="1" colspan="1">Taking the pen to write on the check</td><td align="left" valign="top" rowspan="1" colspan="1">Putting the pen on the desk</td><td align="left" valign="top" rowspan="1" colspan="1">Correct amount, date, signature and recipient name on the check</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Leave the room when you are finished with all activities</td><td align="left" valign="top" rowspan="1" colspan="1">Taking the handle of the exit door</td><td align="left" valign="top" rowspan="1" colspan="1">Closing the door</td><td align="left" valign="top" rowspan="1" colspan="1">Closing the door as the last activity undertaken in the scenario</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Watch the TV</td><td align="left" valign="top" rowspan="1" colspan="1">Taking the remote call</td><td align="left" valign="top" rowspan="1" colspan="1">Returning for the last time the remote control</td><td align="left" valign="top" rowspan="1" colspan="1">TV must have been switched off</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Prepare a hot tea</td><td align="left" valign="top" rowspan="1" colspan="1">Turning on the tea kettle</td><td align="left" valign="top" rowspan="1" colspan="1">Returning the tea kettle after having poured the water in the cup of tea</td><td align="left" valign="top" rowspan="1" colspan="1">Brewed tea</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Write the shopping list for the lunch</td><td align="left" valign="top" rowspan="1" colspan="1">Taking the pen to write on the shopping list</td><td align="left" valign="top" rowspan="1" colspan="1">Replacing the pen</td><td align="left" valign="top" rowspan="1" colspan="1">Write at least one item to eat or drink</td></tr></tbody></table></table-wrap><table-wrap id="t3-cia-7-539" position="float"><label>Table 3</label><caption><p>Characteristics of the participants in protocol 1 (P1)</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1">Characteristics</th><th align="left" valign="top" rowspan="1" colspan="1">NC n = 10</th><th align="left" valign="top" rowspan="1" colspan="1">AD n = 16</th><th align="left" valign="top" rowspan="1" colspan="1"><italic>P</italic> values</th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Female, n (%)</td><td align="left" valign="top" rowspan="1" colspan="1">5 (50%)</td><td align="left" valign="top" rowspan="1" colspan="1">11 (68.8%)</td><td align="left" valign="top" rowspan="1" colspan="1">0.425</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Age-yrs, mean [CI95%]</td><td align="left" valign="top" rowspan="1" colspan="1">73.9 [69.4, 78.4]</td><td align="left" valign="top" rowspan="1" colspan="1">76.7 [72.7, 80.7]</td><td align="left" valign="top" rowspan="1" colspan="1">0.182</td></tr><tr><td colspan="4" align="left" valign="top" rowspan="1">Level of education, n (%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Unknown</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td><td align="left" valign="top" rowspan="1" colspan="1">–</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> No formal education</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td><td align="left" valign="top" rowspan="1" colspan="1">–</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Elementary school</td><td align="left" valign="top" rowspan="1" colspan="1">1 (10%)</td><td align="left" valign="top" rowspan="1" colspan="1">7 (43.8%)</td><td align="left" valign="top" rowspan="1" colspan="1">0.099</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Middle school</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td><td align="left" valign="top" rowspan="1" colspan="1">4 (25.0%)</td><td align="left" valign="top" rowspan="1" colspan="1">0.136</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> High school</td><td align="left" valign="top" rowspan="1" colspan="1">2 (20.0%)</td><td align="left" valign="top" rowspan="1" colspan="1">2 (12.5%)</td><td align="left" valign="top" rowspan="1" colspan="1">0.625</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Post-secondary education</td><td align="left" valign="top" rowspan="1" colspan="1">7 (70.0%)</td><td align="left" valign="top" rowspan="1" colspan="1">3 (18.8%)</td><td align="left" valign="top" rowspan="1" colspan="1">0.015<xref ref-type="table-fn" rid="tfn7-cia-7-539">*</xref></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">MMSE<xref ref-type="table-fn" rid="tfn2-cia-7-539">a</xref>, mean [CI95%]</td><td align="left" valign="top" rowspan="1" colspan="1">28.1 [26.8, 29.4]</td><td align="left" valign="top" rowspan="1" colspan="1">20.7 [18.7, 22.7]</td><td align="left" valign="top" rowspan="1" colspan="1"><0.001<xref ref-type="table-fn" rid="tfn8-cia-7-539">**</xref></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">IADL-E<xref ref-type="table-fn" rid="tfn3-cia-7-539">b</xref>, mean [CI95%]</td><td align="left" valign="top" rowspan="1" colspan="1">10.5 [9.7, 11.3]</td><td align="left" valign="top" rowspan="1" colspan="1">14.3 [11.2, 17.5]</td><td align="left" valign="top" rowspan="1" colspan="1">0.031<xref ref-type="table-fn" rid="tfn7-cia-7-539">*</xref></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">MADRS<xref ref-type="table-fn" rid="tfn4-cia-7-539">c</xref>, mean [CI95%]</td><td align="left" valign="top" rowspan="1" colspan="1">3.5 [0.3, 6.7]</td><td align="left" valign="top" rowspan="1" colspan="1">4.3 [1.9, 6.6]</td><td align="left" valign="top" rowspan="1" colspan="1">0.698</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">GDS<xref ref-type="table-fn" rid="tfn5-cia-7-539">d</xref>, mean [CI95%]</td><td align="left" valign="top" rowspan="1" colspan="1">7.2 [1.5, 12.9]</td><td align="left" valign="top" rowspan="1" colspan="1">7.9 [5.4, 10.5]<xref ref-type="table-fn" rid="tfn6-cia-7-539">e</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.411</td></tr></tbody></table><table-wrap-foot><fn id="tfn1-cia-7-539"><p><bold>Notes:</bold></p></fn><fn id="tfn2-cia-7-539"><label>a</label><p>Scores on the Mini Mental State Examination (MMSE) range from 0 to 30, with higher scores indicating better cognitive function;</p></fn><fn id="tfn3-cia-7-539"><label>b</label><p>score on the Instrumental Activities of Daily Living for Elderly (IADL-E) range from 0 to 36, with lower score indicating a better functional independency;</p></fn><fn id="tfn4-cia-7-539"><label>c</label><p>scores on the Montgomery Asberg Depression Rating Scale (MADRS) range from 0 to 60 (10 items range from 0 to 6), with higher scores indicating depressive state;</p></fn><fn id="tfn5-cia-7-539"><label>d</label><p>scores on the Geriatric Depression Scale (GDS) range from 0 to 30, with higher scores indicating depressive state;</p></fn><fn id="tfn6-cia-7-539"><label>e</label><p>1 missing data.</p></fn><fn id="tfn7-cia-7-539"><label>*</label><p><italic>P</italic> < 0.05;</p></fn><fn id="tfn8-cia-7-539"><label>**</label><p><italic>P</italic> < 0.001.</p></fn><fn id="tfn9-cia-7-539"><p><bold>Abbreviations:</bold> NC, normal control; AD, Alzheimer disease.</p></fn></table-wrap-foot></table-wrap><table-wrap id="t4-cia-7-539" position="float"><label>Table 4</label><caption><p>Characteristics of the participants in protocol 2 (P2)</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1">Characteristics</th><th align="left" valign="top" rowspan="1" colspan="1">NC n = 19</th><th align="left" valign="top" rowspan="1" colspan="1">MCI n = 19</th><th align="left" valign="top" rowspan="1" colspan="1"><italic>P</italic>-values</th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Female, n (%)</td><td align="left" valign="top" rowspan="1" colspan="1">15 (78.9%)</td><td align="left" valign="top" rowspan="1" colspan="1">9 (47.4%)</td><td align="left" valign="top" rowspan="1" colspan="1">0.091</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Age-yrs, mean [CI95%]/(±SD)</td><td align="left" valign="top" rowspan="1" colspan="1">71.7 [69.2, 74.3]</td><td align="left" valign="top" rowspan="1" colspan="1">75.2 [73.2, 77.3]</td><td align="left" valign="top" rowspan="1" colspan="1">0.070</td></tr><tr><td colspan="4" align="left" valign="top" rowspan="1">Level of education, n (%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Unknown</td><td align="left" valign="top" rowspan="1" colspan="1">2 (10.5%)</td><td align="left" valign="top" rowspan="1" colspan="1">2 (10.5%)</td><td align="left" valign="top" rowspan="1" colspan="1">1.00</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> No formal education</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td><td align="left" valign="top" rowspan="1" colspan="1">–</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Elementary school</td><td align="left" valign="top" rowspan="1" colspan="1">1 (5.3%)</td><td align="left" valign="top" rowspan="1" colspan="1">5 (26.3%)</td><td align="left" valign="top" rowspan="1" colspan="1">0.405</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Middle school</td><td align="left" valign="top" rowspan="1" colspan="1">4 (21.0%)</td><td align="left" valign="top" rowspan="1" colspan="1">7 (36.8%)</td><td align="left" valign="top" rowspan="1" colspan="1">0.269</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> High school</td><td align="left" valign="top" rowspan="1" colspan="1">4 (21.0%)</td><td align="left" valign="top" rowspan="1" colspan="1">3 (15.8%)</td><td align="left" valign="top" rowspan="1" colspan="1">1.00</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"> Post-secondary education</td><td align="left" valign="top" rowspan="1" colspan="1">8 (42.1%)</td><td align="left" valign="top" rowspan="1" colspan="1">2 (10.5%)</td><td align="left" valign="top" rowspan="1" colspan="1">0.062</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">MMSE<xref ref-type="table-fn" rid="tfn11-cia-7-539">a</xref>, mean [CI95%]</td><td align="left" valign="top" rowspan="1" colspan="1">28.8 [28.3, 29.3]</td><td align="left" valign="top" rowspan="1" colspan="1">25.8 [24.8, 26.8]</td><td align="left" valign="top" rowspan="1" colspan="1"><0.001<xref ref-type="table-fn" rid="tfn16-cia-7-539">**</xref></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">IADL-E<xref ref-type="table-fn" rid="tfn12-cia-7-539">b</xref>, mean [CI95%]</td><td align="left" valign="top" rowspan="1" colspan="1">9.6 [9.0, 10.1]</td><td align="left" valign="top" rowspan="1" colspan="1">9.9 [9.1, 10.7]</td><td align="left" valign="top" rowspan="1" colspan="1">0.488</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">MADRS<xref ref-type="table-fn" rid="tfn13-cia-7-539">c</xref>, mean [CI95%]</td><td align="left" valign="top" rowspan="1" colspan="1">2.8 [1.1, 4.5]</td><td align="left" valign="top" rowspan="1" colspan="1">4.6 [2.9, 6.4]<xref ref-type="table-fn" rid="tfn15-cia-7-539">e</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.075</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">GDS<xref ref-type="table-fn" rid="tfn14-cia-7-539">d</xref>, mean [CI95%]</td><td align="left" valign="top" rowspan="1" colspan="1">7.1 [3.7, 10.4]<xref ref-type="table-fn" rid="tfn15-cia-7-539">e</xref></td><td align="left" valign="top" rowspan="1" colspan="1">8.4 [5.5, 11.3]</td><td align="left" valign="top" rowspan="1" colspan="1">0.525</td></tr></tbody></table><table-wrap-foot><fn id="tfn10-cia-7-539"><p><bold>Notes:</bold></p></fn><fn id="tfn11-cia-7-539"><label>a</label><p>Scores on the Mini Mental State Examination (MMSE) range from 0 to 30, with higher scores indicating better cognitive function;</p></fn><fn id="tfn12-cia-7-539"><label>b</label><p>score on the Instrumental Activities of Daily Living for Elderly (IADL-E) range from 0 to 36, with lower score indicating a better functional independency;</p></fn><fn id="tfn13-cia-7-539"><label>c</label><p>scores on the Montgomery Asberg Depression Rating Scale (MADRS) range from 0 to 60 (10 items range from 0 to 6), with higher scores indicating depressive state;</p></fn><fn id="tfn14-cia-7-539"><label>d</label><p>scores on the Geriatric Depression Scale (GDS) range from 0 to 30, with higher scores indicating depressive state.</p></fn><fn id="tfn15-cia-7-539"><label>e</label><p>1 missing data.</p></fn><fn id="tfn16-cia-7-539"><label>**</label><p><italic>P</italic> < 0.001.</p></fn><fn id="tfn17-cia-7-539"><p><bold>Abbreviations:</bold> NC, normal control; MCI middle cognitive impairment.</p></fn></table-wrap-foot></table-wrap><table-wrap id="t5-cia-7-539" position="float"><label>Table 5</label><caption><p>Evaluation of predictive performance of our assessment methodology based on the DAS scores: Leave-one-out cross-validation (LOOCV) results<xref ref-type="table-fn" rid="tfn19-cia-7-539">a</xref></p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th align="left" valign="top" rowspan="1" colspan="1">DAS<sub>.,P1</sub>() score</th><th align="left" valign="top" rowspan="1" colspan="1">DAS<sub>.,P2</sub>() score</th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">K value of the K-folder for the cross-validation method, K</td><td align="left" valign="top" rowspan="1" colspan="1">26</td><td align="left" valign="top" rowspan="1" colspan="1">38</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Number of observations of each training dataset used for classifying the new test data (n<sub>test</sub> = 1), n<sub>training</sub></td><td align="left" valign="top" rowspan="1" colspan="1">25</td><td align="left" valign="top" rowspan="1" colspan="1">37</td></tr><tr><td colspan="3" align="left" valign="top" rowspan="1"><bold>Relationship between the DAS scores compared with current rating scales</bold></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Spearman’s correlation coefficient with MMSE, mean (±SD)</td><td align="left" valign="top" rowspan="1" colspan="1">0.68 (±0.03)</td><td align="left" valign="top" rowspan="1" colspan="1">0.81 (±0.01)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Spearman’s correlation with IADL-E, mean (±SD)</td><td align="left" valign="top" rowspan="1" colspan="1">−0.64 (±0.03)</td><td align="left" valign="top" rowspan="1" colspan="1">−0.05 (±0.03)</td></tr><tr><td colspan="3" align="left" valign="top" rowspan="1"><bold>Predictive performance of the ecological assessment based on the DAS scores results</bold><xref ref-type="table-fn" rid="tfn20-cia-7-539">b</xref></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Threshold of cut-off point, mean (±SD)<xref ref-type="table-fn" rid="tfn21-cia-7-539">c</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.62 (±0.01)</td><td align="left" valign="top" rowspan="1" colspan="1">0.21 (±0.01)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Accuracy rate</td><td align="left" valign="top" rowspan="1" colspan="1">88.5%</td><td align="left" valign="top" rowspan="1" colspan="1">71.1%</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Predictive positive value</td><td align="left" valign="top" rowspan="1" colspan="1">93.3%</td><td align="left" valign="top" rowspan="1" colspan="1">68.2%</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Predictive negative value</td><td align="left" valign="top" rowspan="1" colspan="1">81.8%</td><td align="left" valign="top" rowspan="1" colspan="1">75%</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">False positive rate</td><td align="left" valign="top" rowspan="1" colspan="1">3.9%</td><td align="left" valign="top" rowspan="1" colspan="1">18.4%</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">False negative rate</td><td align="left" valign="top" rowspan="1" colspan="1">7.7%</td><td align="left" valign="top" rowspan="1" colspan="1">10.5%</td></tr></tbody></table><table-wrap-foot><fn id="tfn18-cia-7-539"><p><bold>Notes:</bold></p></fn><fn id="tfn19-cia-7-539"><label>a</label><p>The leave-one-out cross-validation was used to provide an un-biased estimation of the prevision errors of our models (the DAS scores), and therefore to assess how the results of our models will generalize to an independent data (data not used during the fitting procedure). In our context, this methodology consists to estimate the parameter set (k<sub>1,n</sub>, k<sub>2,n</sub>, k<sub>3,n</sub>, k<sub>4,n</sub>), n € {P1, P2} with the training dataset (n<sub>training</sub>) and to define the threshold of cut-off point from the DAS scores computed from the training dataset, and then to validate this assessment methodology to classify the test data. For the LOOCV, this procedure was repeated K times: each observation in the initial sample is used once as the test data;</p></fn><fn id="tfn20-cia-7-539"><label>b</label><p>predictive performance was computed according to the LOOCV methodology;</p></fn><fn id="tfn21-cia-7-539"><label>c</label><p>the threshold was defined for each training dataset as the cut-off that minimizes the absolute value between the specificity and the sensitivity to optimize both.</p></fn></table-wrap-foot></table-wrap><table-wrap id="t6-cia-7-539" position="float"><label>Table 6</label><caption><p>Spearman’s correlation coefficients between DAS<sub>.,n</sub>() scores with Diagnosis, MMSE and IADL-E</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th colspan="2" align="left" valign="top" rowspan="1">Diagnosis</th><th colspan="2" align="left" valign="top" rowspan="1">MMSE</th><th colspan="2" align="left" valign="top" rowspan="1">IADL-E</th></tr><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th colspan="2" align="left" valign="top" rowspan="1"><hr></hr></th><th colspan="2" align="left" valign="top" rowspan="1"><hr></hr></th><th colspan="2" align="left" valign="top" rowspan="1"><hr></hr></th></tr><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th align="left" valign="top" rowspan="1" colspan="1">P1<xref ref-type="table-fn" rid="tfn23-cia-7-539">a</xref></th><th align="left" valign="top" rowspan="1" colspan="1">P2<xref ref-type="table-fn" rid="tfn24-cia-7-539">b</xref></th><th align="left" valign="top" rowspan="1" colspan="1">P1</th><th align="left" valign="top" rowspan="1" colspan="1">P2</th><th align="left" valign="top" rowspan="1" colspan="1">P1</th><th align="left" valign="top" rowspan="1" colspan="1">P2</th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">RE<sub>ff</sub></td><td align="left" valign="top" rowspan="1" colspan="1">−0.50<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.11</td><td align="left" valign="top" rowspan="1" colspan="1">0.55<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">−0.15</td><td align="left" valign="top" rowspan="1" colspan="1">−0.53<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">−0.01</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Index 1</td><td align="left" valign="top" rowspan="1" colspan="1">−0.63<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">−0.20</td><td align="left" valign="top" rowspan="1" colspan="1">0.59<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.32</td><td align="left" valign="top" rowspan="1" colspan="1">−0.62<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">−0.01</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Index 2</td><td align="left" valign="top" rowspan="1" colspan="1">−0.69<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.34<xref ref-type="table-fn" rid="tfn25-cia-7-539">*</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.70<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.34<xref ref-type="table-fn" rid="tfn25-cia-7-539">*</xref></td><td align="left" valign="top" rowspan="1" colspan="1">−0.64<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.07</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Index 3</td><td align="left" valign="top" rowspan="1" colspan="1">−0.76<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.77<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.77<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.77<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">−0.65<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">−0.08</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Index 4</td><td align="left" valign="top" rowspan="1" colspan="1">−0.76<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.81<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.81<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.81<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">−0.64<xref ref-type="table-fn" rid="tfn26-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">−0.06</td></tr></tbody></table><table-wrap-foot><fn id="tfn22-cia-7-539"><p><bold>Notes:</bold></p></fn><fn id="tfn23-cia-7-539"><label>a</label><p>For P1, Diagnosis = 0 refers to NC group, Diagnosis = 1 refers to AD group;</p></fn><fn id="tfn24-cia-7-539"><label>b</label><p>for P2, Diagnosis = 0 refers to NC group, Diagnosis = 1 refers to MCI group.</p></fn><fn id="tfn25-cia-7-539"><label>*</label><p><italic>P</italic> < 0.05;</p></fn><fn id="tfn26-cia-7-539"><label>**</label><p><italic>P</italic> < 0.001.</p></fn></table-wrap-foot></table-wrap><table-wrap id="t7-cia-7-539" position="float"><label>Table 7</label><caption><p>Ratio of efficacy and qualitative parameters in the two protocols for each diagnosis group</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1">Raw parameters</th><th colspan="2" align="left" valign="top" rowspan="1">Participants</th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>Raw parameters for the protocol 1 (P1)</bold></td><td align="left" valign="top" rowspan="1" colspan="1"><bold>NC group (N = 10)</bold></td><td align="left" valign="top" rowspan="1" colspan="1"><bold>AD group (N = 16)</bold></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Ratio of efficacy, mean [CI(95%)]<xref ref-type="table-fn" rid="tfn28-cia-7-539">*</xref></td><td align="left" valign="top" rowspan="1" colspan="1">0.71 [0.68, 0.74]</td><td align="left" valign="top" rowspan="1" colspan="1">0.61 [0.54, 0.68]</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Omission of at least one activity, n (%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td><td align="left" valign="top" rowspan="1" colspan="1">2 (12.5%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Repetition of at least one activity, n (%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td><td align="left" valign="top" rowspan="1" colspan="1">6 (37.5%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Incorrect order, n (%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td><td align="left" valign="top" rowspan="1" colspan="1">4 (25%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">At least one failure to complete one activity at the first time, n (%)</td><td align="left" valign="top" rowspan="1" colspan="1">1 (10%)</td><td align="left" valign="top" rowspan="1" colspan="1">7 (43.75%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1"><bold>Raw parameters for the protocol 2 (P2)</bold></td><td align="left" valign="top" rowspan="1" colspan="1"><bold>NC group (N = 19)</bold></td><td align="left" valign="top" rowspan="1" colspan="1"><bold>MCI group (N = 19)</bold></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Ratio of efficacy, mean [CI(95%)]</td><td align="left" valign="top" rowspan="1" colspan="1">0.54 [0.49, 0.59]</td><td align="left" valign="top" rowspan="1" colspan="1">0.56 [0.52, 0.61]</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Omission of at least one activity, n (%)</td><td align="left" valign="top" rowspan="1" colspan="1">0 (0%)</td><td align="left" valign="top" rowspan="1" colspan="1">3 (15.8%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Repetition of at least one activity excluding leisure activity, n (%)</td><td align="left" valign="top" rowspan="1" colspan="1">3 (15.8%)</td><td align="left" valign="top" rowspan="1" colspan="1">6 (31.6%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">No respect of 2 or 3 constraints order, n (%)</td><td align="left" valign="top" rowspan="1" colspan="1">6 (31.6%)</td><td align="left" valign="top" rowspan="1" colspan="1">8 (42.1%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">At least one activity not achieved, n (%)<xref ref-type="table-fn" rid="tfn29-cia-7-539">**</xref></td><td align="left" valign="top" rowspan="1" colspan="1">3 (15.8%)</td><td align="left" valign="top" rowspan="1" colspan="1">13 (68.4%)</td></tr></tbody></table><table-wrap-foot><fn id="tfn27-cia-7-539"><p><bold>Notes:</bold></p></fn><fn id="tfn28-cia-7-539"><label>*</label><p><italic>P</italic> < 0.05;</p></fn><fn id="tfn29-cia-7-539"><label>**</label><p><italic>P</italic> < 0.001.</p></fn><fn id="tfn30-cia-7-539"><p><bold>Abbreviations:</bold> NC, normal control; AD, Alzheimer disease; MCI, middle cognitive impairment.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>France</li><li>Indonésie</li><li>Pays-Bas</li></country></list><tree><country name="France"><noRegion><name sortKey="Sacco, Guillaume" sort="Sacco, Guillaume" uniqKey="Sacco G" first="Guillaume" last="Sacco">Guillaume Sacco</name></noRegion><name sortKey="Bordone, Nathalie" sort="Bordone, Nathalie" uniqKey="Bordone N" first="Nathalie" last="Bordone">Nathalie Bordone</name><name sortKey="Bremond, Francois" sort="Bremond, Francois" uniqKey="Bremond F" first="François" last="Bremond">François Bremond</name><name sortKey="Bremond, Francois" sort="Bremond, Francois" uniqKey="Bremond F" first="François" last="Bremond">François Bremond</name><name sortKey="Darmon, Nelly" sort="Darmon, Nelly" uniqKey="Darmon N" first="Nelly" last="Darmon">Nelly Darmon</name><name sortKey="David, Renaud" sort="David, Renaud" uniqKey="David R" first="Renaud" last="David">Renaud David</name><name sortKey="David, Renaud" sort="David, Renaud" uniqKey="David R" first="Renaud" last="David">Renaud David</name><name sortKey="Dechamps, Arnaud" sort="Dechamps, Arnaud" uniqKey="Dechamps A" first="Arnaud" last="Dechamps">Arnaud Dechamps</name><name sortKey="Derreumaux, Alexandre" sort="Derreumaux, Alexandre" uniqKey="Derreumaux A" first="Alexandre" last="Derreumaux">Alexandre Derreumaux</name><name sortKey="Derreumaux, Alexandre" sort="Derreumaux, Alexandre" uniqKey="Derreumaux A" first="Alexandre" last="Derreumaux">Alexandre Derreumaux</name><name sortKey="Guerin, Olivier" sort="Guerin, Olivier" uniqKey="Guerin O" first="Olivier" last="Guerin">Olivier Guerin</name><name sortKey="Guerin, Olivier" sort="Guerin, Olivier" uniqKey="Guerin O" first="Olivier" last="Guerin">Olivier Guerin</name><name sortKey="Joumier, Veronique" sort="Joumier, Veronique" uniqKey="Joumier V" first="Véronique" last="Joumier">Véronique Joumier</name><name sortKey="Joumier, Veronique" sort="Joumier, Veronique" uniqKey="Joumier V" first="Véronique" last="Joumier">Véronique Joumier</name><name sortKey="Konig, Alexandra" sort="Konig, Alexandra" uniqKey="Konig A" first="Alexandra" last="Konig">Alexandra Konig</name><name sortKey="Lee, Ji Hyun" sort="Lee, Ji Hyun" uniqKey="Lee J" first="Ji-Hyun" last="Lee">Ji-Hyun Lee</name><name sortKey="Piano, Julie" sort="Piano, Julie" uniqKey="Piano J" first="Julie" last="Piano">Julie Piano</name><name sortKey="Robert, Philippe" sort="Robert, Philippe" uniqKey="Robert P" first="Philippe" last="Robert">Philippe Robert</name><name sortKey="Robert, Philippe" sort="Robert, Philippe" uniqKey="Robert P" first="Philippe" last="Robert">Philippe Robert</name><name sortKey="Sacco, Guillaume" sort="Sacco, Guillaume" uniqKey="Sacco G" first="Guillaume" last="Sacco">Guillaume Sacco</name><name sortKey="Sacco, Guillaume" sort="Sacco, Guillaume" uniqKey="Sacco G" first="Guillaume" last="Sacco">Guillaume Sacco</name><name sortKey="Teboul, Bernard" sort="Teboul, Bernard" uniqKey="Teboul B" first="Bernard" last="Teboul">Bernard Teboul</name></country><country name="Indonésie"><noRegion><name sortKey="Dechamps, Arnaud" sort="Dechamps, Arnaud" uniqKey="Dechamps A" first="Arnaud" last="Dechamps">Arnaud Dechamps</name></noRegion></country><country name="Pays-Bas"><noRegion><name sortKey="Konig, Alexandra" sort="Konig, Alexandra" uniqKey="Konig A" first="Alexandra" last="Konig">Alexandra Konig</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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