Mihoko Otake-Matsuura

Background: Early identification of older adults with lower cognitive screening performance may facilitate appropriate clinical evaluation and intervention to delay the progress of cognitive decline and onset of dementia. Because facial information can be acquired noninvasively and unobtrusively during everyday life, it has attracted increasing attention as a potential digital biomarker. However, it remains unclear which facial regions are associated with cognitive decline under a neutral facial condition. Furthermore, it is unknown whether these facial characteristics primarily reflect static facial appearance or facial movements. Objective: This study aimed to identify facial action unit (AU) patterns associated with lower cognitive screening performance during a fixation-cross viewing condition that is less susceptible to the influence of language and emotional elicitation. Methods: Older adults were classified into either a lower cognitive screening performance group (Montreal Cognitive Assessment Japanese version [MoCA-J] score ≤25; n=31) or a healthy control group (MoCA-J score ≥26; n=14). Facial videos were recorded while participants viewed a fixation cross for 1 minute. OpenFace 2.0 was used to extract the intensities of 17 AUs and the presence of 18 AUs. Video analyses were first performed to identify AU characteristics associated with cognitive screening performance. For AU intensity, frame-level mixed-effects models with participant-specific random intercepts and a first-order autoregressive (AR(1)) correlation structure were used, adjusting for age, Geriatric Depression Scale score, and sex, and participant-level sensitivity analyses were conducted to assess the consistency of the frame-level findings. For AU presence, participant-level analyses were performed because the frame-level models did not yield reliable parameter estimates. Subsequently, single-frame analyses were performed to examine whether the AU characteristics identified in the video analyses could be explained solely by static facial appearance. As this study was exploratory and hypothesis-generating, P values were not adjusted for multiple comparisons. Results: For AU intensity, frame-level video analyses showed that the lower cognitive screening performance group had a higher probability of zero intensity for AU10 (upper lip raiser), with participant-level analysis based on the proportion of zero-intensity frames yielding consistent results. In contrast, single-frame analyses of AU intensity showed no significant group difference for AU10, suggesting that the observed difference may reflect facial movements rather than static facial appearance. For AU presence, video analyses showed no significant group differences. Conclusions: Older adults with lower cognitive screening performance exhibited distinct AU patterns related to AU10 (upper lip raiser) during fixation-cross viewing, which may reflect subtle differences in facial movements around the mouth. These exploratory findings identify candidate facial biomarkers associated with lower cognitive screening performance and warrant validation in larger, balanced, independent samples.

Traditional psychiatric assessments for depression are often hindered by subjective bias and patient recall in-accuracy. This paper presents a multimodal passive Brain-Computer Interface (pBCI) designed for the objective screening of depressive traits through the end-to-end decoding of neural dynamics. We implemented a hybrid EEG-fNIRS framework to capture synchronized electro-hemodynamic responses during an emotional working memory (EWM) task. To classify sub-clinical depressive tendencies based on BDI-II scores, we utilized SincShallowNet, a deep learning architecture optimized for raw signal processing via learnable Sinc-filters. Our results demonstrate that the pBCI achieves peak performance in the auditory modality, with the integration of EEG and low-pass filtered fNIRS (0.15 Hz) yielding a balanced accuracy of 90.9% and an F1-score of 0.867. By isolating purely endogenous neural markers during the EWM maintenance phase, the system provides a robust “silent observer” for mental state monitoring. These findings validate the potential of multimodal pBCIs as high-precision, data-driven tools for early-stage depression screening, offering a scalable alternative to traditional clinical interviews and a foundation for longitudinal mental health monitoring.

Background: Alzheimer's disease (AD) accounts for the majority of dementia-related disorders among aging populations. Given the irreversible nature of AD, early detection of cognitive impairment is critical for improving prognosis and facilitating timely interventions before individuals meet the clinical criteria for AD. Objective: The objective of this review is to provide a comprehensive summary of recent advances in task-based electroencephalography (EEG), such as using attention and inhibitory control tasks, which has recently emerged as a promising non-invasive biomarker for assessing neurophysiological alterations associated with AD and mild cognitive impairment (MCI). Methods: This systematic review evaluates the efficacy of task-based EEG biomarkers in distinguishing cognitively impaired individuals from those without impairment. A comprehensive literature search was conducted across PubMed, Semantic Scholar, and SpringerLink databases for studies published between 2017 and 2024. Results: Findings indicate consistent neurophysiological alterations in MCI and AD, particularly reductions in event-related potential amplitudes and prolonged latencies, with P3 abnormalities observed in about half of the studies assessing selective attention and inhibitory control. Similarly, a comparable number of studies using working memory tasks report disrupted functional connectivity patterns, increased low-frequency oscillations (delta and theta activity), and reduced fast oscillations (alpha and beta activity). Conclusions: These EEG-based indices demonstrate potential as objective biomarkers for detecting neural alterations associated with cognitive decline in both AD and preclinical dementia stages. Further research is needed to standardize EEG protocols and validate their clinical utility for early diagnosis and disease progression monitoring.

Background: Although individual differences in neuronal states are evident, it is only in recent years that these factors have been incorporated into intervention research. Progress in analytical technologies applied to hematological examinations have made it increasingly feasible to assess neuronal states in a more accessible and efficient manner. This study utilized advanced analytical approaches to determine whether cognitive intervention outcomes are influenced by the concentration of blood‐derived biomarkers, such as neurofilament light chain (NfL), since NfL in plasma is considered a promising biomarker for neurodegenerative conditions, notably including Alzheimer's disease. Method: The intervention protocol implemented in this study was Photo‐Integrated Conversation Moderated by Robots (PICMOR), a group‐based conversational approach shown to promote verbal fluency in older populations. In order to assess the potential modulation of intervention effects by individual neuronal states, we performed a randomized controlled trial (UMIN Clinical Trials Registry number: UMIN000036599) to examine how longitudinal changes in cognitive performance, including verbal fluency, correlate with baseline NfL levels. Plasma levels of NfL were assessed twice on the Simoa platform, employing Simoa NF‐Light Advantage kits and the Simoa HD‐1 Analyzer instrument (Quanterix Corporation). Result: Positive effects of the PICMOR intervention on verbal fluency were observed in individuals with lower NfL levels, suggesting a relatively preserved neuronal state. The intervention effect was positively significant at the 5% level for individuals with NfL less than 12(pg/mL). In contrast, individuals with higher baseline NfL levels experienced negative effects on verbal fluency from the intervention. The intervention effect was negatively significant at the 5 % level for individuals with NfL more than 28(pg/mL). Conclusion: Our results indicate that the effects of cognitive intervention are modulated by the plasma NfL concentration. Consequently, it is recommended that future intervention studies incorporate the neuronal condition of participants to assess the effects of the intervention.

Background: Following empirical evidence suggesting a strong connection between social activities and longevity/well-being, this topic has now entered an intervention phase, which evaluates the effectiveness of social activity interventions and accumulates practical knowledge. Among these interventions, conversation—as a core component of social activity—has emerged as a promising target for cognitive, social, and psychological health. Objective: This study examined the effects of “Photo-Integrated Conversation Moderated by Application” (PICMOA), an application-based remote conversational intervention, on the cognitive function and psychological and social well-being, as reflected by selected indicators, among community-dwelling older adults with subjective cognitive concerns in Japan. Methods: The PICMOA trial is a randomized controlled trial introducing an open-label, two parallel group trial design with a 1:1 allocation. In this trial, the effects of the PICMOA intervention, a weekly application-based group conversation, were compared with weekly health education videos. The participants included community dwellers aged 65 years and older with subjective cognitive concerns. The main outcomes included cognitive function assessed through the Telephone Interview for Cognitive Status in Japanese, verbal fluency test, and Digit Span Forward and Backward tests. The secondary outcomes included indicators related to psychological and social well-being, assessed using the Multidimensional Scale of Perceived Social Support, the UCLA Loneliness Scale-10 item version, the 5-item World Health Organization Well-Being Index, and the Health Utilities Index Mark 3. Results: In total, 81 participants were randomized and divided into two groups (intervention: n = 41; control: n = 40). A total of 75 participants who completed the intervention and evaluations were analyzed (intervention: n = 35; control: n = 40). There were no significant improvements associated with cognitive function and psychological metrics in the intervention group compared with the control group during the 12-week intervention. However, the ancillary analysis showed significant decline in the categorical fluency performance for those who were unfamiliar with smartphones at baseline (b = -5.47, SE = 2.04, P = 0.009), suggesting a moderating effect of participants’ familiarity with smartphones at baseline. Conclusions: This trial showed no significant improvements in cognitive and psychological outcomes after the PICMOA intervention. However, the findings raise important considerations regarding participants’ familiarity with digital devices and intervention setting. Further research is needed to accumulate evidence on the duration and intensity of intervention and individual support for improving digital literacy. Clinical trial number: UMIN000047247 (http://www.umin.ac.jp/ctr/), registered on March 22, 2022.

Background Dementia prevention has the potential to bring considerable benefits in diverse contexts. Conversation requires various cognitive functions and is therefore considered a natural multi-component preventive measure that can be practiced in daily life. Although an emerging line of research supports the potential of conversation-based cognitive interventions, further research is needed to elucidate which elements are effective and through what mechanisms. In addition, given that previous studies have shown that older adults embedded in social networks with a high proportion of non-family members have higher cognitive function, fostering social interactions between older adults with those beyond their family would be beneficial, while assessing the ecological validity of delivering conversation-based program in naturalistic community settings is essential. Furthermore, it remains to be clarified whether participants can integrate lessons from conversation-based programs into their daily routines in a voluntary and sustained manner. This study aims to examine the feasibility of the long-term conversation-based program, with preliminary analyses of its key components for future rigorous effectiveness tests. Methods The study is a single-arm longitudinal intervention in a community setting in Japan. Participants will attend monthly sessions over five years, engaging in conversations based on the Coimagination method. The feasibility and adherence are assessed mainly by dropout rates and speech frequencies in sessions, respectively. The primary outcome is verbal fluency, repeatedly improved by previous conversational interventions. The key components of the intervention such as perspective taking and time orientation will also be measured. Preliminary intervention effects will be assessed by the interaction between adherence and time in a mixed-effects model. Discussion The study following this protocol is expected to provide insights into the feasibility and ecological validity of our conversation-based program and its barriers, as well as preliminary findings for conducting a future long-term randomized controlled trial to rigorously verify the intervention effects. Because the intervention will be conducted in parallel in two regions, suggestions for external validity are also expected.

The coimagination method (Otake, 2009) is designed to prevent dementia in individuals with mild cognitive impairment (MCI) by utilizing the brain’s natural processes. This method involves participants sharing their thoughts and feelings through group conversations centered around shared photos. The coimagination method contains two phases: (1) each participant talk about their memories and experiences related to the photos they bring, and (2) other participants ask questions about the photos. Automating the MCI estimation could be helpful for assisting individuals with MCI during coimagination. However, previous MCI estimation methods rarely focused on group conversation scenarios, despite the potential of multimodal features observed in these scenarios in revealing cognitive states. This study focuses MCI individuals defined by cognitive test scores (e.g., Mini-Mental State Examination (MMSE)). We explore MCI estimation from three aspects. First, we clarify whether MCI can be effectively estimated by constructing estimation models using linguistic and acoustic features from coimagination sessions. Second, we evaluate the impact of using data from the two distinct phases, as they may activate participants’ cognitive functions differently. Finally, we analyze the effects of incorporating subtasks including participants’ conversational customary and engagement level during coimagination via multitask learning. The experimental results demonstrated that individuals with MCI can be effectively estimated from group conversations from coimagination, with the highest macro F1 score of 0.693. The results also demonstrated that the performance improved when using data from the phase that highly activates cognitive functions and when considering conversation customary as a subtask.

「福祉科技與服務管理學刊」創辦於2012年12月，由中華福祉科技與服務管理學會發行，旨在提供老人福祉科技(gerontechnology)及高齡者照護服務與管理之相關學者、產業界和從業人員，以中文發表研發成果或實務經驗之平台，期能促進跨領域知識交流與傳播，提升整體研究水平與相關產業發展，進而為高齡化社會衍生之各種問題提出具體解決方案，提升高齡者之生活品質。

Background: Social communication is a key factor in maintaining cognitive function and contributes to well-being in later life. Objective: This study will examine the effects of “Photo-Integrated Conversation Moderated by Application version 2” (PICMOA-2), which is a web-based conversational intervention, on cognitive performance, frailty, and social and psychological indicators among community-dwelling older adults. Methods: This study is a randomized controlled trial with an open-label, 2-parallel group trial and 1:1 allocation design. Community dwellers aged 65 years and older were enrolled in the trial and divided into the intervention and control groups. The intervention group receives the PICMOA-2 program, a web-based group conversation, once every 2 weeks for 6 months. The primary outcome is verbal fluency, including phonemic and semantic fluency. The secondary outcomes are other neuropsychiatric batteries, including the Mini-Mental State Examination, Logical Memory (immediate and delay), verbal paired associates, and comprehensive functional status evaluated by questionnaires, including frailty, social status, and well-being. The effect of the intervention will be examined using a mixed linear model. As a secondary aim, we will test whether the intervention effects vary with the covariates at baseline to examine the effective target attributes. Results: Recruitment was completed in July 2023. A total of 66 participants were randomly allocated to intervention or control groups. As of January 1, 2024, the intervention is ongoing. Participants are expected to complete the intervention at the end of February 2024, and the postintervention evaluation will be conducted in March 2024. Conclusions: This protocol outlines the randomized controlled trial study design evaluating the effect of a 6-month intervention with PICMOA-2. This study will provide evidence on the effectiveness of social interventions on cognitive function and identify effective target images for remote social intervention. Trial Registration: UMIN Clinical Trials UMIN000050877; https://tinyurl.com/5eahsy66 International Registered Report Identifier (IRRID): DERR1-10.2196/56608