New machine-learning algorithms from Columbia University detect cognitive impairment in older drivers.
An older person's cognitive health is not always obvious. Cognitive impairment and dementia manifest gradually over time, and a person may be unaware of their advance. During this subtle transition, such a person may continue living as they always have, going about their business at home and behind the wheel. But this could lead to a dangerous car accident.
So, researchers from Columbia University have announced the development of AI algorithms that can detect mild cognitive impairment and dementia in older people based on the way they drive. The authors report in the journal Geriatrics that their algorithm is 88 percent accurate.
"Driving is a complex task involving dynamic cognitive processes and requiring essential cognitive functions and perceptual motor skills," says senior author Guohua Li, professor of epidemiology. "Our study indicates that naturalistic driving behaviors can be used as comprehensive and reliable markers for mild cognitive impairment and dementia."
Random forest model
The algorithms the researchers developed were based on a common AI statistical method involving "decision trees" that form a "random forest model." The most successful algorithm, according to lead author Sharon Di, associate professor of civil engineering, was based on "variables derived from the naturalistic driving data and basic demographic characteristics, such as age, sex, race/ethnicity and education level."
Decision trees are often used in memes in which answering "yes" or "no" regarding some attribute leads you down a path to another question, which in turn ultimately leads to a final conclusion.
Data used in the study
The algorithm was developed using data sourced by the Longitudinal Research on Aging Drivers (LongROAD) study sponsored by the AAA Foundation for Traffic Safety. It came from in-vehicle recording devices that captured the driving behaviors of 2,977 participants from August 2015 through March 2019. At the time the project began, the motorists' ages ranged from 65 to 79 years. From the raw data, the authors of the new study derived 29 behavioral variables, which they used to develop cognitive profiles of the drivers.
Credit: Zoran Zeremski/Adobe Stock
The researchers then developed a series of machine-learning models to predict cognitive issues, with differing success rates. While models based on driving variables alone were just 66 percent accurate, and demographic models less so at 29 percent, using both models together produced an accuracy rate of 88 percent.
The researchers also explored the validity of individual factors as predictors of cognitive issues. In order of most reliable to least reliable, they were: (1) age; (2) percentage of trips traveled within 15 miles of home; (3) race/ethnicity; (4) minutes per round trip; and (5) number of hard braking events.
Li is hopeful that his team's work can help keep roadways and older drivers safe. "If validated," he says, "the algorithms developed in this study could provide a novel, unobtrusive screening tool for early detection and management of mild cognitive impairment and dementia in older drivers."
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Older people are in grave danger of being left behind.
Many young people have embraced the convenience of digital technologies such as online shopping, car hailing, digital payments, and telemedicine. But many elderly without a grasp of the latest knowledge are at risk of being left behind.
Several news reports in China during the outbreak of COVID-19 put this issue in the spotlight: an elderly woman who wanted to pay for her medical insurance with cash was refused due to concerns that her cash might be carrying the virus.
The woman, who had not set up mobile payment, was left alone in the service centre at a loss.
In another case, an elderly man without a phone was asked to get off the bus after failing to show the driver his health-status code via the app used at all public places in China.
These incidents are stark reminders of the widening digital gap for the elderly.
China: an ageing population puts a spotlight on the digital divide
The challenge is not unique to China, but it is particularly pressing for the country given the rapid transformation of its massive population of 1.4 billion into an aging society.
Around 2022, China is projected to become an "aged society" with 14% of the population above 65 years old – some 200 million people. It would typically take nearly a hundred years for many countries to reach this stage, while it will only have taken 21 years in China.
What's even more staggering is that by 2050, the number of Chinese elderly is estimated to reach 380 million, amounting to nearly 30% of the country's overall population.
With just a small population of the elderly online, more needs to be done to provide access and guidance before the problem exacerbates with the rapidly rising aging population.
Pandemic pushes the elderly out of offline comfort zone
According to statistics from China's Ministry of Industry and Information Technology (MIIT), out of the 274 million mobile phone accounts of elderly users (those 60 years old and above) in China today, about 134 million are using smart phones to browse the internet. This means approximately 140 million still lack access to it.
The pandemic, however, has pushed a great number of elderly people online, in China and globally. The Chinese government issued plans in November last year to help elderly people overcome barriers to using smart technology.
Meanwhile tech companies, such as e-commerce company JD.com, are stepping up their efforts to ease the transition. Here are three major trends in this arena:
1. Taking online in-store
Brick-and-mortar stores have started to arrange assistants in dedicated zones to help elderly customers make sense of everything from digital payments to robot services. These are all services that many young people, who grew up with the internet from an early age, take for granted – but they can also be learned.
At JD's omnichannel supermarket SEVEN FRESH, elderly customers are guided by staff to place grocery orders online, that are then delivered to their doorsteps at a specific time. Similarly, in JD's offline pharmacy, customers can sit on a sofa inside the store and wait to collect their medicine, pay for it with the help of in-store assistants, and walk away with professional healthcare advice.
"We are keen to use and benefit from these new technologies, but getting to grips with them is no easy task for us," said Ms Zhang, 78, an empty nester who tried to use a self-help health screening robot in a JD pharmacy store.
Her words speak to the difficulties many elderly people face. "By using this machine, I have not only experienced advanced technology, but also gained confidence," said Ms Zhang, after having mastered the robot.
In terms of online services, many elderly customers shy away from voice systems or chatbots. In light of this, China's top three telecom operators recently announced a speed-dial system to transfer users above 65 directly to human service personnel.
Furthermore, upon the request of MIIT, adaptive versions of more than 150 apps and websites in China are being built, featuring simpler interfaces, fewer pop-up adds and more anti-fraud support.
2. From louder smartphones to voice-activated home appliances
Tailormade smartphones play an important role in easing elderly people's transition into the digital space. Phones with big buttons, larger font size and high-volume speakers have popped up recently.
Last year, JD launched China's first 5G smartphone for the elderly in partnership with ZTE. The phone is equipped with services such as remote assistance, synchronised family photo sharing album and fast medical consultation services – handy for both the elderly and their children.
Importantly, it enables adult children to manage their elderly parents' phones from afar – something that is becoming more necessary as families are increasingly separated by the demands of work in a location far from home. (JD data found that 70% of elderly consumers believe children are indispensable in their care process and 68% want to spend more time with their children, but this is not always possible.)
Besides customised smartphones, JD and other companies are exploring a variety of ways to adopt advanced technologies to improve elderly people's lives.
These include: voice-activated IoT home appliances for users with limited mobility; an AI-powered speech recognition system that can communicate in a variety of dialects; and a big-data based health management system that can provide more accurate health advice.
3. Enabling the elderly a good investment for brands
Training goes a long way to abating the fear surrounding new technology. Last year, JD organised classes for the elderly on how to use digital devices, starting with basics like downloading apps, and increasing in complexity to cover how to line up for a hospital appointment virtually, scan QR codes and use mobile payments.
This has economic benefits too. With more and more elderly finding their footing in the digital world, they are adding fuel to the already booming silver economy.
During 2020, JD saw more elderly consumers start shopping online due to COVID-19; and they've kept up the habit since, appreciating the added convenience and plethora of choices. This has led the company to use big data to work on more products designed specifically for elderly consumers.
But it's about much more than just learning how to use the technology. With a better grasp of e-commerce, elderly parents are now turning around and making purchases for their children. Some are even joining flash sales campaigns, participating in the highly popular new phenomenon of group buying, and even grabbing digital red envelopes.
And, in diverting themselves from loneliness, especially during the pandemic, they are turning to livestreaming, short videos and singing apps for entertainment.
Behind these skills are newfound confidence, freedom and connection; the idea that they are "too old" or that "technology is just for young people" is simply a thing of the past.
Researchers from Israel reversed two key processes involved in aging.
- Israeli scientists reversed two major processes involved in aging.
- Their new therapy counteracted the shortening of telomeres and the accumulation of old and dying cells.
- The study participants underwent oxygen treatments in hyperbaric chambers.
Scientists from Israel carried out a study that might prove groundbreaking in the human quest to slow the biological march of time. Researchers used oxygen treatments in hyperbaric chambers to stop blood cells from aging, actually making them grow younger.
The scientists devised a novel program that uses high-pressure oxygen in a pressure chamber to reverse two key processes that stem from aging. They were able to counteract the shortening of telomeres, which are protective regions at the ends of every chromosome, and the body's aggregation of old and poorly-functioning cells.
As we get older, our cells continue to divide, while the telomeres keep getting shorter. If they become too short, the cells stop replicating (becoming "senescent") and eventually die. This results in genetic aging. Analyzing the study participant immune cells, the researchers saw a lengthening in 38 percent of the telomeres, while the senescent cells decreased by 37 percent. This is similar to the cellular state of their bodies 25 years earlier, the researchers noted.
The pressurized chamber involved in the study.
Credit: Shamir Medical Center
The study involved 35 healthy people over 64 years old, who underwent 60 hyperbaric sessions in 3 months. With the air pressure in the chamber twice that of normal, the subjects would breathe pure oxygen, saturating their blood and bodily tissues.
The research team was led by Professor Shai Efrati from Tel Aviv University, who is also the Founder and Director of the Sagol Center of Hyperbaric Medicine at the Shamir Medical Center, as well as Dr. Amir Hadanny, the Sagol Center's Chief Medical Research Officer.
In a press release, Professor Efrati explained that their team has been working on hyperbaric research and therapy for many years, looking to develop treatments based on exposing patients to varying concentrations of high-pressure oxygen. One of their achievements was in improving aging people's brain functions. The current study was focused on seeing if the aging process could be slowed down at the cellular level in healthy adults.
What are telomeres?
"Today telomere shortening is considered the 'Holy Grail' of the biology of aging," Professor Efrati elaborated. "Researchers around the world are trying to develop pharmacological and environmental interventions that enable telomere elongation. Our HBOT protocol was able to achieve this, proving that the aging process can in fact be reversed at the basic cellular-molecular level."
Dr. Hadanny added that, previously, lifestyle changes and a great deal of exercise were required to achieve some impact on the shortening of telomeres. But in their "pioneering" study, "only three months of HBOT were able to elongate telomeres at rates far beyond any currently available interventions or lifestyle modifications."
While more research is required to expand upon these results, you can check out the promising study published in the journal Aging.
Research suggests that aging affects a brain circuit critical for learning and decision-making.
As people age, they often lose their motivation to learn new things or engage in everyday activities. In a study of mice, MIT neuroscientists have now identified a brain circuit that is critical for maintaining this kind of motivation.
This circuit is particularly important for learning to make decisions that require evaluating the cost and reward that come with a particular action. The researchers showed that they could boost older mice's motivation to engage in this type of learning by reactivating this circuit, and they could also decrease motivation by suppressing the circuit.
"As we age, it's harder to have a get-up-and-go attitude toward things," says Ann Graybiel, an Institute Professor at MIT and member of the McGovern Institute for Brain Research. "This get-up-and-go, or engagement, is important for our social well-being and for learning — it's tough to learn if you aren't attending and engaged."
Graybiel is the senior author of the study, which appears today in Cell. The paper's lead authors are Alexander Friedman, a former MIT research scientist who is now an assistant professor at the University of Texas at El Paso, and Emily Hueske, an MIT research scientist.
Evaluating cost and benefit
The striatum is part of the basal ganglia — a collection of brain centers linked to habit formation, control of voluntary movement, emotion, and addiction. For several decades, Graybiel's lab has been studying clusters of cells called striosomes, which are distributed throughout the striatum. Graybiel discovered striosomes many years ago, but their function had remained mysterious, in part because they are so small and deep within the brain that it is difficult to image them with functional magnetic resonance imaging (fMRI).
In recent years, Friedman, Graybiel, and colleagues including MIT research fellow Ken-ichi Amemori have discovered that striosomes play an important role in a type of decision-making known as approach-avoidance conflict. These decisions involve choosing whether to take the good with the bad — or to avoid both — when given options that have both positive and negative elements. An example of this kind of decision is having to choose whether to take a job that pays more but forces a move away from family and friends. Such decisions often provoke great anxiety.
In a related study, Graybiel's lab found that striosomes connect to cells of the substantia nigra, one of the brain's major dopamine-producing centers. These studies led the researchers to hypothesize that striosomes may be acting as a gatekeeper that absorbs sensory and emotional information coming from the cortex and integrates it to produce a decision on how to act. These actions can then be invigorated by the dopamine-producing cells.
The researchers later discovered that chronic stress has a major impact on this circuit and on this kind of emotional decision-making. In a 2017 study performed in rats and mice, they showed that stressed animals were far more likely to choose high-risk, high-payoff options, but that they could block this effect by manipulating the circuit.
In the new Cell study, the researchers set out to investigate what happens in striosomes as mice learn how to make these kinds of decisions. To do that, they measured and analyzed the activity of striosomes as mice learned to choose between positive and negative outcomes.
During the experiments, the mice heard two different tones, one of which was accompanied by a reward (sugar water), and another that was paired with a mildly aversive stimulus (bright light). The mice gradually learned that if they licked a spout more when they heard the first tone, they would get more of the sugar water, and if they licked less during the second, the light would not be as bright.
Learning to perform this kind of task requires assigning value to each cost and each reward. The researchers found that as the mice learned the task, striosomes showed higher activity than other parts of the striatum, and that this activity correlated with the mice's behavioral responses to both of the tones. This suggests that striosomes could be critical for assigning subjective value to a particular outcome.
"In order to survive, in order to do whatever you are doing, you constantly need to be able to learn. You need to learn what is good for you, and what is bad for you," Friedman says.
"A person, or this case a mouse, may value a reward so highly that the risk of experiencing a possible cost is overwhelmed, while another may wish to avoid the cost to the exclusion of all rewards. And these may result in reward-driven learning in some and cost-driven learning in others," Hueske says.
The researchers found that inhibitory neurons that relay signals from the prefrontal cortex help striosomes to enhance their signal-to-noise ratio, which helps to generate the strong signals that are seen when the mice evaluate a high-cost or high-reward option.
Loss of motivation
Next, the researchers found that in older mice (between 13 and 21 months, roughly equivalent to people in their 60s and older), the mice's engagement in learning this type of cost-benefit analysis went down. At the same time, their striosomal activity declined compared to that of younger mice. The researchers found a similar loss of motivation in a mouse model of Huntington's disease, a neurodegenerative disorder that affects the striatum and its striosomes.
When the researchers used genetically targeted drugs to boost activity in the striosomes, they found that the mice became more engaged in performance of the task. Conversely, suppressing striosomal activity led to disengagement.
In addition to normal age-related decline, many mental health disorders can skew the ability to evaluate the costs and rewards of an action, from anxiety and depression to conditions such as PTSD. For example, a depressed person may undervalue potentially rewarding experiences, while someone suffering from addiction may overvalue drugs but undervalue things like their job or their family.
The researchers are now working on possible drug treatments that could stimulate this circuit, and they suggest that training patients to enhance activity in this circuit through biofeedback could offer another potential way to improve their cost-benefit evaluations.
"If you could pinpoint a mechanism which is underlying the subjective evaluation of reward and cost, and use a modern technique that could manipulate it, either psychiatrically or with biofeedback, patients may be able to activate their circuits correctly," Friedman says.
The research was funded by the CHDI Foundation, the Saks Kavanaugh Foundation, the National Institutes of Health, the Nancy Lurie Marks Family Foundation, the Bachmann-Strauss Dystonia and Parkinson's Foundation, the William N. and Bernice E. Bumpus Foundation, the Simons Center for the Social Brain, the Kristin R. Pressman and Jessica J. Pourian '13 Fund, Michael Stiefel, and Robert Buxton.