How In-Home Technologies Mediate Caregiving Relationships in Later Life

In-home technologies can support older adults' activities of daily living, provide physical safety and security, and connect elders to family and friends. They facilitate aging in place while reducing caregiver burden. One of older adults' primary concerns about in-home technologies is their potential to reduce human contact, particularly from cherished caregivers. In this exploratory in situ study, we provided an ecosystem of networked monitoring technologies to six older adults and their caregivers. We analyzed the amount and content of communication between them. The amount of noncomputer-mediated communication did not decrease through the 6-week study. The content of communication coalesced into four themes: communication about the technologies, communication facilitated by technologies, intrusiveness of technologies, and fun and playfulness with the technologies. Results suggest that in-home technologies, designed with sensitivity to older adults' primary motivations, have the potential to shape and tailor important relationships in later life.     

Image enhancement using a human visual system model

In this paper we report the result of a set of computer experiments carried out to enhance digital images. We use a special line weight function (LWF) which is a combination of zero- and second-order Hermite functions. We are motivated by the physiological evidence reported in R. A. Young, Spatial Vision 2(4), 273–293 (1987), that visual receptive fields are shaped like the sum of a Gaussian function and its Laplacian. This function can also be derived mathematically when the contrast sensitivity experiments in psychophysics are posed as an eigenvalue problem (A. L. Stewart and R. Pinkham, Biol. Cybernetics 64, 373–379 (1991). Analyses of the edge location error show that the proposed function has extremely good localization capability (i.e. the points marked by the operator is as close as possible to the center of the true edge). We also show that the LWF does not detect phantom edges which do not correspond to significant image intensity changes.     

Aging and the vulnerability of speech to dual task demands.

Tracking a digital pursuit rotor task was used to measure dual task costs of language production by young and older adults. Tracking performance by both groups was affected by dual task demands: time on target declined and tracking error increased as dual task demands increased from the baseline condition to a moderately demanding dual task condition to a more demanding dual task condition. When dual task demands were moderate, older adults' speech rate declined but their fluency, grammatical complexity, and content were unaffected. When the dual task was more demanding, older adults' speech, like young adults' speech, became highly fragmented, ungrammatical, and incoherent. Vocabulary, working memory, processing speed, and inhibition affected vulnerability to dual task costs: vocabulary provided some protection for sentence length and grammaticality, working memory conferred some protection for grammatical complexity, and processing speed provided some protection for speech rate, propositional density, coherence, and lexical diversity. Further, vocabulary and working memory capacity provided more protection for older adults than for young adults although the protective effect of processing speed was somewhat reduced for older adults as compared to the young adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Daily negative mood affects fasting glucose in Type 2 diabetes.

Objective: To examine the relationship between mood and blood glucose in a 21-day daily diary study. Design: During a home visit, information was gathered from 206 persons with Type 2 diabetes regarding demographics, disease characteristics and treatment, and depressive symptoms. They had blood drawn at a laboratory, yielding HbA1C. The participants were then telephoned each evening for 21 days and were asked about their positive and negative mood during the past 24 hours. They also tested their blood glucose upon rising in the morning. Main Outcome Measures: The main outcomes measures were positive and negative affect and fasting glucose. Results: Multilevel analyses revealed a relationship between negative affect on one day and morning glucose on the next day. There was no such relationship between positive affect and glucose, nor was there a comparable effect of glucose on one day and either positive or negative affect on the next day. Conclusion: The observed relationship between mood and blood glucose appears to be because of negative affect, not positive, with no evidence of a lagged effect of glucose on mood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Discovery of Potent Nonstructural Protein 5A (NS5A) Inhibitors with a Unique Resistance Profile—Part 2

In ongoing studies towards novel hepatitis C virus (HCV) therapeutics, inhibitors of nonstructural protein 5A (NS5A) were evaluated. Specifically, starting from previously reported lead compounds, peripheral substitution patterns of a series of biaryl‐linked pyrrolidine NS5A replication complex inhibitors were probed and structure–activity relationships were elucidated. Using molecular modelling and a supercritical fluid chromatographic (SFC) technique, intramolecular H‐bonding and peripheral functional group topology were evaluated as key determinants of activity and membrane permeability. The novel compounds exhibited retained potency as compared with the lead compounds, and also showed promising results against a panel of resistance viruses. Together, the results of the study take us a step closer towards understanding the potency of daclatasvir, a clinical candidate upon which the compounds were based, and to designing improved analogues as second‐generation antiviral agents targeting NS5A.     

Privacy concerns in assisted living technologies

The challenges of an aging population require the adoption of in-home and medical technologies to complement the traditional caregiver model. Adoption of such technologies is, however, impinged by privacy concerns. This study investigates a four-dimensional framework that explains the trade-offs between functionality and privacy as constructed by older adults. The four dimensions constitute perceived utility, data granularity, data recipient, and activity sensitivity. We conducted a survey-based study to empirically examine the applicability and robustness of this framework. Our results have implications for the adoption of a wide range of privacy-enhancing technologies. By focusing on the intersection of an under-studied group (nontechnical older adults) and sensitive data (medical and at home), this work has the potential to enable privacy enhancing technologies (PETs) that might be widely adopted.     

Understanding verbal fluency in healthy aging, Alzheimer's disease, and Parkinson's disease.

Objective: Verbal fluency measures are frequently part of batteries designed to assess executive function (EF), but are also used to assess semantic processing ability or word knowledge. The goal of the present study was to identify the cognitive components underlying fluency performance. Method: Healthy young and older adults, adults with Parkinson's disease, and adults with Alzheimer's disease performed letter, category, and action fluency tests. Performance was assessed in terms of number of items generated, clustering, and the time course of output. A series of neuropsychological assessments were also administered to index verbal ability, working memory, EF, and processing speed as correlates of fluency performance. Results: Findings indicated that regardless of the particular performance measure, young adults performed the best and adults with Alzheimer's disease performed most poorly, with healthy older adults and adults with Parkinson's disease performing at intermediate levels. The exception was the action fluency task, where adults with Parkinson's disease performed most poorly. The time course of fluency performance was characterized in terms of slope and intercept parameters and related to neuropsychological constructs. Speed of processing was found to be the best predictor of performance, rather than the efficiency of EF or semantic knowledge. Conclusions: Together, these findings demonstrate that the pattern of fluency performance looks generally the same regardless of how performance is measured. In addition, the primary role of processing speed in performance suggests that the use of fluency tasks as measures of EF or verbal ability warrants reexamination. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The role of visual attention in predicting driving impairment in older adults.

This study evaluated the role of visual attention (as measured by the DriverScan change detection task and the Useful Field of View Test [UFOV]) in the prediction of driving impairment in 155 adults between the ages of 63 and 87. In contrast to previous research, participants were not oversampled for visual impairment or history of automobile accidents. Although a history of automobile accidents within the past 3 years could not be predicted using any variable, driving performance in a low-fidelity simulator could be significantly predicted by performance in the change detection task and by the divided and selection attention subtests of the UFOV in structural equation models. The sensitivity and specificity of each measure in identifying at-risk drivers were also evaluated with receiver operating characteristic curves. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Discovery of Potent Nonstructural Protein 5A (NS5A) Inhibitors with a Unique Resistance Profile—Part 1

Nonstructural protein 5A (NS5A) represents a novel target for the treatment of hepatitis C virus (HCV). Daclatasvir, recently reported by Bristol–Myers–Squibb, is a potent NS5A inhibitor currently under investigation in phase 3 clinical trials. While the performance of daclatasvir has been impressive, the emergence of resistance could prove problematic and as such, improved analogues are being sought. By varying the biphenyl‐imidazole unit of daclatasvir, novel inhibitors of HCV NS5A were identified with an improved resistance profile against mutant strains of the virus while retaining the picomolar potency of daclatasvir. One compound in particular, methyl ((S)‐1‐((S)‐2‐(4‐(4‐(6‐(2‐((S)‐1‐((methoxycarbonyl)‐L ‐valyl)pyrrolidin‐2‐yl)‐1H‐imidazol‐5‐yl)quinoxalin‐2‐yl)phenyl)‐1H‐imidazol‐2‐yl)pyrrolidin‐1‐yl)‐3‐methyl‐1‐oxobutan‐2‐yl)carbamate ( 17 ), exhibited very promising activity and showed good absorption and a long predicted human pharmacokinetic half‐life. This compound represents a promising lead that warrants further evaluation.