CogNotes can be summed up as “Alzheimer’s Disease
assessment embedded in the creative act of music composition.” Together, with
partners the Lincoln Park Performing Arts School and the Yamaha Corporation, a
group of seniors are going through a multi-month composition workshop that’s
outfitted with cognitive measures that are sensitive to the earliest transition
to Alzheimer’s Disease.
Early
Alzheimer’s Detection
There are two problems with Alzheimer’s Diagnosis,
right now.
- The
education problem: As we get older, the brain
changes. There is healthy cognitive decline and something
more. It is difficult, especially in the early stages, to discern
the difference.
- The
prognosis problem: Even if you could
identify the early stages of Alzheimer’s, how difficult would it be to
accept? I’ve heard older adults say things like, “I’d rather just
die than know I had Alzheimer’s Disease.” There is a general feeling
of hopelessness that accompanies the disease making it exceptionally
difficult for at-risk individuals to be proactive.
CogNotes tackles these problems by building
cognitive assessment into the creative process. Rather than waiting for
patients to cross the chasm and self-select to get a check-up, researchers are
proposing a simple, disease relevant, cognitive metrics embedded into the
activities. Now Hyperscore, and incredibly powerful music composition
technology, is outfitted with a companion to perform cognitive assessment as
part of the creative process.
About
CogNotes
This innovative
program works by having the user compose a song and then play a
Concentration-like memory game that takes place in a virtual living room and involves
recalling excerpts of melody pairs and other associative memory tasks. CogNotes
is actually a first cognitive diagnostic tool to perform daily assessments, or
at least with enough frequency that an individual can flag initial signs of Alzheimer’s
disease soon enough to start effective treatment.
The ability to
self-identify the disease early is what the researchers say is ground breaking;
the symptoms of Alzheimer’s disease—memory loss, forgetfulness, trouble finding
the right words—are so similar to those associated with natural aging they
often go unnoticed. “The common scenario is a family member brings someone for
testing two years after symptoms have started and the disease is already so
advanced it’s too late to do much about it,” says Adam Boulanger, CogNotes’
creator and a post doctoral associate at the MIT Media Lab.
CogNotes’ other
advantage over conventional cognitive tests is that it tracks an individual
over time, all the time. “Alzheimer’s disease affects people slowly, symptoms
change and worsen, and can span decades. By offering people a diagnostic tool
that is intellectually rewarding and creatively stimulating, it becomes
something they want to do every day,” says Boulanger, who is a musician and
composer. “Today they use droll pencil and paper tests developed in the
’50s that are conducted in one sitting.”
About
Hyperscore
Designed by Mary Farbood and Tod Machover during the
Toy Symphony Project, Hyperscore is a graphical computer-assisted composition
program intended to make composing music accessible to users without musical
training as well as experienced musicians. The software maps complex musical
concepts to intuitive visual representations. Color, shape, and texture are
used to convey high-level musical features such as timbre, melodic contour, and
harmonic tension.
One of the interesting things about music is that it
touches on just about every aspect of human cognition. From memory to motor,
emotion, planning, execution… music is everywhere in the brain. I imagined a
version of Hyperscore where the discrete elements being used to compose become
probes for cognitive performance. CogNotes takes musical snippets from the
Hyperscore environment and uses them to engage memory in a way that targets the
kind of memory that is at risk in the earliest phases of Alzheimer’s Disease.
The result has implications far beyond music.
The games we play, the mobile applications we use, the way we are social online
– all of these technology enabled environments structure the way we engage with
our environments and one another. By examining those structures with an
eye for research-based mechanisms of information manipulation, activity,
perception, decision making, and behavior, probes for health metrics can be
built into many activities of daily life. Music is just such a great
place to start because people love it.
Research
Boulanger enlisted
students and teachers from the Lincoln Park Performing Arts Charter School in
Midland, Pennsylvania to mentor 18 subjects between 50 and 65. “They started by
doing baseline memory tests,” recalls Russell. “We started with 100 and then
counted backward by sevens. Then we were given a list of numbers verbally, then
they’d talk to us for awhile and asked if we could repeat the numbers.”
Russell and her
fellow subjects couldn’t view their results; they had to be blinded to the data
for it to be valid. “While we were testing other aspects of reliability and
accuracy, we found the data remained consistent even as the participants
mastered the application and developed creatively,” says Boulanger. They also
found musicians appeared to have no advantage. “We found it bizarrely
counterintuitive. People scored equivalently no matter what their musical
background. Now that we know the data is reliable, the next step is to give
users visibility to their own information”. Exactly how that will be delivered
is still in development. They’re plan is to use social media to facilitate
communication between CogNotes users and their peers and doctors.
Within the year,
Boulanger’s goal is to make CogNotes and other software available to the public
via hospitals, doctors’ offices and online. His vision is to embed cognitive
assessment tools into a variety of social and creative endeavors like piano
lessons, games and writing and social media apps “that people have always
wanted to learn anyway.“
If Alzheimer’s can
be detected early, medication and mental exercises have a better chance of
stabilizing memory loss or at least slowing down the progression. “Our goal is
to offer these applications to healthy adults so they can look out for
beginning symptoms that might be otherwise undetected,” says Boulanger. “The
current climate is for individuals to be more responsible for their own
healthcare and this speaks to that.”
How it works?
When a user first boots up CogNotes on the heels of
a Hyperscore composition session, they start at level 1 of the test. They
will hear a 1.5 second sample from their composition work revealed at a
location on the screen. Locations either light up or “flip open and
closed” while the audio snippet plays. After a brief pause, the user will
hear only the audio snippet, and will have to locate the place that flipped
open to release the sound.
At the second level, the user will get two totally
new locations and two new samples from their composition work.
Audio-location pairs are randomly distributed before test iterations.
Furthermore, during testing, the order of presentation of the audio cues is
also randomized, making it unlike “Simon” or other games where you chain one
new audio-location pair after another in a single, persistently lengthening
sequence. The sequence in our assessment is different each iteration. The
test focuses on novel pairs of associations, rather than the memory of a
sequence of associations.
If you make a mistake, all is not lost. The
test follows a three-strike you’re out rule.
Sources
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