Robots, AI and Cognitive Training in an Era of Mass Age-related Cognitive Decline
Never at any point in human history has the prevalence of age-related cognitive decline been so great. Since the second world war, the population of Western Europe and eastern Asia has grown and grown older. As a result of improvements in medicine, nutrition and workplace safety standards, and with the help of a precipitous drop in infant mortality rates, the average life span of these countries has continued to rise [1]. In 2015, people over 60 years of age in Western Europe represented 21% of the population [2]. Presently in countries such as Japan, according to Haruaki Deguchi of The Japan Times [3], those individuals 65 years of age or older have come to represent up to 28% of the population. All of this, despite the dropping infant mortality rate.
And these figures have not peaked. Indeed, they are predicted to grow, perhaps considerably [2]. By 2030, 33% of the population of Western Europe is expected to be above 60 years of age [2]. In contrast, in Japan, by 2060, one in every 2.5 people will be 65 years old, or older [3]. Following this trend, the elderly may comprise up to 38.4% of the population by 2065 [4]. Worldwide, by 2050 it is predicted that more people will be older than 60 years than under 15 [2].
More important, concomitant with exploding elderly populations of affluent countries is the prevalence of age-related cognitive decline. This impairment appears along a continuum from Mild Cognitive Impairment (MCI) or possibly pre-dementia to Alzheimer’s disease. With the loss of cognition comes the decline in Activities of Daily Living (ADL). A loss in cognition initially can mean the momentary delay in access to common words in a commonplace conversation and progress to the inability to place a familiar face in the street or to identify a family member, and the disintegration of short-term memory. Along this continuum irritation turns to concern and rising anxiety. But in the initial stages the centrality of cognition in human locomotion produces additional reason for concern. Cognitive decline has been shown to effect sensory motor control. Early stages of cognitive decline are in fact detectable in changes of gait and coordination. The deleterious reality increases the incidence of injuries like burns and falls [5].
Worldwide, according to recent estimates, one person every seven seconds is identified with dementia. By the age of 65, 10 to 20% of seniors can be found to experience MCI [6]. While those grappling with MCI may find their symptoms unchanged over time or discover the integrity of their cognition returning to an earlier state, for those experiencing cognitive decline in their mid-60s and beyond, there is a high chance it will progress towards full-blown dementia, at a rate between 10 to 15% per year. This serious concern is compounded by the growing numbers of seniors manifesting symptoms of pre-dementia or Alzheimer’s Disease. References [7], [8]. By 2050 it is estimated that 9, 200,000 people will be afflicted by Alzheimer’s disease around the world [9]. Furthermore, while cognitive decline is devastating for those it touches, it further impacts the physical wellbeing of those suffering from cognitive decline [10]–[12] and, as mentioned, increases the likelihood of physical injury. Consequently, this rise in cognitive decline is projected to place a seemingly insurmountable strain on the medical profession, social services, and taxpayers. For example, while it has been estimated that for every elderly person in 2015, seven health workers were available, by 2030 it is expected that this number will drop to slightly under five [2].
However, as has been noted by Calhoun [13] and Thorndike [14], and is known as the Flynn Effect, I.Q. scores, as calculated using such tools as the Wechseler Intelligence Scale for Children (WISC), have been rising for decades, and not only with children. In fact, in the last five decades measurable I.Q. scores, have risen by 15 points, on average. Similarly, measures of semantic and episodic memory, have also risen, according to Ronnlund [15]. Since evolution cannot be at play this change can only be explained by environment and diet [16]. This would suggest that human intervention can play a role in rehabilitation or mitigation of dementia symptoms.
In fact, non-pharmaceutical approaches to combat age-related cognitive decline have been explored and the results provide reason for optimism. These forms of intervention include therapist-patient cognitive training, physical exercise, animal therapy, and Human Robot Interaction (HRI). Early studies have shown that HRI has the benefit of improving mood, social relationships among patients and emotional expression of individual dementia sufferers [17]–[19]. Furthermore, unprecedented developments in artificial intelligence (AI), robotics and the field of cognitive psychology have demonstrated to be effective, at the very least, at delaying the symptoms for those suffering various levels of age-related cognitive decline [20].
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The associate editor coordinating the review of this manuscript and approving it for publication was Yu-Huei Cheng .
For more about the lead author, see Alistair A. Vogan