Alzheimer's disease is a universal medical challenge. A timely identification of this ailment can reduce expenses and enhance the patient's quality of life. Alzheimer's diagnosis includes a critical component called cognitive assessment. These examinations have been carried out by neurologists, utilizing paper-and-pencil ever since the development of neurological tests. But it's obvious that integrating digital technologies into such assessments has many advantages. This chapter describes the design of an Android application, GanglioNav WithYou, for conducting cognitive assessments in Alzheimer's patients. The researchers have built a 3D virtual neurologist to conduct this assessment for Alzheimer patients. The virtual neurologist will ask questions that test the different mental abilities of patients such as time orientation, ability to recall things, concentration skills, language skills, visual interpretation skills, etc. At the end of the assessment, the total score is calculated, and the virtual neurologist will generate a detailed assessment report.
TopIntroduction
Alzheimer's disease (AD) is a progressive, irreversible neurological illness that accounts for approximately 60 percent of all dementia cases (Qiao et al., 2022). More than 55 million individuals worldwide had dementia by the year 2020 (alzint.org, n.d.) and this number will roughly double every 20 years, reaching 78 million in 2030 and 139 million in 2050 (alzint.org, n.d.). Much of the increase will affect the developing globe. In low- and middle-income countries, 60 percent of adults suffer from dementia; by 2050, that percentage will rise to 71 percent (alzint.org, n.d.).
According to research, most people living with dementia do not have an official diagnosis. According to the study, around three-quarters of those with dementia have not been diagnosed (alzint.org, n.d.). The main clinical signs of Alzheimer's disease include cognitive impairment, memory impairment, speech disorders, and behavioral abnormalities (Arlt, 2013; Iodice et al., 2021; Jia et al., 2021; Lanzi et al., 2021; Martínez-Nicolás et al., 2021; Narasimhan et al., 2021). Magnetic resonance imaging (MRI) (Chen et al., 2022; Fathi et al., 2022; Saleem et al., 2022) has gained greater attention as a crucial tool for the early identification of some brain disorders and is an excellent measure to evaluate the stage of a subject, such as Normal Control (NC), mild cognitive impairment (MCI), and Alzheimer's disease (AD) (Orouskhani et al., 2022).
For neurodegenerative disorders in general, and specifically for dementia and its most common form, Alzheimer's disease (AD), age is a significant risk factor. The yearly prevalence of AD and its impact on society and the economy are rising along with rising life expectancy. As a result, it will be more crucial than ever to screen for dementia and cognitive impairment. Traditional paper-and-pencil cognitive tests and a series of neurological evaluations are often necessary for an AD diagnosis (Vos et al., n.d.). The problem is that many people wait until they or their loved ones notice a deterioration in memory before seeking a medical evaluation of cognitive functioning. There might already have been considerable, irreparable brain damage by then, along with fast worsening cognitive impairment (Vos et al., n.d.). Therefore, earlier diagnosis is significant and could aid clinical trial research in selecting the appropriate patients. So, tools that enable earlier diagnosis are necessary for earlier intervention so that a neurological workup can be taken into account.
Determining clinical scores such as the mini mental state examination (MMSE) of people now and in the future using MRI is also becoming a major topic in early Alzheimer's disease diagnosis (Tahami Monfared et al., 2022; Tian et al., 2022). The mini mental state exam is a simple 30-point questionnaire that can used to predict several neurodegenerative disorders such as Alzheimer’s and dementia in the older generation (Hoops et al., 2009; Kang et al., 1997). It can be used to: (1) screen for cognitive impairment; (2) evaluate the degree of impairment at a particular time; (3) track an individual's progression of cognitive alterations over time; and (4) record an individual's response to therapy. It evaluates a variety of cognitive components, such as language, orientation, memory, and visuospatial ability. The total score across all items reflects the degree of cognitive impairment that is currently present. Reduced test scores over time reflect deterioration in cognitive.
Scores correspond with other mental tests, electroencephalography, computerized tomography, magnetic resonance imaging, single photon emission computed tomography (SPECT) scan, CSF proteins and enzymes, and brain biopsy synapse counts and are reliable between tests and between raters. Dementia, delirium, mental retardation, Parkinson's disease, stroke, and some forms of depression are all associated with lower test scores than healthy controls. (Counsell et al., 2022; Zhou et al., 2022). Alzheimer’s disease patients lose 3–4 points per year of illness after the onset of memory disturbance, although there is wide variability in this phenomenon (Jahn, 2013).