Overview

By 2050, one in six people in the world will be over 65, leading to an increase in the number of people with neurocognitive disorders (NCD), such as Alzheimer's disease. The number of cases will rise from 57 million to 153 million by 2050. This presents challenges for healthcare systems, as NCDs affect not only mental health but also the physical health, psychological well-being, and social relationships of patients, as well as their caregivers (PCA).

In Quebec, primary care is often inadequate for people living with NCDs due to delays in accessing resources, incomplete coverage of needs, and the COVID-19 pandemic, which has exacerbated these challenges. This situation can lead to a deterioration in patients' health, affecting their quality of life as well as that of their PCAs, while also increasing healthcare costs.

Many elderly people wish to age at home, but cognitive and functional decline complicates this desire. PCAs, generally family members or close friends, play an essential role in the daily support of these individuals. Their role, as defined in the Act to support caregivers in Quebec, includes non-professional and voluntary assistance to improve the quality of life of the person being cared for.

However, the support provided by PCAs can lead to significant stress, especially if public services are insufficient. The exhaustion of PCAs is often correlated with the severity of the care recipient's loss of autonomy. This exhaustion impacts the mental and physical health of PCAs, leading to isolation, depression, and anxiety, as well as reduced productivity and an increase in sick leave. It is therefore urgent to find support solutions to prevent PCA burnout.

Telehealth, which involves remote consultations through information and communication technologies (ICT), appears to be a promising solution to improve access to care for people with NCDs, especially in underserved areas. By enabling remote monitoring, telehealth facilitates aging in place while stimulating the remaining capacities of patients, such as responsiveness to sensory stimuli.

Artificial intelligence (AI) is also a promising tool for tracking the health of older adults in real-time, detecting early signs of diseases, and providing personalized recommendations. Virtual assistants or avatars, like "Talk-to-Jo," can interact with patients to reduce their sense of loneliness. However, the effectiveness of these technologies depends on their accessibility and adaptability to the needs of patients, particularly in cases of sensory impairments.

"Talk-to-Jo" is a digital avatar designed for older adults with NCDs and their PCAs. It asks questions about memory and depression and provides tailored recommendations to prevent or stabilize detected disorders. A first version of this tool is currently available on a tablet.

With the growing number of people living with NCDs, it is essential to develop support solutions based on telemedicine and AI. It is important to assess the usability and acceptability of these technologies by patients and their PCAs to ensure their effectiveness.

Eligibility

1. Person living with an neurocognitive disorder (NCD):
   1. Inclusion criteria:
      • Be 65 years old or older.
      • Have an NCD, whether minor or major, in a mild to moderate stage, diagnosed within the past year.
      • Be receiving care for an NCD at the outpatient clinic of the Montreal Geriatric University Institute.
      • Have a caregiver.
      • Live in a personal residence or in a non-medicalized senior residence.
      • Be able to understand spoken and written French. The "Talk-to-Jo" avatar has only been developed in the French language and can only communicate and understand French.
   2. Exclusion criteria:
      • Inability to provide informed consent for participation in the study.
      • Participating in a concurrent experimental clinical study, to avoid interference with our study.
      • Living in a Long-Term Care Facility or in a medicalized section of an non-medicalized senior residence.
      • Inability to understand spoken and written French.
      • Having a moderate to severe visual or auditory impairment. The criterion for assessing hearing impairment will be the person's ability to understand and participate in a phone conversation. Individuals with impairments who use hearing aids or glasses to compensate for the impairments may be included. 2. Caregiver
   3. Inclusion criteria:
      • Be a caregiver for a person living with an NCD (regardless of the relationship: spouse, child, friend, neighbor, family member).
      • Be able to understand spoken and written French.
   4. Exclusion criteria:
      • Have an NCD.
      • Inability to understand spoken and written French.
      • Participating in a concurrent experimental clinical study, to avoid interference with our study.
      • Having a moderate to severe visual or auditory impairment. The criterion for assessing hearing impairment will be the person's ability to understand and participate in a phone conversation. Individuals with impairments who use hearing aids or glasses to compensate for the impairments may be included.