This study will develop and test a daily conversation platform that uses a large language model, a type of artificial intelligence, to support cognitive health in older adults at high risk of dementia.
The platform will guide participants through voice-based conversations about topics that interest them. The conversations are designed to engage memory, attention, language, planning and problem-solving, and the ability to understand social situations. The platform will also analyze conversation data and create a report describing the participant's cognitive performance.
The study has two stages. In the first stage, 15 participants will test the platform through two 20-minute conversation sessions. This group will include healthy younger adults, older adults with normal cognitive function, and older adults with cognitive difficulties. Participants will provide feedback on how easy and acceptable the platform is to use.
In the second stage, 60 older adults at high risk of dementia will be randomly assigned to one of three groups. The groups will receive either conversation-based cognitive activities using the platform, interest-based news reading activities, or weekly health education while waiting to receive the intervention. The study activities will continue for 12 weeks. Researchers will compare changes in cognitive function, emotional well-being, loneliness, social connection, and user experience before and after the study.
The main goals are to learn whether the platform is practical and acceptable for home use and whether it may help support cognitive and psychosocial health.
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LLM Conversation Cognitive Interaction
BehavioralA voice-based cognitive stimulation program delivered through a large language model-driven conversational platform. The platform uses topics selected according to each participant's interests and guides natural conversations designed to engage memory, attention, language, executive function, and social cognition. The platform provides topic summaries, asks questions, responds to participants' answers, and adjusts the depth of follow-up questions based on response quality. Conversation responses are converted into text and used to generate indicators of cognitive performance. The platform is intended for cognitive stimulation and does not provide a clinical diagnosis.
Interest-Based Knowledge Reading
BehavioralA digital cognitive activity that provides short news and knowledge summaries based on participants' interests. The content includes both familiar and unfamiliar topics, as well as preferred and non-preferred topics, to provide varied cognitive challenges. Participants answer multiple-choice questions about each summary. The questions are designed to engage reading comprehension, attention, and memory for the presented information.
Waitlist Health Education
BehavioralGeneral health education materials for older adults delivered through the LINE platform. The materials provide information related to healthy aging and general health management but do not include structured conversational cognitive stimulation or interest-based reading exercises.
Verbal fluency test
The Verbal Fluency Test assesses language production and executive function. Participants will name as many items as possible from specified semantic categories, including fruits and vegetables, within 60 seconds. The outcome is the number of correct, non-repeated words produced. Higher scores indicate better verbal fluency. The primary outcome will be the change in the total number of correct words from baseline to the post-intervention assessment.
Chinese Verbal Learning Test
The Chinese Version Verbal Learning Test assesses verbal learning and memory. A list of 9 two-character nouns is presented across 4 learning trials. After each trial, participants recall as many words as possible. One point is given for each correctly recalled word. The total learning score is the sum of correct responses across the 4 learning trials and ranges from 0 to 36. Higher scores indicate better verbal learning. The primary outcome will be the change in the total learning score from baseline to the post-intervention assessment.
Digit Span subtest
The Digit Span test assesses verbal attention, short-term memory, and working memory. It includes forward and backward digit span tasks. Each correctly repeated sequence receives 1 point. The forward and backward raw scores are added to produce a total score ranging from 0 to 32. Higher scores indicate better verbal attention and working memory. The outcome will be the change in total score from baseline to the post-intervention assessment.
Cookie Theft Picture
The Cookie Theft Picture is a well-known visual stimulus used to assess language comprehension and expressive language abilities. The picture shows a mother washing dishes beside a kitchen sink while the water is overflowing. Two children are standing on a stool and attempting to take cookies from a cupboard. While the participant describes the scene, the assessor evaluates language production, including grammatical structure, word choice, speech fluency, and syntactic errors. The participant is shown the picture and instructed, "Please tell me as completely as possible what is happening in this picture." The task ends when the participant indicates that the description is complete or stops speaking for more than 10 to 15 seconds.
Digit Symbol Substitution Test
The Digit Symbol Substitution Test assesses attention and information processing speed. Participants use a key to match numbers with corresponding symbols and complete as many items as possible within 90 seconds. The score is the number of correctly completed items. Higher scores indicate better attention and processing speed. The outcome will be the change in score from baseline to the post-intervention assessment.
Stroop Color and Word Test
The Stroop Color and Word Test assesses selective attention and inhibitory control. In the incongruent condition, participants identify the ink color while ignoring the meaning of the printed word. The score is the number of correct responses completed within the specified test period. Higher scores indicate better selective attention and inhibitory control. The outcome will be the change in score from baseline to the post-intervention assessment.
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