A Taxonomy of Mental Health and Technology Needs for Alzheimer's and Dementia Caregivers

Individuals with Alzheimer's disease (AD) and Alzheimer's disease-related dementia (ADRD) experience memory and thinking changes that impact their ability to use digital daily management tools. For example, adding an event to a digital calendar requires multiple steps that may act as barriers to independent use for individuals with AD/ADRD. This paper presents AI-Care, a conversational agentic artificial intelligence (AI) layer built on top of a remote caregiving platform co-designed with people with AD/ADRD. AI-Care is designed to reduce the cognitive load on individuals with AD/ADRD when managing everyday tasks such as setting calendar reminders and organizing to-do lists through natural-language interaction with a voice-first chatbot. The system uses a LangGraph-based stateful orchestration approach in which each request passes through sanitization, intent classification, context loading, safety checks, deterministic slot collection, tool execution, and response composition. Safety-critical responses, particularly around medications and allergies, are grounded in caregiver-verified records rather than free-form model generation. The system does not make autonomous medical or treatment decisions. Incomplete or ambiguous requests are handled through controlled multi-turn clarification rather than silent failure or guessing. The system supports both typed and spoken input, with voice output through ElevenLabs text-to-speech. Longer responses are chunked before synthesis to avoid rushed playback. A preliminary pilot with four individuals with mild-to-moderate AD/ADRD showed that users found the system trustworthy, competent, and likable, and were able to complete the evaluated coordination tasks through conversation. We describe the design goals, system architecture, safety controls, and findings from this formative evaluation.

Family caregivers of people living with dementia shoulder emotional and practical responsibilities, yet their own wellbeing often remains peripheral to dementia care. We built CareMirror, an envisioned caregiver wellbeing ecosystem with interconnected caregiver- and clinician-facing interfaces for longitudinal reflection, personalized support, and caregiver-controlled sharing with clinical care. We conducted semi-structured interviews with 14 caregivers, using CareMirror as a design probe to examine how they perceived this ecosystem and what expectations, concerns, and boundaries emerged around clinical connection. Caregivers valued attention to their wellbeing, longitudinal awareness, context-sensitive support, and clinical visibility when it could lead to meaningful follow-up. However, repeated reflection could become burdensome or emotionally difficult, automatic clinical sharing could inhibit candid disclosure, and participants wanted control over what information entered clinical care. They also expected AI to support reflection and communication without replacing caregiver voice or clinician judgment. We contribute design considerations for proactive, clinically connected caregiver wellbeing support.

As populations age, cognitive decline from mild cognitive impairment (MCI) to dementia is a defining health challenge of the coming decades, yet routine assessment often misses its earliest signs. This article critically synthesizes recent technological advances for detecting and managing cognitive impairment in older adults, spanning neurophysiological signals (chiefly electroencephalography, EEG), structural and molecular neuroimaging (MRI and amyloid/tau PET), blood-based biomarkers, and digital markers, integrated through artificial intelligence (AI), machine learning (ML), and deep learning (DL). Beyond summarizing, it contributes a cross-disciplinary taxonomy, a methodological-rigor lens foregrounding subject- and site-independent validation, an integrative early-detection framework linking tiered screening to intervention, and comparison tables of detection methods, interventions, and risk and protective factors. EEG markers (alpha/theta changes, P300 latency) and deep models (CNNs, LSTM/BiLSTM, transformers, self-supervised EEG foundation models) report strong accuracy, yet many rest on small, single-site datasets unlikely to survive rigorous external validation. Elsewhere, gains are tangible: plasma p-tau217 has reached clinical utility, with the first blood test cleared to aid Alzheimer's diagnosis in 2025; anti-amyloid therapies (lecanemab, donanemab) are approved despite modest, contested benefits; and multidomain lifestyle prevention has matured. Wearable, remote, speech, and virtual-reality tools enable continuous, ecologically valid monitoring, and multimodal fusion improves sensitivity and specificity. Barriers remain: standardization, explainability, data privacy, and equitable, externally validated deployment. The field's near-term promise lies in trustworthy, multimodal, longitudinally validated systems linking early detection to actionable, personalized care.