Alexandra Milak
Grade: 10-12
Team Size: 1
Subject Area: Health
Project Type: Experimental
Language: English
Project Summary: Forget Me Not is an experimental project that investigated the effects of different senses on the emotions of Alzheimer's patients and how the senses would alter the behavioural symptoms of Alzheimer's. Through extensive analyses, it has been determined that the senses of touch and smell can effectively change a patient's behaviour and may in the future, be a new form of communication for Dementia patients.
Software Used: Microsoft Word, Microsoft Publisher, Microsoft Excel, Adobe Acrobat, Fathom, iTunes, Adobe Photoshop, Adobe Dreamweaver, SPSS (Statistical Package for the Social Sciences)
Hardware Used: Scanner, Digital Camera
Source of the Idea for the Project: I was inspired to do a project on Alzheimer’s Disease as my great-grandmother died from the disease in 2000. I began to research information on the disease and came to discover the lack of psychological research being conducted with current sufferers of the disease. I came upon a study that determined that music therapy may perhaps alter the behaviours of Alzheimer’s patients so I thought that if one of the senses, hearing could change their behaviours why not discover if the other senses would have the same effect and to what degree.
Special Skills: An understanding of “html” languages, and JavaScript.
Awards Won for the Project:
At the Simcoe County Regional Science and Technology Fair:
-Best of Fair Award
-Pfizer Award of Excellence
-Best of Health Sciences Division Award
-Georgian College Scholarship
-Octal Moon Computer Award
-Gold Medal

This project was selected to compete at the Canada Wide Science Fair in Truro, Nova Scotia in May 2007.

Background:
Alzheimer’s is a progressive neurodegenerative disease characterized by the death of nerve cells through programmed cell death called apoptosis. Symptoms of this disease include memory loss, disorientation and confusion among others. As Alzheimer’s progresses from the cerebellum into the cerebrum the agitated behaviors of patients begins to become prevalent. The disease was first identified by Dr. Alois Alzheimer in 1906. He determined that as the disease progresses, brain cells degenerate and die, and the brain markedly shrinks in size in some regions. Recent studies have been conducted that have determined that music therapy and the sense of hearing can alter the behaviors of Alzheimer’s patients and even though these suffers may continue to show signs of deteriorating functioning, they are able to gain new information when presented in a musical format. Therefore, researchers believe that this may be a new form of communication for Alzheimer’s patients. “It’s a Small World After All” is a fictional story that incorporates the six human emotions: happiness, sadness, surprise, fear, anger and disgust with the four senses: see, hear, touch, and smell. This was the primary material used in the experimentation.

Purpose:
1.) The purpose of this experiment is to determine if the fictional storybook, “It’s a Small World After All,” can help patients recognize the six human emotions through four senses. To determine which emotions patients are most easily able to recognize, which senses can detect emotions the quickest and to determine if this storybook can alter the psychological behaviours of Alzheimer’s patients. 2.) The purpose of the “Alzheimer’s Awareness” survey is to determine how the general public is aware of Alzheimer’s Disease.

Hypothesis:
1.) “It’s a Small World After All,” will be able to effectively alter the psychological behaviours of Alzheimer’s patients. These patients will be able to respond to all six of the emotions when presented in all four of the sense formats. They will have a faster response time to the emotions when presented in touch and smell formats. Patients will also have an easier time recognizing emotions such as happiness, sadness, and anger, and have greater difficulty recognizing emotions such as disgust, fear, and surprise. 2.) Based upon the results from the “Alzheimer’s Awareness” survey it will be determined that the general public is only aware about the basic facts on Alzheimer’s Disease, not having a general understanding of medications and preventative measures that can be made. Generally those who live in an urban or suburban setting and who have a higher degree of education (i.e. post secondary, post graduate) will perform better on the survey, than someone who lives in a rural setting and has a lower level of education.

Procedure:
1.) Its a Small World After All: For the purpose of providing reliable and valid results, the use of human subject was required. Twenty (20) Alzheimer’s and Dementia patients were used to test the hypothesis. Patients were brought in four (4) at a time, and their psychological state was determined as being either content, or agitated. The storybook, “It’s a Small World After All” was read to these patients and throughout the story, they were able to smell, touch, see, and hear objects and other items. They were assessed upon their reaction times to responding to different emotions. In an Observation Chart, patients would receive either an Excellent or Satisfactory rating for their recognition to the emotions. Excellent meant that the patient responded within the first five (5) seconds of the emotion being presented and Satisfactory meant they responded after five (5) seconds or Non-Responsive if they did not respond at all. For the purpose of statistical analysis, an Excellent was given two (2) points for reaction time and Satisfactory was given one (1) points and Non-Responsive was given zero (0). After the story was read to the patients their psychological state was assessed, observations were recorded and statistical analysis was conducted. To test the reliability, the statistical methods used included the mean, variance, Cronbach’s Alpha, and Chi-Square Tests. The validity was determined using Theoretical Validity. 2.) Alzheimer’s Awareness: A short survey was composed of both general knowledge and higher level thinking questions. The website, www.attackingalzheimers.ca was registered as the survey home site and the public was made aware of the survey. The survey was left open for several weeks. After six (6) weeks all of the information was collected from the survey results. Statistical Analysis was conducted in the form of the Correlation Coefficient to determine the reliability of the results.

Results/Observations:
Statistical Analyses were used to assess the results. For the experimentation, “It’s a Small World After All”, the reliability was determined by Cronbach’s Alpha. It determined to have a moderate measure of 0.669 between the various patients and their results from recognizing the various senses and emotions. From the Chi-Square Tests, the likelihood ratio for several variables determined to be a strong measure of 0.987, meaning that the likelihood of the same results being seen through other patients was extremely high. The mean, variance, maximum, minimum and range were also determined. These results back up the reliability of the data that was collected.
Theoretical Validity was used to determine the validity of the results. The storybook, “It’s a Small World After All” can be compared to the Tinkertoy Test (Lezak, 1981). After several trials with human subjects, it was determined that aging individuals begin to have the minds of young children as they grow older. People begin to have the needs of infants and demonstrate similar characteristics to those of a child. The Tinkertoy Test can be compared to “It’s a Small World After All” because the data from this experimentation proved to have similar findings to that of the Tinkertoy Test. Patients would rather smell an object or touch something than listen to music or hear someone read a story. Their attention span is gone. The Tinkertoy Test results were similar. Therefore the validity of these results can be confirmed by the results of the Tinkertoy Test as it has established validity.
Results from the Alzheimer’s Awareness survey were determined through four comparisons measuring the correlation coefficient. A weak-moderate correlation of 0.277961 was determined between the genders of the individuals to their overall results on the survey. A weak-moderate correlation of 0.278359 was determined between the individual’s location of residence to their overall results on the survey. A moderate correlation of 0.300567 was determined between the individual’s level of education to their overall results on the survey. Finally, a weak correlation of 0.000728 was determined between the ages of the individuals to their overall results on the survey.

Conclusions:
After conducting my experiment, there were numerous findings that both supported and contradicted the hypotheses. The first major finding verifies that the fictional storybook, “It’s a Small World After All” was an effective and useful tool in assisting Alzheimer’s patie nts. The psychological state of Alzheimer’s patients became calm and focused throughout the story. Also, these patients were able to recognize all six of the human emotions, having a more difficult time recognizing emotions su ch as fear, and surprise. Surprisingly, one of the significant findings that contradicted the hypotheses was that, in fact, patients had an easier time recognizing emotions through touch and smell. These findings not only contradict the hypotheses but also the belief that hearing through music is a new way to connect with Alzheimer’s patients.
The second major finding supports the hypotheses. It was predicted that individuals who had more education and lived in an urban setting would have greater knowledge on Alzheimer’s Disease and display better results on Alzheimer’s Awareness survey. After completing several statistical analyses and determining the correlation coefficient of numerous variables, it has been determined that the most significant contributing factor to one’s awareness of the disease would be their level of education, followed by location of residence and gender. A person’s age did not prove to have an impact their results on the survey as this variable proved to display the weakest correlation. Generally, the public had very little knowledge about Alzheimer’s Disease and only knew the bare minimum about it. For example, most people were aware of the symptoms however, very few people were aware of the how many drugs are currently on the market to treat Alzheimer’s Disease.
The results from this novel experimentation proved to be helpful in determining that the four senses were effective in assisting and treating the agitated behaviors of Alzheimer’s patients, and “It’s a Small World All” can effectively assist agitated Alzheimer’s patients. Based upon the results from the Alzheimer’s Awareness survey, it was determined that much work needs to be done to educate people about the disease
Future research may be conducted with this project. First of all, the additional sense, taste could be added to determine its effects on Alzheimer’s patients. Secondly, conducting further experiments with other patients who have other forms of Dementia or simply display signs of aging would be beneficial to learn if the book, “It’s a Small World After All” can assist more than just Alzheimer’s patients. Finally, experiments with patients from different health care facilities in different regions (urban, rural) to determine if the setting, and care facility are contributing factors to the results.
In the near future, the four senses and the storybook, “It’s a Small World After All” may be implemented as psychological therapies to help Alzheimer’s patients

Acknowledgments:
The following are acknowledged for their contributions, support, and genuine interest in Forget Me Not: Dr. Carol McMaster: Laurentian University, Kathy Evans-Pearson, Canada Law Books, Craig Pearson, Canada Law Books, Ray Allen, York Region District School Board, Kim Evans-Milak, Mother, and Stephen Milak, Father.

References:
Lezak, Muriel. Tinkertoy Test. 1981. 23 April. 2007.
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=>

Bibliography:
Aiken, Lewis R. Psychological Testing and Assessment. New York, Pearson Educational Group Inc, 2003.
Canton, Barbara J. and others. Mathematics of Data Management. Toronto: McGraw-Hill Ryerson, 2002
Garmezy, Norman. Kimble, Gregory A. Zigler, Edward. Principles of General Psychology Fifth Edition. Toronto: John Wiley & Sons, Inc, 1980.
Forgeron, Nicole. The Impact of Music Therapy on Alzheimer’s Disease Patients. 23 Dec. 2006. <http://faculty.uccb.ns.ca/~gcarre/courses/health/music.htm>
Alzheimer’s Association. 13 Oct. 2006. <http://www.alz.org/>
Wikipedia. Alzheimer’s Disease. 24 Feb. 2007. <http://en.wikipedia.org/wiki/Alzheimer's_disease>