# A Principle-Driven Adaptive Policy for Group Cognitive Stimulation Dialogue for Elderly with Cognitive Impairment

arXiv: https://arxiv.org/abs/2603.10034 · HTML: https://mlsanity.com/paper/2603.10034/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 20 of its 39 references that are in the map.
- First posted on arXiv 1 Mar 2026.

## Builds on (most cited first, 20 of 20)

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- [Gaussian Error Linear Units (GELUs)](https://mlsanity.com/paper/1606.08415/) (2016)
- [A Diversity-Promoting Objective Function for Neural Conversation Models](https://mlsanity.com/paper/1510.03055/) (2015)
- [ERNIE: Enhanced Language Representation with Informative Entities](https://mlsanity.com/paper/1905.07129/) (2019)
- [Towards Emotional Support Dialog Systems](https://mlsanity.com/paper/2106.01144/) (2021)
- [A Survey on Recent Advances in LLM-Based Multi-turn Dialogue Systems](https://mlsanity.com/paper/2402.18013/) (2024)
- [Recent Advances in Deep Learning Based Dialogue Systems: A Systematic Survey](https://mlsanity.com/paper/2105.04387/) (2021)
- [ROUGE 2.0: Updated and Improved Measures for Evaluation of Summarization Tasks](https://mlsanity.com/paper/1803.01937/) (2018)
- [Knowledge Bridging for Empathetic Dialogue Generation](https://mlsanity.com/paper/2009.09708/) (2020)
- [EVA: An Open-Domain Chinese Dialogue System with Large-Scale Generative Pre-Training](https://mlsanity.com/paper/2108.01547/) (2021)
- [EVA2.0: Investigating Open-Domain Chinese Dialogue Systems with Large-Scale Pre-Training](https://mlsanity.com/paper/2203.09313/) (2022)
- [A Cognitive Stimulation Dialogue System with Multi-source Knowledge Fusion for Elders with Cognitive Impairment](https://mlsanity.com/paper/2305.08200/) (2023)
- [ELLMA-T: an Embodied LLM-agent for Supporting English Language Learning in Social VR](https://mlsanity.com/paper/2410.02406/) (2024)
- [Benchmarking Large Language Models on Multiple Tasks in Bioinformatics NLP with Prompting](https://mlsanity.com/paper/2503.04013/) (2025)
- [Large Language Models in Bioinformatics: A Survey](https://mlsanity.com/paper/2503.04490/) (2025)
- [Biological Sequence with Language Model Prompting: A Survey](https://mlsanity.com/paper/2503.04135/) (2025)

## Built on by (most cited first, 1 of 1)

- [From Pattern Recognizers to Personalized Companions: A Survey of Large Language Models in Mental Health](https://mlsanity.com/paper/2609.25186/) (2026)

## Abstract (arXiv)

Cognitive impairment is becoming a major public health challenge. Cognitive Stimulation Therapy (CST) is an effective intervention for cognitive impairment, but traditional methods are difficult to scale, and existing digital systems struggle with group dialogues and cognitive stimulation principles. While Large Language Models (LLMs) are powerful, their application in this context faces key challenges: cognitive stimulation dialogue paradigms, a lack of therapeutic reasoning, and static-only user modeling. To address these issues, we propose a principle-driven adaptive policy actualized through a Group Cognitive Stimulation Dialogue (GCSD) system. We first construct a dataset with over 500 hours of real-world CST conversations and 10,000+ simulated dialogues generated via our Principle-Guided Scenario Simulation strategy. Our GCSD system then integrates four core modules to overcome LLM limitations: (i) a multi-speaker context controller to resolve role confusion; (ii) dynamic participant cognitive state modeling for personalized interaction; (iii) a cognitive stimulation-focused attention loss to instill cognitive stimulation reasoning; and (iv) a multi-dimensional reward strategy to enhance response value. Experimental results demonstrate that GCSD significantly outperforms baseline models across various evaluation metrics. Future work will focus on long-term clinical validation to bridge the gap between computational performance and clinical efficacy.