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Cannings M, Brookman R, Parker S, Hoon L, Ono A, Kawata H, Matsukawa H, Harris CB. Optimizing Technology-Based Prompts for Supporting People Living With Dementia in Completing Activities of Daily Living at Home: Experimental Approach to Prompt Modality, Task Breakdown, and Attentional Support. JMIR Aging 2024; 7:e56055. [PMID: 39178405 PMCID: PMC11380066 DOI: 10.2196/56055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/27/2024] [Accepted: 06/03/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND Assistive technology is becoming increasingly accessible and affordable for supporting people with dementia and their care partners living at home, with strong potential for technology-based prompting to assist with initiation and tracking of complex, multistep activities of daily living. However, there is limited direct comparison of different prompt features to guide optimal technology design. OBJECTIVE Across 3 experiments, we investigated the features of tablet-based prompts that best support people with dementia to complete activities of daily living at home, measuring prompt effectiveness and gaining feedback from people with dementia and their care partners about their experiences. METHODS Across experiments, we developed a specialized iPad app to enable data collection with people with dementia at home over an extended experimental period. In experiment 1, we varied the prompts in a 3 (visual type: text instruction, iconic image, and photographic image) × 3 (audio type: no sound, symbolic sound, and verbal instruction) experimental design using repeated measures across multiple testing sessions involving single-step activities. In experiment 2, we tested the most effective prompt breakdown for complex multistep tasks comparing 3 conditions (1-prompt, 3-prompt, and 7-prompt conditions). In experiment 3, we compared initiation and maintenance alerts that involved either an auditory tone or an auditory tone combined with a verbal instruction. Throughout, we asked people with dementia and their care partners to reflect on the usefulness of prompting technology in their everyday lives and what could be developed to better meet their needs. RESULTS First, our results showed that audible verbal instructions were more useful for task completion than either tone-based or visual prompts. Second, a more granular breakdown of tasks was generally more useful and increased independent use, but this varied across individuals. Third, while a voice or text maintenance alert enabled people with dementia to persist with a multistep task for longer when it was more frequent, task initiation still frequently required support from a care partner. CONCLUSIONS These findings can help inform developers of assistive technology about the design features that promote the usefulness of home prompting systems for people with dementia as well as the preferences and insights of people with dementia and their care partners regarding assistive technology design.
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Affiliation(s)
- Madeleine Cannings
- The MARCS Institute for Brain, Behaviour, and Development, Western Sydney University, Penrith, Australia
| | - Ruth Brookman
- The MARCS Institute for Brain, Behaviour, and Development, Western Sydney University, Penrith, Australia
| | - Simon Parker
- Applied Artificial Intelligence Institute, Deakin University, Burwood, Australia
| | - Leonard Hoon
- Applied Artificial Intelligence Institute, Deakin University, Burwood, Australia
| | - Asuka Ono
- Nippon Telegraph and Telephone, Tokyo, Japan
| | | | | | - Celia B Harris
- The MARCS Institute for Brain, Behaviour, and Development, Western Sydney University, Penrith, Australia
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Klein CB, Klinger LG. Aging Well and Autism: A Narrative Review and Recommendations for Future Research. Healthcare (Basel) 2024; 12:1207. [PMID: 38921321 PMCID: PMC11203987 DOI: 10.3390/healthcare12121207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 06/05/2024] [Accepted: 06/08/2024] [Indexed: 06/27/2024] Open
Abstract
With autism first recognized in the 1940s, the early cohorts of autistic children are beginning to enter older adulthood. Little is known about the experiences and outcomes of autistic older adults. In the general population, "successful aging" is a dominant model among gerontologists and is used to evaluate outcomes in older adulthood. This narrative review aims to provide a framework for understanding and supporting successful aging in older autistic adults. Using Fernández-Ballesteros' four-domain model of "aging well" we review knowledge on aging and autism by examining outcomes in health and functioning, cognitive and physical functioning, positive affect and control, and social participation and engagement. Findings indicate that outcomes in autistic older adults are generally poor, marked by increased medical conditions, low adaptive skills, elevated risk of cognitive decline, limited physical activity, high rates of mental health conditions, low quality of life, and reduced social or community participation. Patterns of challenges are similar across cognitive abilities and profiles of autistic traits. Challenges and next steps in aging and autism research are identified, and future directions for the field are discussed.
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Affiliation(s)
- Claire B. Klein
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
- UNC TEACCH Autism Program, Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Laura G. Klinger
- UNC TEACCH Autism Program, Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Brookman R, Parker S, Hoon L, Ono A, Fukayama A, Matsukawa H, Harris CB. Technology for dementia care: what would good technology look like and do, from carers' perspectives? BMC Geriatr 2023; 23:867. [PMID: 38104074 PMCID: PMC10725604 DOI: 10.1186/s12877-023-04530-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The development of technology in dementia care has largely been without consultation with carers, and has primarily focused on safety, monitoring devices, and supporting activities of daily living. Further, while involving end-users in the design of technology has been recommended, this is yet to become common practice. METHOD We conducted a mixed methods study with the aim of investigating carers' values and priorities for technology development, including prior experiences, barriers to use, and what they would like technology to do. Importantly, we asked carers for their design ideas and bespoke technology solutions for future development. RESULTS Carers of people living with dementia (N = 127), including both unpaid (n = 102) and paid carers (n = 25) residing in Australia, completed an online survey. In addition, a subsample of carers (n = 23) participated in semi-structured interviews. Findings demonstrate that carers want technology to be person-centred, customisable, and to increase opportunities for meaningful social connection. Findings also demonstrate the ability of carers to generate creative design solutions for dementia care. CONCLUSIONS These findings and implications will be discussed in relation to the importance of co-design with carers and engineers during the design phase of assistive technology. Also, the importance of technology to enhance, not replace, human-to-human social interactions is highlighted.
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Affiliation(s)
- Ruth Brookman
- MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, NSW, Australia.
| | | | | | - Asuka Ono
- Nippon Telegraph and Telephone (NTT), Tokyo, Japan
| | | | | | - Celia B Harris
- MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, NSW, Australia
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Wiseman L, Isbel S, Boag A, Halpin-Healy C, Gibson D, Bail K, Noble JM, D'Cunha NM. Online gallery facilitated art activities for people with dementia during the COVID-19 pandemic and beyond: A narrative review. DEMENTIA 2023; 22:1950-1976. [PMID: 37647250 PMCID: PMC10644691 DOI: 10.1177/14713012231198748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Art activities for people with dementia have a range of therapeutic benefits including psychosocial wellbeing and enhanced quality of life. Successful art programs promote social engagement, are inclusive and empowering, and enable opportunity for people with dementia to express themselves verbally and non-verbally. The COVID-19 pandemic and associated social distancing precautions have impacted the capacity of art galleries and museums to deliver in-person programs. However, they have also provided a new opportunity. This paper explores the potential benefits, challenges, and future directions for research relating to the online delivery of gallery-facilitated art activities for people with dementia. The evidence revealed that increased digitisation of programs increased access for participants, however, the majority of the research was published before the pandemic. Nevertheless, COVID-19 has necessitated many museums and galleries to engage with people with dementia online. Future research is needed to improve the usability of online delivery platforms and a comparison of online and onsite delivery is recommended, particularly to evaluate benefits to people living in rural and remote areas where access to museums and galleries may be limited.
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Affiliation(s)
- Lara Wiseman
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
- Ageing Research Group, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Stephen Isbel
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
- Ageing Research Group, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Adriane Boag
- National Gallery of Australia, Parkes, ACT, Australia
| | | | - Diane Gibson
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
- Ageing Research Group, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Kasia Bail
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
- Ageing Research Group, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - James M Noble
- Arts and Minds, New York, NY, USA
- Taub Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Nathan M D'Cunha
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
- Ageing Research Group, Faculty of Health, University of Canberra, Bruce, ACT, Australia
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Pillette L, Moreau G, Normand JM, Perrier M, Lecuyer A, Cogne M. A Systematic Review of Navigation Assistance Systems for People With Dementia. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2023; 29:2146-2165. [PMID: 35007194 DOI: 10.1109/tvcg.2022.3141383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Technological developments provide solutions to alleviate the tremendous impact on the health and autonomy due to the impact of dementia on navigation abilities. We systematically reviewed the literature on devices tested to provide assistance to people with dementia during indoor, outdoor and virtual navigation (PROSPERO ID number: 215585). Medline and Scopus databases were searched from inception. Our aim was to summarize the results from the literature to guide future developments. Twenty-three articles were included in our study. Three types of information were extracted from these studies. First, the types of navigation advice the devices provided were assessed through: (i) the sensorial modality of presentation, e.g., visual and tactile stimuli, (ii) the navigation content, e.g., landmarks, and (iii) the timing of presentation, e.g., systematically at intersections. Second, we analyzed the technology that the devices were based on, e.g., smartphone. Third, the experimental methodology used to assess the devices and the navigation outcome was evaluated. We report and discuss the results from the literature based on these three main characteristics. Finally, based on these considerations, recommendations are drawn, challenges are identified and potential solutions are suggested. Augmented reality-based devices, intelligent tutoring systems and social support should particularly further be explored.
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Yuen B, Lane A, Mocnik S. Using Delphi Technique to Develop a Shared Vision for Dementia-Friendly Singapore. JOURNAL OF AGING AND ENVIRONMENT 2022. [DOI: 10.1080/26892618.2022.2140374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Belinda Yuen
- Lee Kuan Yew Centre for Innovative Cities, Singapore University of Technology and Design, Singapore, Singapore
| | - Anna Lane
- Swinburne University of Technology, Melbourne, Australia
| | - Spela Mocnik
- Lee Kuan Yew Centre for Innovative Cities, Singapore University of Technology and Design, Singapore, Singapore
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Shabha G, Edwards DJ, Gaines K, Laycok P. Toward an Integrated Context-Based Design Approach for Dementia Residential Care Homes: A Review of Key Operational Design Problems. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:323-342. [PMID: 35833917 DOI: 10.1177/19375867221100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES, PURPOSE, OR AIM This article seeks to develop a context-based management system focusing on assessing key operational and design problems and affecting wayfinding in dementia residential care homes. BACKGROUND Dementia is multifaceted neurocognitive impairments largely attributed to cognitive deterioration manifested in memory loss and visuospatial deficit which have wider practical implications to both environmental safety and wayfinding and navigation of dementia user. Two key questions were addressed in this context: (1) How can cognitively facilitating assistive technology (AT) be made more user-focused to mitigate the impacts of cognitive impairments on environmental safety and wayfinding? (2) How can design intervention and changes in design topology, colors and texture, and internal finishing aid wayfinding, navigation, and orientation in dementia residential care homes? METHOD A systematic literature review and analysis was undertaken to assess the efficacy of key cognitively-related AT to support activities of daily living and environmental safety of dementia sufferers in a care home and aid wayfinding, navigation, and orientation. RESULTS Several key design variables to facilitate wayfinding and spatial orientation were identified which include design topology, floor finishing, signposting, and use of color and texture strengthened by meaning, emotional connection to places and cognitively focused intervention via memory cueing and objects-centered recognition. CONCLUSIONS Key operational and design guidelines were proposed to assist built environment, care home developers, clinicians and healthcare professionals, and care services providers. There is a need to move toward a dementia-centered design to address the challenges facing people living with dementia in care homes. This should be based on the interrelated behavioral, cognitive, and communication factors.
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Affiliation(s)
- Ghasson Shabha
- School of Engineering and the Built Environment, Birmingham City University, Birmingham, United Kingdom
| | - David J Edwards
- School of Engineering and the Built Environment, Birmingham City University, Birmingham, United Kingdom
| | - Kristi Gaines
- Department of Design, Texas Tech University (TTU), Lubbock, TX, USA
| | - Paul Laycok
- School of Engineering and the Built Environment, Birmingham City University, Birmingham, United Kingdom
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Yaddaden A, Spalla G, Gouin-Vallerand C, Briskie-Semeniuk P, Bier N. A mixed reality cognitive orthosis to support older adults in achieving their daily living activities: A qualitative study (Preprint). JMIR Rehabil Assist Technol 2021; 9:e34983. [PMID: 35857354 PMCID: PMC9350820 DOI: 10.2196/34983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/14/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Amel Yaddaden
- École de réadaptation, Université de Montréal, Montreal, QC, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Guillaume Spalla
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
- Laboratoire Domus, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Charles Gouin-Vallerand
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
- Laboratoire Domus, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Patricia Briskie-Semeniuk
- École de réadaptation, Université de Montréal, Montreal, QC, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Nathalie Bier
- École de réadaptation, Université de Montréal, Montreal, QC, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
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Behera CK, Condell J, Dora S, Gibson DS, Leavey G. State-of-the-Art Sensors for Remote Care of People with Dementia during a Pandemic: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2021; 21:4688. [PMID: 34300428 PMCID: PMC8309480 DOI: 10.3390/s21144688] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/31/2021] [Accepted: 07/02/2021] [Indexed: 01/10/2023]
Abstract
In the last decade, there has been a significant increase in the number of people diagnosed with dementia. With diminishing public health and social care resources, there is substantial need for assistive technology-based devices that support independent living. However, existing devices may not fully meet these needs due to fears and uncertainties about their use, educational support, and finances. Further challenges have been created by COVID-19 and the need for improved safety and security. We have performed a systematic review by exploring several databases describing assistive technologies for dementia and identifying relevant publications for this review. We found there is significant need for appropriate user testing of such devices and have highlighted certifying bodies for this purpose. Given the safety measures imposed by the COVID-19 pandemic, this review identifies the benefits and challenges of existing assistive technologies for people living with dementia and their caregivers. It also provides suggestions for future research in these areas.
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Affiliation(s)
- Chandan Kumar Behera
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| | - Joan Condell
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| | - Shirin Dora
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| | - David S. Gibson
- Northern Ireland Centre for Stratified Medicine (NICSM), Biomedical Sciences Research Institute, University of Ulster, Altnagelvin Area Hospital, C-TRIC Building, Glenshane Road, Londonderry BT47 6SB, UK;
| | - Gerard Leavey
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
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Stara V, Vera B, Bolliger D, Rossi L, Felici E, Di Rosa M, de Jong M, Paolini S. Usability and Acceptance of the Embodied Conversational Agent Anne by People With Dementia and Their Caregivers: Exploratory Study in Home Environment Settings. JMIR Mhealth Uhealth 2021; 9:e25891. [PMID: 34170256 PMCID: PMC8386369 DOI: 10.2196/25891] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/03/2021] [Accepted: 03/10/2021] [Indexed: 01/17/2023] Open
Abstract
Background Information and communication technologies are tools that are able to support cognitive functions, monitor health and movements, provide reminders to maintain residual memory abilities, and promote social support, especially among patients with dementia. Among these technologies, embodied conversational agents (ECAs) are seen as screen-based entities designed to stimulate human face-to-face conversation skills, allowing for natural human-machine interaction. Unfortunately, the evidence that such agents deliver care benefits in supporting people affected by dementia and their caregivers has not yet been well studied. Therefore, research in this area is essential for the entire scientific community. Objective This study aims to evaluate the usability and acceptability of the virtual agent Anne by people living with dementia. The study is also designed to assess the ability of target users to use the system independently and receive valuable information from it. Methods We conducted a 4-week trial that involved 20 older adults living with dementia and 14 family caregivers in home environment settings in Italy. This study used a mixed methods approach, balancing quantitative and qualitative instruments to gather data from users. Telemetry data were also collected. Results Older users were particularly engaged in providing significant responses and participating in system improvements. Some of them clearly discussed how technical problems related to speech recognition had a negative impact on the intention to use, adaptiveness, usefulness, and trust. Moreover, the usability of the system achieved an encouraging score, and half of the sample recognized a role of the agent Anne. This study confirms that the quality of automatic speech recognition and synthesis is still a technical issue and has room for improvement, whereas the touch screen modality is almost stable and positively used by patients with dementia. Conclusions This study demonstrated the ability of target users to use the system independently in their home environment; overall, the involved participants shared good engagement with the system, approaching the virtual agents as a companion able to support memory and enjoyment needs. Therefore, this research provides data that sustain the use of ECAs as future eHealth systems that are able to address the basic and higher-level needs of people living with dementia. This specific field of research is novel and poorly discussed in the scientific community. This could be because of its novelty, yet there is an urgent need to strengthen data, research, and innovation to accelerate the implementation of ECAs as a future method to offer nonpharmacological support to community-dwelling people with dementia.
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Affiliation(s)
- Vera Stara
- Model of Care and New Technologies, IRCCS INRCA - National Institute of Health and Science on Ageing, Ancona, Italy
| | - Benjamin Vera
- iHomeLab - University of Applied Sciences & Arts, Lucerne, Switzerland
| | - Daniel Bolliger
- iHomeLab - University of Applied Sciences & Arts, Lucerne, Switzerland
| | - Lorena Rossi
- Model of Care and New Technologies, IRCCS INRCA - National Institute of Health and Science on Ageing, Ancona, Italy
| | - Elisa Felici
- Model of Care and New Technologies, IRCCS INRCA - National Institute of Health and Science on Ageing, Ancona, Italy
| | - Mirko Di Rosa
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA - National Institute of Health and Science on Ageing, Ancona, Italy
| | - Michiel de Jong
- Research Group IT Innovations in Healthcare, Windesheim University of Applied Sciences, Zwolle, Netherlands
| | - Susy Paolini
- Unit of Neurology, IRCCS INRCA - National Institute of Health and Science on Ageing, Ancona, Italy
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Bomilcar I, Bertrand E, Morris RG, Mograbi DC. The Seven Selves of Dementia. Front Psychiatry 2021; 12:646050. [PMID: 34054604 PMCID: PMC8160244 DOI: 10.3389/fpsyt.2021.646050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/23/2021] [Indexed: 11/13/2022] Open
Abstract
The self is a complex and multifaceted phenomenon, encompassing a variety of cognitive processes and psychosocial influences. Considering this, there is a multiplicity of "selves," the current review suggesting that seven fundamental self-processes can be identified that further our understanding of the experience of dementia. These include (1) an embodied self, manifest as corporeal awareness; (2) an agentic self, related to being an agent and influencing life circumstances; (3) an implicit self, linked to non-conscious self-processing; (4) a critical self, which defines the core of self-identity; (5) a surrogate self, based on third-person perspective information; (6) an extended self, including external objects or existences that are incorporated into the self; and, finally, (7) an emergent self, a property of the self-processes that give rise to the sense of a unified self. These are discussed in relation to self-awareness and their use in making sense of the experience of dementia.
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Affiliation(s)
- Iris Bomilcar
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elodie Bertrand
- Laboratoire Mémoire, Cerveau et Cognition (LMC2, URP 7536), Institut de Psychologie, Université de Paris, Paris, France
| | - Robin G. Morris
- Department of Psychology, King's College Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Daniel C. Mograbi
- Department of Psychology, King's College Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
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Lazar A, Brewer RN, Kacorri H, Hong J, Punzalan MND, Mahathir M, Vander Hyde O, Ross W. How Content Authored by People with Dementia Affects Attitudes towards Dementia. PROCEEDINGS OF THE ACM ON HUMAN-COMPUTER INTERACTION 2021; 5:10.1145/3479542. [PMID: 35187410 PMCID: PMC8855361 DOI: 10.1145/3479542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Negative attitudes shape experiences with stigmatized conditions such as dementia, from affecting social relationships to influencing willingness to adopt technology. Consequently, attitudinal change has been identified as one lever to improve life for people with stigmatized conditions. Though recognized as a scaleable approach, social media has not been studied in terms of how it should best be designed or deployed to target attitudes and understanding of dementia. Through a mixed methods design with 123 undergraduate college students, we study the effect of being exposed to dementia-related media, including content produced by people with dementia. We selected undergraduate college students as the target of our intervention, as they represent the next generation that will work and interact with individuals with dementia. Our analysis describes changes over the period of two weeks in attitudes and understanding of the condition. The shifts in understanding of dementia that we found in our qualitative analysis were not captured by the instrument we selected to assess understanding of dementia. While small improvements in positive and overall attitudes were seen across all interventions and the control, we observe a different pattern with negative attitudes, where transcriptions of content produced by people with dementia significantly reduced negative attitudes. The discussion presents implications for supporting people with dementia as content producers, doing so in ways that best affect attitudes and understanding by drawing on research on cues and interactive media, and supporting students in changing their perspectives towards people with dementia.
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Schaat S, Koldrack P, Yordanova K, Kirste T, Teipel S. Real-Time Detection of Spatial Disorientation in Persons with Mild Cognitive Impairment and Dementia. Gerontology 2019; 66:85-94. [PMID: 31362286 DOI: 10.1159/000500971] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 05/15/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Detecting manifestations of spatial disorientation in real time is a key requirement for adaptive assistive navigation systems for people with dementia. OBJECTIVE To identify predictive patterns of spatial disorientation in cognitively impaired people during unconstrained locomotion behavior in an urban environment. METHODS Accelerometric data and GPS records were gathered during a wayfinding task along a route of about 1 km in 15 people with amnestic mild cognitive impairment or clinically probable Alzheimer's disease dementia (13 completers). We calculated a set of 48 statistical features for each 10-s segment of the acceleration sensor signal to characterize the physical motion. We used different classifiers with the wrapper method and leave-one-out cross-validation for feature selection and for determining accuracy of disorientation detection. RESULTS Linear discriminant analysis using three features showed the best classification results, with a cross-validated ROC AUC of 0.75, detecting 65% of all scenes of spatial disorientation in real time. Consideration of an additional feature that informed about a person's distance to the next traffic junction did not provide an additional information gain. CONCLUSIONS Accelerometric data are able to capture the uniformity and activity of a person's walking, which are identified as the most informative locomotion features of spatially disoriented behavior. This serves as an important basis for real-time navigation assistance. To improve the required accuracy of real-time disorientation prediction, as a next step we will analyze whether location-based behavior is able to inform about person-centered habitual factors of orientation.
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Affiliation(s)
- Samer Schaat
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany,
| | - Philipp Koldrack
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | | | - Thomas Kirste
- Department of Computer Science, University of Rostock, Rostock, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic and Psychotherapeutic Medicine, University of Rostock, Rostock, Germany
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Anderberg P, Barnestein-Fonseca P, Guzman-Parra J, Garolera M, Quintana M, Mayoral-Cleries F, Lemmens E, Sanmartin Berglund J. The Effects of the Digital Platform Support Monitoring and Reminder Technology for Mild Dementia (SMART4MD) for People With Mild Cognitive Impairment and Their Informal Carers: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e13711. [PMID: 31228177 PMCID: PMC6611150 DOI: 10.2196/13711] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/09/2019] [Accepted: 05/25/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Many countries are witnessing a trend of growth in the number and proportion of older adults within the total population. In Europe, population aging has had and will continue to have major social and economic consequences. This is a fundamentally positive development where the added life span is of great benefit for both the individual and the society. Yet, the risk for the individual to contract noncommunicable diseases and disability increases with age. This may adversely affect the individual's ability to live his or her life in the way that is desired. Cognitive conditions constitute a group of chronic diseases that predominantly affects older people. Recent technology advancements can help support the day-to-day living activities at home for people with cognitive impairments. OBJECTIVE A digital platform (Support Monitoring and Reminder for Mild Dementia; SMART4MD) is created to improve or maintain the quality of life for people with mild cognitive impairment (PwMCI) and their carers. The platform will provide reminders, information, and memory support in everyday life, with the purpose of giving structure and lowering stress. In the trial, we will include participants with a diagnosed neurocognitive disorder as well as persons with an undiagnosed subjective memory problem and cognitive impairment, that is, 20 to 28 points on the Mini-Mental State Examination. METHODS A pragmatic, multicenter RCT is being conducted in Spain, Sweden, and Belgium. The targets for recruitment are 1200 dyads-split into an intervention group and a control group that are in usual care. Intervention group participants will be provided with a data-enabled computer tablet with the SMART4MD app. Its core functionalities, intended to be used daily at home, are based on reminders, cognitive supporting activities, and sharing health information. RESULTS Inclusion of participants started in December 2017, and recruitment is expected to end in February 2019. Furthermore, there will be 3 follow-up visits at 6, 12, and 18 months after the baseline visit. CONCLUSIONS This RCT is expected to offer benefits at several levels including in-depth knowledge of the possibilities of introducing a holistic multilayered information and communication technology solution for this group. SMART4MD has been developed in a process involving the structured participation of PwMCI, their informal carers, and clinicians. The adoption of SMART4MD faces the challenge of this age group's relative unfamiliarity with digital devices and services. However, this challenge can also be an opportunity for developing a digital device tailored to a group at risk of digital exclusion. This research responds to the wider call for the development of digital devices which are accessible and affordable to older people and this full scale RCT can hopefully serve as a model for further studies in this field. TRIAL REGISTRATION ClinicalTrials.gov NCT03325699; https://clinicaltrials.gov/ct2/show/NCT03325699. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/13711.
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Affiliation(s)
- Peter Anderberg
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Pilar Barnestein-Fonseca
- Research Unit, La Unidad de Gestión Clínica de Mental Health, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario Málaga, Malaga, Spain
| | - Jose Guzman-Parra
- Research Unit, La Unidad de Gestión Clínica de Mental Health, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario Málaga, Malaga, Spain
| | - Maite Garolera
- Brain, Cognition and Behavior - Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain
| | - María Quintana
- Brain, Cognition and Behavior - Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain
| | - Fermin Mayoral-Cleries
- Research Unit, La Unidad de Gestión Clínica de Mental Health, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario Málaga, Malaga, Spain
| | - Evi Lemmens
- University Colleges Leuven-Limburg, Genk, Belgium
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McCarron HR, Zmora R, Gaugler JE. A Web-Based Mobile App With a Smartwatch to Support Social Engagement in Persons With Memory Loss: Pilot Randomized Controlled Trial. JMIR Aging 2019; 2:e13378. [PMID: 31518270 PMCID: PMC6715400 DOI: 10.2196/13378] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/25/2019] [Accepted: 05/14/2019] [Indexed: 01/23/2023] Open
Abstract
Background It is estimated that the number of individuals living with dementia worldwide will increase from 50 million in 2017 to 152 million by 2050. Assistive technology has been recognized as a promising tool to improve the lives of persons living with memory loss and their caregivers. The use of assistive technology in dementia care is expanding, although it is most often intended to manage care and promote safety. There is a lack of assistive technology designed to aid persons with memory loss in participating in meaningful activities. The Social Support Aid (SSA) is a mobile phone-based app that employs facial recognition software. It was designed to assist persons with memory loss remember the names and relationships of the people they interact with to promote social engagement. Objective This study uses a pilot randomized controlled trial (RCT) design to evaluate the SSA. The objectives were to ascertain (1) the feasibility and utility of the SSA, (2) whether the outcomes of SSA use suggest potential benefits for persons living with memory loss and their care partners, and (3) how study design components could inform subsequent RCTs. Methods Persons with memory loss were randomized to the SSA (n=20) or the usual care control group (n=28). Quantitative data were collected at three timepoints (baseline, 3 months, and 6 months). Participants in the intervention group participated in qualitative interviews following completion of their 6-month survey. Results Participant eligibility, willingness to be randomized, and retention were not barriers to conducting a full-scale RCT; however, recruitment strategies should be addressed before doing so. Feasibility and utility scores indicated that participants felt neutral about the technology. Use of the SSA was not significantly associated with changes in quality of social interactions or quality of life measures over the 6 months of follow-up (P>.05). The qualitative analysis revealed three themes that described how and why the SSA worked or not: (1) outcomes, (2) reasons why it was or was not useful, and (3) recommendations. Conclusions There is a need to develop effective assistive technology that improves the quality of life of persons with memory loss. Assistive technology that allows persons living with memory loss to maintain some level of autonomy should be a priority for future research. This study suggests reasons why the SSA facial recognition software did not appear to improve the quality of social interaction and quality of life of people with memory loss. Results also provide recommendations for future assistive technology development and evaluation. Trial Registration ClinicalTrials.gov NCT03645694; https://clinicaltrials.gov/ct2/show/NCT03645694 (Archived by WebCite at http://www.webcitation.org/78dcVZIqq)
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Affiliation(s)
- Hayley R McCarron
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Rachel Zmora
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Joseph E Gaugler
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
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16
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Guisado-Fernández E, Giunti G, Mackey LM, Blake C, Caulfield BM. Factors Influencing the Adoption of Smart Health Technologies for People With Dementia and Their Informal Caregivers: Scoping Review and Design Framework. JMIR Aging 2019; 2:e12192. [PMID: 31518262 PMCID: PMC6716546 DOI: 10.2196/12192] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/13/2018] [Accepted: 03/11/2019] [Indexed: 01/22/2023] Open
Abstract
Background Smart Health technologies (s-Health technologies) are being developed to support people with dementia (PwD) and their informal caregivers at home, to improve care and reduce the levels of burden and stress they experience. However, although s-Health technologies have the potential to facilitate this, the factors influencing a successful implementation in this population are still unknown. Objective The aim of this study was to review existing literature to explore the factors influencing PwD and their informal caregivers’ adoption of s-Health technologies for home care. Methods Following the Arksey and O’Malley methodology, this study is a scoping review providing a narrative description of the scientific literature on factors influencing s-Health technology adoption for PwD and their informal caregivers. A search was conducted using PubMed, the Cochrane library, the IEEE library, and Scopus. Publications screening was conducted by 2 researchers based on inclusion criteria, and full-text analysis was then conducted by 1 researcher. The included articles were thematically analyzed by 2 researchers to gain an insight into factors influencing adoption that PwD and their informal caregivers have to encounter when using s-Health technologies. Relevant information was identified and coded. Codes were later discussed between the researchers for developing and modifying them and for achieving a consensus, and the researchers organized the codes into broader themes. Results Emerging themes were built in a way that said something specific and meaningful about the research question, creating a list of factors influencing the adoption of s-Health technologies for PwD and their informal caregivers, including attitudinal aspects, ethical issues, technology-related challenges, condition-related challenges, and identified gaps. A design framework was created as a guide for future research and innovation in the area of s-Health technologies for PwD and their informal caregivers: DemDesCon for s-Health Technologies. DemDesCon for s-Health Technologies addresses 4 domains to consider for the design and development of s-Health technologies for this population: cognitive decline domain, physical decline domain, social domain, and development domain. Conclusions Although s-Health technologies have been used in health care scenarios, more work is needed for them to fully achieve their potential for use in dementia care. Researchers, businesses, and public governments need to collaborate to design and implement effective technology solutions for PwD and their informal caregivers, but the lack of clear design guidelines seems to be slowing the process. We believe that the DemDesCon framework will provide them with the guidance and assistance needed for creating meaningful devices for PwD home care and informal caregivers, filling a much-needed space in the present knowledge gap.
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Affiliation(s)
- Estefanía Guisado-Fernández
- University College Dublin School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland.,Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | | | - Laura M Mackey
- University College Dublin School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
| | - Catherine Blake
- University College Dublin School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
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Fabricatore C, Radovic D, Lopez X, Grasso-Cladera A, Salas CE. When technology cares for people with dementia: A critical review using neuropsychological rehabilitation as a conceptual framework. Neuropsychol Rehabil 2019; 30:1558-1597. [PMID: 30896282 DOI: 10.1080/09602011.2019.1589532] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Clinicians and researchers have become increasingly interested in the potential of technology in assisting persons with dementia (PwD). However, several issues have emerged in relation to how studies have conceptualized who the main technology user is (PwD/carer), how technology is used (as compensatory, environment modification, monitoring or retraining tool), why it is used (i.e., what impairments and/or disabilities are supported) and what variables have been considered as relevant to support engagement with technology. In this review we adopted a Neuropsychological Rehabilitation perspective to analyse 253 studies reporting on technological solutions for PwD. We analysed purposes/uses, supported impairments and disabilities and how engagement was considered. Findings showed that the most frequent purposes of technology use were compensation and monitoring, supporting orientation, sequencing complex actions and memory impairments in a wide range of activities. The few studies that addressed the issue of engagement with technology considered how the ease of use, social appropriateness, level of personalization, dynamic adaptation and carers' mediation allowed technology to adapt to PWD's and carers' preferences and performance. Conceptual and methodological tools emerged as outcomes of the analytical process, representing an important contribution to understanding the role of technologies to increase PwD's wellbeing and orient future research.
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Affiliation(s)
- Carlo Fabricatore
- School of Computing and Engineering, University of Huddersfield, Huddersfield, UK
| | - Darinka Radovic
- Centro de Modelamiento Matemático, Universidad de Chile, Santiago, Chile
| | - Ximena Lopez
- School of Computing and Engineering, University of Huddersfield, Huddersfield, UK
| | - Aitana Grasso-Cladera
- Laboratorio de Neurociencia Cognitiva y Social, LANCyS, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Christian E Salas
- Laboratorio de Neurociencia Cognitiva y Social, LANCyS, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile.,Unidad de Neuropsicología Clínica, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
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18
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Affiliation(s)
- Katherine Wayne
- AGE-WELL NCE and University of Ottawa Centre for Health Law, Policy & Ethics
- Department of Philosophy, Carleton University
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Bennett B, McDonald F, Beattie E, Carney T, Freckelton I, White B, Willmott L. Assistive technologies for people with dementia: ethical considerations. Bull World Health Organ 2017; 95:749-755. [PMID: 29147055 PMCID: PMC5677608 DOI: 10.2471/blt.16.187484] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/09/2017] [Accepted: 03/29/2017] [Indexed: 12/03/2022] Open
Abstract
The sustainable development goals (SDGs) adopted by the United Nations in 2015 include a new target for global health: SDG 3 aims to “ensure healthy lives and promote well-being for all at all ages.” Dementia care of good quality is particularly important given the projected increase in the number of people living with the condition. A range of assistive technologies have been proposed to support dementia care. However, the World Health Organization estimated in 2017 that only one in 10 of the 1 billion or more people globally who could benefit from these technologies in some way actually has access to them. For people living with dementia, there has been little analysis of whether assistive technologies will support their human rights in ways that are consistent with the United Nations Convention on the Rights of Persons with Disabilities. The aim of this paper is to examine the relevant provisions of the convention and consider their implications for the use of assistive technologies in dementia care. Assistive technologies can clearly play an important role in supporting social engagement, decision-making and advance planning by people living with dementia. However, concerns exist that some of these technologies also have the potential to restrict freedom of movement and intrude into privacy. In conclusion, an analysis of the implications of assistive technologies for human rights laws is needed to ensure that technologies are used in ways that support human rights and help meet the health-related SDG 3.
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Affiliation(s)
- Belinda Bennett
- Australian Centre for Health Law Research, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4000, Australia
| | - Fiona McDonald
- Australian Centre for Health Law Research, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4000, Australia
| | - Elizabeth Beattie
- Dementia Collaborative Research Centre, Queensland University of Technology, Brisbane, Australia
| | - Terry Carney
- Law School, University of Sydney, Sydney, Australia
| | - Ian Freckelton
- Law School, University of Melbourne, Melbourne, Australia
| | - Ben White
- Australian Centre for Health Law Research, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4000, Australia
| | - Lindy Willmott
- Australian Centre for Health Law Research, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4000, Australia
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