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Monnet F, Craven MP, Dupont C, Van den Block L, Pivodic L. Usability of web-based tools designed for communication and decision-making in dementia: Systematic review and design brief. Int J Med Inform 2024; 188:105484. [PMID: 38772276 DOI: 10.1016/j.ijmedinf.2024.105484] [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: 10/31/2023] [Revised: 05/04/2024] [Accepted: 05/13/2024] [Indexed: 05/23/2024]
Abstract
INTRODUCTION There is an increased number of web-based tools designed for people with dementia and their family caregivers and addressing communication and decision-making. The loss of cognitive functions associated with dementia can impact individuals' experiences and use of web-based tools. There is a need for high quality and user-friendly web-based tools that support communication and decision-making for people with dementia and their family caregivers. OBJECTIVE To identify usability requirements, usability testing methods, and design suggestions from studies focusing on web-based tools for communication and decision-making support in dementia care. METHODS We conducted a systematic review with narrative synthesis. Five databases were systematically searched in February 2023. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. RESULTS A total of 1,032 articles were identified and 7 fulfilled inclusion criteria. Web-based tools addressed technology usage, health promotion, home modification information, shared decision-making facilitation, information needs and social isolation. Methods to test usability included surveys, interviews, focus groups, cognitive walkthroughs and think-aloud procedures. Findings suggested reducing cognitive load, enhancing readability, providing clear language, and emphasising the need for additional support for people with dementia. Design recommendations include optimising information delivery and presentation, enhancing visual elements, streamlining navigation, providing concrete examples, using clear language, and offering training and tailored support. CONCLUSION Usability requirements ranged from visual appearance and navigation to delivery of content and support needed. This review contributes to efforts to improve design and development of web-based tools targeting communication and decision-making in dementia care. Further research should address tailored support to enhance usability for people with dementia.
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Affiliation(s)
- Fanny Monnet
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium; Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussel, Belgium.
| | - Michael P Craven
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, Nottingham, UK; NIHR MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Charlèss Dupont
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium; Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Lieve Van den Block
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium; Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Lara Pivodic
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium; Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussel, Belgium
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Zheng J, Gresham M, Phillipson L, Hall D, Jeon YH, Brodaty H, Low LF. Exploring the usability, user experience and usefulness of a supportive website for people with dementia and carers. Disabil Rehabil Assist Technol 2024; 19:1369-1381. [PMID: 37086036 DOI: 10.1080/17483107.2023.2180546] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 02/08/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE This study explores the usability, usefulness and user experience of the Forward with Dementia website for people with dementia and family carers, and identifies strategies to improve web design for this population. METHODS The website was iteratively user-tested by 12 participants (five people with dementia, seven carers) using the Zoom platform. Data collection involved observations, semi-structured interviews and questionnaires. Integrative mixed-method data analysis was used, informed by inductive thematic qualitative analysis. RESULTS Users of Version 1 of the website experienced web functionality, navigation and legibility issues. Strategies for desirable web design were identified as simplifying functions, streamlining navigation and decluttering page layouts. Implementation of strategies produced improvements in usability, user experience and usefulness in Version 2, with mean System Usability Scale scores improving from 15 to 84, and mean task completion improving from 55% to 89%. The user journey for people with dementia and carers overlapped, but each group had their own unique needs in the context of web design. CONCLUSIONS The interplay between a website's content, functionality, navigation and legibility can profoundly influence user perceptions of a website. Dementia-related websites play an important role in informing audiences of management strategies, service availability and planning for the progression of dementia. Findings of this study may assist in guiding future web development targeting this population.
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Affiliation(s)
- Jacky Zheng
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Meredith Gresham
- Discipline of Psychiatry and Mental Health, Centre for Healthy Brain Ageing, UNSW Sydney, Sydney, Australia
| | - Lyn Phillipson
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Danika Hall
- Discipline of Psychiatry and Mental Health, Centre for Healthy Brain Ageing, UNSW Sydney, Sydney, Australia
| | - Yun-Hee Jeon
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Henry Brodaty
- Discipline of Psychiatry and Mental Health, Centre for Healthy Brain Ageing, UNSW Sydney, Sydney, Australia
| | - Lee-Fay Low
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Giannios G, Mpaltadoros L, Alepopoulos V, Grammatikopoulou M, Stavropoulos TG, Nikolopoulos S, Lazarou I, Tsolaki M, Kompatsiaris I. A Semantic Framework to Detect Problems in Activities of Daily Living Monitored through Smart Home Sensors. SENSORS (BASEL, SWITZERLAND) 2024; 24:1107. [PMID: 38400265 PMCID: PMC10892043 DOI: 10.3390/s24041107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
Activities of daily living (ADLs) are fundamental routine tasks that the majority of physically and mentally healthy people can independently execute. In this paper, we present a semantic framework for detecting problems in ADLs execution, monitored through smart home sensors. In the context of this work, we conducted a pilot study, gathering raw data from various sensors and devices installed in a smart home environment. The proposed framework combines multiple Semantic Web technologies (i.e., ontology, RDF, triplestore) to handle and transform these raw data into meaningful representations, forming a knowledge graph. Subsequently, SPARQL queries are used to define and construct explicit rules to detect problematic behaviors in ADL execution, a procedure that leads to generating new implicit knowledge. Finally, all available results are visualized in a clinician dashboard. The proposed framework can monitor the deterioration of ADLs performance for people across the dementia spectrum by offering a comprehensive way for clinicians to describe problematic behaviors in the everyday life of an individual.
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Affiliation(s)
- Giorgos Giannios
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Lampros Mpaltadoros
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Vasilis Alepopoulos
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Margarita Grammatikopoulou
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Thanos G. Stavropoulos
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Spiros Nikolopoulos
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Ioulietta Lazarou
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
| | - Magda Tsolaki
- Department of Neurology I, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD), 54643 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Buildings A & B, 57001 Thessaloniki, Greece
| | - Ioannis Kompatsiaris
- Information Technologies Institute, Centre for Research & Technology Hellas, 6th Km Charilaou-Thermi, 57001 Thessaloniki, Greece; (G.G.); (L.M.); (V.A.); (M.G.); (T.G.S.); (I.L.); (I.K.)
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Formica C, Bonanno M, Sorbera C, Quartarone A, Giambò FM, Marra A, Calabrò RS. Smartphone-Based Cognitive Telerehabilitation: A Usability and Feasibility Study Focusing on Mild Cognitive Impairment. SENSORS (BASEL, SWITZERLAND) 2024; 24:525. [PMID: 38257618 PMCID: PMC10820398 DOI: 10.3390/s24020525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/03/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024]
Abstract
The implementation of cognitive health apps in patients with mild cognitive impairment (MCI) is challenging because of their cognitive, age, and other clinical characteristics. In this project, we aimed to evaluate the usability and feasibility of the Rehastart app tested in MCI patients. Eighteen subjects affected by MCI due to neurodegenerative disorders (including Parkinson's disease, multiple sclerosis, and amnestic/multidomain MCI) and eighteen healthcare professionals were recruited to this study. Patients were registered on the app by clinicians and they were assigned a protocol of specific cognitive exercises. The recruitment was conducted in the period between March and June 2023. The trial testing of the app consisted of three sessions per week for three weeks, with each session lasting about 30 min. After three weeks, the participants as well as medical personnel were invited to rate the usability and feasibility of the Rehastart mobile application. The instruments employed to evaluate the usability and feasibility of the app were the System Usability Scale (SUS), The Intrinsic Motivation Inventory (IMI) and the Client Satisfaction Questionnaire (CSQ). We did not find statistically significant differences on the SUS (p = 0.07) between healthcare professionals and patients. In addition, we found promising results on subscales of the Intrinsic Motivation Inventory, suggesting high levels of interest and enjoyment when using the Rehastart app. Our study demonstrated that smartphone-based telerehabilitation could be a suitable tool for people with MCI due to neurodegenerative disorders, since the Rehastart app was easy to use and motivating for both patients and healthy people.
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Affiliation(s)
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, S.S. 113, 98124 Messina, Italy; (C.F.); (C.S.); (A.Q.); (F.M.G.); (A.M.); (R.S.C.)
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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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Welch V, Ghogomu ET, Barbeau VI, Dowling S, Doyle R, Beveridge E, Boulton E, Desai P, Huang J, Elmestekawy N, Hussain T, Wadhwani A, Boutin S, Haitas N, Kneale D, Salzwedel DM, Simard R, Hébert P, Mikton C. Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1369. [PMID: 38024780 PMCID: PMC10681039 DOI: 10.1002/cl2.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Background Social isolation and loneliness are more common in older adults and are associated with a serious impact on their well-being, mental health, physical health, and longevity. They are a public health concern highlighted by the COVID-19 pandemic restrictions, hence the need for digital technology tools to enable remotely delivered interventions to alleviate the impact of social isolation and loneliness during the COVID-19 restrictions. Objectives To map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings. Search Methods We searched the following databases from inception to May 16, 2021, with no language restrictions. Ovid MEDLINE, Embase, APA PsycInfo via Ovid, CINAHL via EBSCO, Web of Science via Clarivate, ProQuest (all databases), International Bibliography of the Social Sciences (IBSS) via ProQuest, EBSCO (all databases except CINAHL), Global Index Medicus, and Epistemonikos. Selection Criteria Titles and abstracts and full text of potentially eligible articles were independently screened in duplicate following the eligibility criteria. Data Collection and Analysis We developed and pilot tested a data extraction code set in Eppi-Reviewer and data were individually extracted and coded based on an intervention-outcome framework which was also used to define the dimensions of the evidence and gap map. Main Results We included 200 articles (103 primary studies and 97 systematic reviews) that assessed the effects of digital interventions to reduce social isolation and/or loneliness in older adults. Most of the systematic reviews (72%) were classified as critically low quality, only 2% as high quality and 25% were published since the COVID-19 pandemic. The evidence is unevenly distributed with clusters predominantly in high-income countries and none in low-income countries. The most common interventions identified are digital interventions to enhance social interactions with family and friends and the community via videoconferencing and telephone calls. Digital interventions to enhance social support, particularly socially assistive robots, and virtual pets were also common. Most interventions focused on reducing loneliness and depression and improving quality of life of older adults. Major gaps were identified in community level outcomes and process indicators. No included studies or reviews assessed affordability or digital divide although the value of accessibility and barriers caused by digital divide were discussed in three primary studies and three reviews. Adverse effects were reported in only two studies and six reviews. No study or review included participants from the LGBTQIA2S+ community and only one study restricted participants to 80 years and older. Very few described how at-risk populations were recruited or conducted any equity analysis to assess differences in effects for populations experiencing inequities across PROGRESS-Plus categories. Authors' Conclusions The restrictions placed on people during the pandemic have shone a spotlight onto social isolation and loneliness, particularly for older adults. This evidence and gap map shows available evidence on the effectiveness of digital interventions for reducing social isolation or loneliness in older adults. Although the evidence is relatively large and recent, it is unevenly distributed and there is need for more high-quality research. This map can guide researchers and funders to consider areas of major gaps as priorities for further research.
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Affiliation(s)
- Vivian Welch
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Sierra Dowling
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | - Ella Beveridge
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | - Elisabeth Boulton
- School of Health Sciences, Division of Nursing, Midwifery and Social WorkUniversity of ManchesterManchesterUK
| | - Payaam Desai
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | - Jimmy Huang
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Arpana Wadhwani
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Dylan Kneale
- Social Science Research Unit, EPPI‐Centre, UCL Institute of EducationUniversity College LondonLondonUK
| | - Douglas M. Salzwedel
- Department of Anesthesiology, Pharmacology and TherapeuticsUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Paul Hébert
- Bruyère Research InstituteUniversity of OttawaOttawaOntarioCanada
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Monnet F, Dupont C, Smets T, De Vleminck A, Van Audenhove C, Van den Block L, Pivodic L. Advance Care Planning Website for People With Dementia and Their Family Caregivers: Protocol for a Development and Usability Study. JMIR Res Protoc 2023; 12:e46935. [PMID: 37494084 PMCID: PMC10413243 DOI: 10.2196/46935] [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: 03/02/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Web-based tools for people with dementia and their family caregivers have considerably increased over the years and offer promising solutions to several unmet needs such as supporting self-care in daily life, facilitating treatment delivery, or ensuring their ability to communicate. The use of web-based tools in the field of advance care planning (ACP) for people with dementia and their family caregivers has yet to be explored and requires careful consideration, given the sensitive topic and the specific needs of people with dementia and their families. OBJECTIVE This paper reports the protocol for a study aiming to develop and simultaneously test the usability of an ACP website designed for, and with, people with dementia and their families. METHODS The development of the website is based on a process map for the development of web-based decision support interventions and on the Medical Research Council framework for complex intervention development and evaluation. Additionally, we apply a user-centered approach in combination with patient and public involvement (PPI) throughout the development process. We describe our iterative development approach to the website. Participants and a PPI group give feedback on 4 prototypes of the ACP website. For each iteration, we aim to include 12 participants (3 people with dementia, 3 family caregivers, and 3 dyads) in usability testing. In the first 3 iterations, usability testing includes (1) a think-aloud exercise, (2) researcher observations, and (3) the System Usability Scale questionnaire. The last iteration of usability testing is composed of a semistructured interview assessing the layout, content, face validity, and readability of the website. Qualitative data from the think-aloud exercises and interviews are analyzed using thematic analysis. Mean scores are calculated for the System Usability Scale questionnaire. RESULTS This study received approval from the Ethical Review Board of Brussels University Hospital of the Vrije Universiteit Brussel. Recruitment began in October 2021. The target date for paper submission of the results of the development and usability testing will be in 2023. CONCLUSIONS The methods in this protocol describe a feasible and inclusive approach to the development of an ACP website together with people with dementia, their family caregivers, and other stakeholders. We provide a clear overview of how to combine PPI input and user-centered development methods, leading to a transparent and reliable development process. This protocol might stimulate the active participation of people with dementia, their caregivers, and regional stakeholders in future studies on web-based technologies. The results of this study will be used to refine the design and create a relevant and user-friendly ACP website that is ready to be tested in a larger evaluation study. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46935.
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Affiliation(s)
- Fanny Monnet
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Charlèss Dupont
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tinne Smets
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Aline De Vleminck
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Lieve Van den Block
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lara Pivodic
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
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Hevink M, Wolfs C, Ponds R, Doucet S, McAiney C, Vedel I, Maćkowiak M, Rymaszewska J, Rait G, Robinson L, Poole M, Gresham M, Jeon YH, Phillipson L, Low LF, Brodaty H, de Vugt M, Verhey F. Experiences of people with dementia and informal caregivers with post-diagnostic support: Data from the international COGNISANCE study. Int J Geriatr Psychiatry 2023; 38:e5916. [PMID: 37132330 DOI: 10.1002/gps.5916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/18/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVES The study aims to describe people with dementia and informal caregivers' respective experiences of support after diagnosis and compares these experiences. Additionally, we determine how people with dementia and informal caregivers who are satisfied with support differ from those dissatisfied. METHODS A cross-sectional survey study in Australia, Canada, the Netherlands, Poland, and United Kingdom was carried out to examine people with dementia and informal caregivers experience with support (satisfaction with information, access to care, health literacy, and confidence in ability to live well with dementia). The separate surveys contained closed questions. Analysis consisted of descriptive statistics and Chi-square tests. RESULTS Ninety people with dementia and 300 informal caregivers participated, and 69% of people with dementia and 67% of informal caregivers said support after diagnosis helped them deal more efficiently with their concerns. Up to one-third of people with dementia and informal caregivers were dissatisfied with information about management, prognosis, and strategies for living positively. Few people with dementia (22%) and informal caregivers (35%) received a care plan. People with dementia were more often satisfied with information, had more often confidence in their ability to live well with dementia, and were less often satisfied with access to care compared to informal caregivers. Informal caregivers who were satisfied with support were more satisfied with information and access to care compared to informal caregivers not satisfied with support. CONCLUSIONS Experience of dementia support can be improved and people with dementia and informal caregiver differ in their experiences of support.
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Affiliation(s)
- Maud Hevink
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Claire Wolfs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Rudolf Ponds
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Shelley Doucet
- Department of Nursing and Health Sciences, The Centre for Research in Integrated Care, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Carrie McAiney
- School of Public Health Sciences, University of Waterloo and Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
| | - Isabelle Vedel
- Department of Family Medicine, McGill University, and Lady Davis Institute for Medical Research, and Jewish General Hospital, Montreal, Quebec, Canada
| | - Maria Maćkowiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | - Greta Rait
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Marie Poole
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Meredith Gresham
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lyn Phillipson
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lee-Fay Low
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
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9
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Dupont C, Monnet F, Pivodic L, Vleminck AD, Audenhove CV, Van den Block L, Smets T. Evaluating an advance care planning website for people with dementia and their caregivers: Protocol for a mixed method study. Digit Health 2023; 9:20552076231197021. [PMID: 37654712 PMCID: PMC10467240 DOI: 10.1177/20552076231197021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/02/2023] Open
Abstract
Background Web-based tools (e.g., websites, apps) for people with dementia and their family caregivers may be useful in supporting advance care planning (ACP). Using a user-centred design approach, we developed an ACP website for people with dementia and their families. This protocol describes how we will test and evaluate the ACP website. Publishing a study protocol can guide others who want to evaluate web-based tools. Moreover, the data collection methods used in this study are very innovative since they aim to involve people living with dementia without overburdening them. Methods We will conduct an evaluation study of the ACP website in Flanders, Belgium, using a convergent parallel mixed methods pre-post-test design with continuous follow-up. Thirty eligible dyads of people with mild to moderate dementia (both early and late onset) and their family caregivers will use the website in their everyday life for 8 weeks. We will evaluate the usage, usability, acceptability, and feasibility of the website, as well as the experiences of users. Additionally, we evaluate the effects of using the website on ACP readiness, ACP knowledge, attitudes, perceived barriers to engage in ACP, self-efficacy and skills to engage in ACP. Results Recruitment and data collection is foreseen between end of 2022 and 2023. Conclusion This evaluation study of an ACP website for people with dementia and their family caregivers will be the first to evaluate how a web-based tool can support people living with dementia and their families in ACP. The strength of this study lies in the combination of interviews, surveys, and ongoing data logging, which provide insights into the use of support tools in people's daily context. We expect that recruiting people with dementia and their families will be difficult so we have set up a thorough strategy to reach the anticipated sample size.
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Affiliation(s)
- Charlèss Dupont
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
| | - Fanny Monnet
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
| | - Lara Pivodic
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
| | - Aline De Vleminck
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
| | | | - Lieve Van den Block
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
| | - Tinne Smets
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
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Domenicucci R, Ferrandes F, Sarlo M, Borella E, Belacchi C. Efficacy of ICT-based interventions in improving psychological outcomes among older adults with MCI and dementia: A systematic review and meta-analysis. Ageing Res Rev 2022; 82:101781. [PMID: 36343879 DOI: 10.1016/j.arr.2022.101781] [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: 08/04/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022]
Abstract
The purpose of this systematic review and meta-analysis was to investigate empirical evidence about the effectiveness of Information and Communication Technology-based interventions (ICTs) on different psychological outcomes in adults aged over 60 years with Mild Cognitive Impairment (MCI) or dementia. We conducted a systematic search on Pubmed, Web of Science, Scopus, and PsycInfo with publication year between January 2010 up to April 2021. Any pre-post quantitative intervention study with at least one of the following domains examined: quality of life (QoL), psychological well-being, social interaction, engagement, mood, anxiety, stress, loneliness, self-efficacy, or self-esteem was included. The risk of bias and quality of evidence were assessed using tools based on the Cochrane Handbook for Systematic Review of Interventions criteria. Forty-eight studies with a total of 1488 participants met the selection criteria. Because of the high heterogeneity, we ran nine different random effects meta-analyses divided by outcome and type of cognitive decline which indicated that these treatments were ineffective overall, with some exceptions. Only anxiety (small effect size =-0.375 [-0.609; -0.140]) and behavioral symptoms (BS) (medium effect size =-0.585 [-1.019; -0.152]) in people with dementia (PwD) were found to change significantly. Moreover, effect sizes for QoL in dementia and for mood in people with MCI became significant when moderated by type of ICT, living situation, and experimental setting. In particular, Virtual Reality (VR) appeared to be more effective than other devices for both PwD and MCI, and nursing homes were found to be the best setting for administering these treatments. The trim and fill method found no evidence of publication bias in any of the 9 analyses. However, quality of evidence within (RoB 2, RoB 2 Crossover, ROBINS) and across (GRADE assessment) studies was low, thus these findings should be interpreted with caution. In general, ICT-based intervention can be considered a promising approach for improving anxiety and BS in PwD, and for improving QoL in PwD and mood in people with MCI, specifically when VR is used, when participants live in nursing homes, and when interventions are carried out in nursing homes.1.
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Affiliation(s)
- Riccardo Domenicucci
- University of Urbino 'Carlo Bo', Department of Communication Sciences, Humanities and International Studies, Italy.
| | - Federico Ferrandes
- University of Urbino 'Carlo Bo', Department of Communication Sciences, Humanities and International Studies, Italy
| | - Michela Sarlo
- University of Urbino 'Carlo Bo', Department of Communication Sciences, Humanities and International Studies, Italy
| | - Erika Borella
- University of Padua, Department of General Psychology, Italy
| | - Carmen Belacchi
- University of Urbino 'Carlo Bo', Department of Communication Sciences, Humanities and International Studies, Italy
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11
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Nkodo JA, Gana W, Debacq C, Aidoud A, Poupin P, Camus V, Fougère B. The Role of Telemedicine in the Management of the Behavioral and Psychological Symptoms of Dementia: A Systematic Review. Am J Geriatr Psychiatry 2022; 30:1135-1150. [PMID: 35241355 DOI: 10.1016/j.jagp.2022.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 01/25/2023]
Abstract
The first-line management of behavioral and psychological symptoms of dementia (BPSD) is based on nonpharmacologic interventions such as the provision of guidance and medical support to caregivers. However, accessibility to specialized care and medical resources is often scarce. The ongoing COVID-19 pandemic has compromised the delivery of outpatient care (notably in order to minimize the risk of disease transmission), thus making it essential to provide other means of accessing care for these patient populations. The use of telemedicine (TM) may be a means of increasing access to specialist care for patients with disabilities and poor access to health services, such as those with BPSD. The aim of this study is to provide a review of the literature on the use of TM for treatment and follow-up of patients with BPSD and their caregivers. We searched the PUBMED, EMBASE and CINAHL for articles published between January 1st, 2000, and December 31st, 2020, on the applicability of TM support for people with BPSD and their caregivers. We included open-label studies, qualitative studies, and randomized controlled trials . We did not include studies on the use of TM during the COVID-19 pandemic. A total of 22 publications were included and reviewed. TM was found to 1) be acceptable and feasible for both patients and caregivers, 2) decrease the frequency and intensity of BPSD, and 3) improve the caregiver's perceived wellbeing and mental health. Videoconferencing was effective for patient-centered interventions in nursing homes. Telephone-based interventions were more relevant when they were targeted at caregivers. The published studies are lacking in scope and high-quality studies are now needed to confirm these findings and assess TM's cost-effectiveness and ability to improve the management of patients with BPSD. In view of the ongoing COVID-19 pandemic, remote solutions for assessing and monitoring individuals with BPSD are urgently needed - particularly those living in rural areas and so-called "medical deserts."
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Affiliation(s)
- Jacques-Alexis Nkodo
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France; Service de Psychiatrie Universitaire (JAN, VC), CHRU Tours, Tours, France.
| | - Wassim Gana
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France
| | - Camille Debacq
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France
| | - Amal Aidoud
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France
| | - Pierre Poupin
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France
| | - Vincent Camus
- Service de Psychiatrie Universitaire (JAN, VC), CHRU Tours, Tours, France; UMR INSERM U1253 & Université de Tours (VC), Tours, France
| | - Bertrand Fougère
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France; Education, Ethics, Health (EA 7505) (BF), Tours University, Tours, France
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12
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Clarkson P, Pitts R, Islam S, Peconi J, Russell I, Fegan G, Beresford R, Entwistle C, Gillan V, Orrell M, Challis D, Chester H, Hughes J, Kapur N, Roe B, Malik B, Robinson C. Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial. J Neurol Neurosurg Psychiatry 2022; 93:1001-1009. [PMID: 34667103 DOI: 10.1136/jnnp-2021-326748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/04/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Common memory aids for people with dementia at home are recommended. However, rigorous evaluation is lacking, particularly what guidance or support is valued. OBJECTIVE To investigate effects of memory aids and guidance by dementia support practitioners (DSPs) for people in early-stage dementia through a pragmatic, randomised controlled trial. METHODS Of 469 people with mild-to-moderate dementia and their informal carers, 468 were randomised to a DSP with memory aids or to usual care plus existing dementia guide. Allocation was stratified by Trust/Health Board; time since first attendance at memory service; gender; age; and living with primary carer or not. Primary outcome was Bristol Activities of Daily Living Scale (BADLS) Score at 3 and 6 months (primary end-point). Secondary outcomes for people with dementia: quality of life (CASP-19; DEMQOL); cognition and functioning (Clinical Dementia Rating Scale; S-MMSE); capability (ICECAP-O); social networks (LSNS-R); and instrumental daily living activities (R-IDDD). Secondary outcomes for carers: psychological health (GHQ-12); sense of competence (SSCQ). RESULTS DSPs were successfully trained, compliance was good and welcomed by participants. Mean 6 months BADLS Score increased to 14.6 (SD: 10.4) in intervention and 12.6 (SD: 8.1) in comparator, indicative of greater dependence in the activities of daily living. Adjusted between-group difference was 0.38 (95% CI: -0.89 to 1.65, p=0.56). Though this suggests greater dependency in the intervention group the difference was not significant. No differences were found in secondary outcomes. CONCLUSIONS This intervention did not maintain independence in the activities of daily living with no improvement in other outcomes for people with dementia or carers. TRIAL REGISTRATION NUMBER Current Controlled Trials ISRCTN12591717.
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Affiliation(s)
- Paul Clarkson
- Social Care and Society, The University of Manchester, Manchester, UK
| | - Rosa Pitts
- Social Care and Society, The University of Manchester, Manchester, UK
| | - Saiful Islam
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Julie Peconi
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Ian Russell
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Greg Fegan
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Rebecca Beresford
- Social Care and Society, The University of Manchester, Manchester, UK
| | | | - Vincent Gillan
- Social Care and Society, The University of Manchester, Manchester, UK
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - David Challis
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Helen Chester
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Jane Hughes
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Narinder Kapur
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Brenda Roe
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK
| | - Baber Malik
- Social Care and Society, The University of Manchester, Manchester, UK
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13
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Ahmed M, Marín M, How D, Judica E, Tropea P, Bentlage E, J. Ferreira J, Bouça-Machado R, Brach M. End-Users and Other Stakeholders’ Needs and Requirements in the Development of a Personalized Integrated Care Platform (PROCare4Life) for Older People with Dementia or Parkinson Disease: A Mixed-Methods Study (Preprint). JMIR Form Res 2022; 6:e39199. [DOI: 10.2196/39199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/18/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
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14
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Dequanter S, Fobelets M, Steenhout I, Gagnon MP, Bourbonnais A, Rahimi S, Buyl R, Gorus E. Determinants of technology adoption and continued use among cognitively impaired older adults: a qualitative study. BMC Geriatr 2022; 22:376. [PMID: 35484488 PMCID: PMC9047390 DOI: 10.1186/s12877-022-03048-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Technology offers opportunities to support older adults with mild cognitive impairments to remain independent and socially connected, but is often not used. Although determinants of technology use among older adults in general are well studied, much less is known about how these factors impact technology use behaviour in cognitively impaired older adults. This study aimed to bridge this gap in research by examining the factors underlying technology use in community-dwelling older adults with mild cognitive impairments. Methods We applied a generic qualitative design and used 16 semi-structured interviews to collect data from Belgian (Flemish) community-dwelling older adults diagnosed with Mild Cognitive Impairment or dementia and informal caregivers. To get data from different perspectives, a focus group with professional caregivers was added. We used thematic analysis with an inductive approach to identify and select themes from the data. Results We identified two themes: introduction of technology and determinants of technology adoption and continued use. Successful technology adoption in cognitively impaired older adults is need-driven and subject to individual, technological and contextual characteristics. Specific for older adults with cognitive impairments are the importance of disease awareness and cognitive ability for adoption and continued use, respectively. Although social support can be a valuable alternative to technology, it is an important facilitator of continued technology use in these older adults. Similarly, integration of technologies in daily routines can buffer discontinuation of technologies. Conclusions Future research is encouraged to validate our findings in a postpandemic era and to further develop a novel theoretical framework for technology acceptance among older adults with cognitive impairments. Moreover, identification of crucial determinants as well as strategies to remove use barriers are also important future research tasks. Clinical practice should focus on improving disease awareness to facilitate technology adoption and policies should invest in training and support of professional caregivers and in reimbursement strategies to facilitate implementation of technology in practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03048-w.
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Affiliation(s)
- Samantha Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maaike Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Iris Steenhout
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | | | | | - Samira Rahimi
- Department of Family Medicine, McGill University, Montreal, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,MILA - Quebec Artificial Intelligence Institute, Montreal, Quebec, Canada
| | - Ronald Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ellen Gorus
- Department of Gerontology, Faculty of Medicine and Pharmacy, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium. .,Department of Geriatrics, UZ Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
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15
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Dequanter S, Steenhout I, Fobelets M, Gagnon MP, Sasseville M, Bourbonnais A, Giguère A, Ndiaye MA, Lambert A, Gorus E, Buyl R. Technology implementation in care practices for community-dwelling older adults with mild cognitive decline: Perspectives of professional caregivers in Quebec and Brussels. Digit Health 2022; 8:20552076221139693. [PMID: 36420317 PMCID: PMC9677160 DOI: 10.1177/20552076221139693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/01/2022] [Indexed: 10/24/2023] Open
Abstract
OBJECTIVE As worldwide population aging is accelerating, innovative technologies are being developed to support independent living among community-dwelling older adults with mild cognitive decline. However, the successful implementation of these interventions is often challenging. Until now, literature on implementation issues related to the specific context of older adults with mild cognitive decline is lacking and the few studies available do not focus specifically on the perspective of professional caregivers. Yet the perspective of these caregivers is important as they can be considered a key facilitator for technology implementation among this population. Therefore, this study was the first to examine technology implementation among community-dwelling older adults with mild cognitive decline from the broader perspective of professional caregivers. METHODS In this qualitative study, two focus groups consisting of a heterogeneous pool of professional caregivers were conducted: one in Quebec (Canada, n = 6) and one in Brussels (Belgium, n = 8). Braun and Clarke' method for thematic analysis, guided by a qualitative descriptive approach was applied to inductively identify themes from the data. RESULTS We identified factors influencing technology implementation in older adults with mild cognitive decline on three levels: an individual level (e.g., characteristics of older adults with mild cognitive decline and professional caregivers' attitude), an organizational level (e.g., lack of training among professional caregivers) and a level referring to the broader context (e.g., ethical considerations). CONCLUSIONS This study contributes to the research gap in knowledge on the needs of professional caregivers to facilitate technology implementation among the population of older adults with cognitive decline. Future directions for research, practice, and policy are given, more specifically to improve knowledge among caregivers and on the development of decision support to retrieve safe and effective technologies that suit patient-centered care.
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Affiliation(s)
- S Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - I Steenhout
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Square, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Teacher Education, Vrije Universiteit Brussel, Brussels, Belgium
| | - MP Gagnon
- Department of Nursing Sciences, Université Laval, Quebec, Canada
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Quebec, Canada
| | - M Sasseville
- Department of Nursing Sciences, Université Laval, Quebec, Canada
- VITAM Centre de recherche en santé durable, Centre Intégré de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec, Canada
| | - A Bourbonnais
- Faculty of Nursing, Université de Montreal, Montreal, Canada
- Research Centre of the Institut Universitaire de gériatrie de Montréal, Canada
| | - A Giguère
- Department of Nursing Sciences, Université Laval, Quebec, Canada
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Quebec, Canada
| | - MA Ndiaye
- Arthritis Research Canada, Richmond, Canada
| | - A Lambert
- Department of Nursing Sciences, Université Laval, Quebec, Canada
| | - E Gorus
- Department of Gerontology, Faculty of Medicine and Pharmacy, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Geriatrics, UZ Brussel, Brussels, Belgium
| | - R Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
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Hirt J, Langer G, Wilde F, Bauernschmidt D, Meyer G, Bieber A. Technology-based counselling in dementia (TeCoDem): study protocol of a mixed-methods systematic review with qualitative comparative analysis and meta-analysis. BMJ Open 2021; 11:e054157. [PMID: 34880025 PMCID: PMC8655568 DOI: 10.1136/bmjopen-2021-054157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Information technology can enhance timely and individual support for people with dementia and informal carers. There is some evidence that people with dementia and informal carers would benefit from technology-based counselling. However, it remains unclear which features of those interventions relate to beneficial outcomes and which aspects are necessary for a successful implementation. Therefore, the primary objectives are: (1) to identify conditions of successful implementation of technology-based counselling interventions in dementia and (2) to investigate the effectiveness of those interventions. METHODS AND ANALYSIS We will conduct a mixed-methods systematic review. The first primary objective requires evidence from various study designs addressing aspects on effective and non-effective implementation of technology-based counselling. This could be telephone-based, web-based or mobile-based interventions for people with dementia and informal carers. For the second primary objective, randomised controlled trials (RCTs) dealing with any outcomes will be included. Year of publication and language will not be restricted. We will search CINAHL, Cochrane Library, MEDLINE, PsycINFO and Web of Science up to April 2021. Additionally, we will perform web searching and citation tracking. To achieve the first primary objective, a Qualitative Comparative Analysis (QCA) will be conducted. The QCA enables us to identify necessary or sufficient components for a successful implementation. To reach the second primary objective, a meta-analysis will be performed with respect to potential clinical and statistical heterogeneity of RCTs. The revised Risk of Bias tool 2.0 will be used to check the risk of bias in RCTs. For all other study designs, the Mixed Method Appraisal Tool will be used. ETHICS AND DISSEMINATION Ethics approval is not required for this review. We will disseminate our findings through scientific and non-scientific journal articles and conference presentations as well as formats directed to the public and decision-makers in healthcare. PROSPERO REGISTRATION NUMBER CRD42021245473.
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Affiliation(s)
- Julian Hirt
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Center for Dementia Care, Institute of Applied Nursing Sciences, Department of Health, Eastern Switzerland University of Applied Sciences, St Gallen, Switzerland
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Gero Langer
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Fabian Wilde
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Dorothee Bauernschmidt
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Gabriele Meyer
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anja Bieber
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Seok JW, Shin J, Kang B, Lee H, Cho E, Lee KH. Non-pharmacological interventions using information and communication technology for behavioral and psychological symptoms of dementia: A systematic review and meta-analysis protocol. J Adv Nurs 2021; 78:282-293. [PMID: 34812533 DOI: 10.1111/jan.15109] [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: 09/14/2021] [Revised: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 11/27/2022]
Abstract
AIM To review and examine the effectiveness of non-pharmacological interventions on behavioural and psychological symptoms of dementia using information and communication technology. DESIGN This is a systematic review and meta-analysis. METHODS The databases including PubMed, CINAHL with Full Text (EBSCOhost), PsycINFO, Embase, and the Cochrane Library will be searched for all published studies. Studies will be screened and selected with criteria described in PICOS format. Risk of bias will be assessed by the National Institute for Health and Clinical Excellence checklist. Data will be extracted from eligible studies and used to perform a meta-analysis examining the overall effects and effects on individual outcomes. Additionally, we will conduct meta-regression to examine the association between explanatory variables and behavioural and psychological symptoms. This study has been funded since June 2020. DISCUSSION This study will be the first to reveal the effects of non-pharmacological interventions using information and communication technology on behavioural and psychological symptoms of dementia. Furthermore, this study will provide updated and valid evidence of interventions using this for managing behavioural and psychological symptoms of dementia. IMPACT Although non-pharmacological interventions using information and communication technology for older adults living with dementia are continuously developing, their direct effect remains unclear. This study will evaluate the effectiveness of these interventions on behavioural and psychological symptoms of dementia and provide the evidence to implement these interventions among older adults living with dementia. Thus, caregivers and nursing staff can manage behavioural and psychological symptoms of dementia more effectively by incorporating information and communication technology.
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Affiliation(s)
- Jo Woon Seok
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Jinhee Shin
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Bada Kang
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Hyangkyu Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Eunhee Cho
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Kyung Hee Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
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Dequanter S, Gagnon MP, Ndiaye MA, Gorus E, Fobelets M, Giguère A, Bourbonnais A, Buyl R. The Effectiveness of e-Health Solutions for Aging With Cognitive Impairment: A Systematic Review. THE GERONTOLOGIST 2021; 61:e373-e394. [PMID: 32525977 PMCID: PMC8437510 DOI: 10.1093/geront/gnaa065] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives e-Health solutions are an innovative approach to support aging with cognitive impairment. Because technology is developing at a fast pace, the aim of this review was to present an overview of the research regarding the effectiveness of these solutions. Moreover, the availability of these solutions was examined. Research Design and Methods Systematic searches were conducted in 7 databases. Full texts of potentially relevant references were assessed by 2 reviewers, and discrepancies were solved through discussion. Data on study characteristics, technology type, application domain, availability, outcomes, and effects were extracted. A categorization exercise and narrative synthesis were conducted. Results In total, 72 studies describing 70 e-Health solutions were identified. The majority of solutions comprised cognitive training for older adults, followed by educational and supportive web platforms for caregivers. Outcomes included mainly measures of cognition, psychosocial functioning, caregiving processes, caregiver–care receiver relationship, and activities of daily living. Positive effects of cognitive training technologies were observed on cognitive functioning of older adults, as well as those of supportive web platforms on behavioral and psychological symptoms of dementia and caregiver self-efficacy. The effects of these solutions on depression in both target groups were inconclusive. The methodological quality of the studies was moderate to good. However, some important limitations were observed. Discussion and Implications The review identified cognitive training solutions and supportive web platforms as the most effective on a limited number of outcomes. Although other solutions seem promising, further research has to overcome methodological issues. Furthermore, solutions for leisure and reminiscence and outcomes specifically related to independent living deserve more attention.
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Affiliation(s)
- Samantha Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Belgium
| | - Marie-Pierre Gagnon
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada.,Faculty of Nursing Sciences, Université Laval, Québec, Canada
| | - Mame-Awa Ndiaye
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada
| | - Ellen Gorus
- Department of Gerontology, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Belgium
| | - Maaike Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Belgium
| | - Anik Giguère
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada.,Faculty of Nursing Sciences, Université Laval, Québec, Canada
| | | | - Ronald Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Belgium
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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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20
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Luscombe N, Morgan-Trimmer S, Savage S, Allan L. Digital technologies to support people living with dementia in the care home setting to engage in meaningful occupations: protocol for a scoping review. Syst Rev 2021; 10:179. [PMID: 34148547 PMCID: PMC8214930 DOI: 10.1186/s13643-021-01715-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 05/19/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND People living with all stages of dementia should have the opportunity to participate in meaningful occupations. For those living in care homes, this may not always occur and residents may spend significant parts of the day unengaged, especially those living with more advanced dementia. Digital technologies are increasingly being used in health care and could provide opportunities for people living with dementia (PLWD) in care homes to engage in meaningful occupations and support care staff to provide these activities. With technology advancing at a rapid rate, the objective of this scoping review is to provide an up-to-date systematic map of the research on the diverse range of digital technologies that support engagement in meaningful occupations. In particular, focus will be given to barriers and facilitators to inform future intervention design and implementation strategies, which have not yet been clearly mapped across the full range of these digital technologies. METHOD A scoping review will be conducted to systematically search for published research using a comprehensive search strategy on thirteen databases. Published, peer-reviewed studies that focused on PLWD in the care home setting and assessed any form of digital technology that supported a meaningful occupation will be included. All methodologies which meet the criteria will be included. Data will be extracted and charted to report the range of digital technologies, underlying mechanisms of action, facilitators and barriers to implementation. DISCUSSION Mapping the range of technologies to support PLWD to engage in meaningful occupations will identify gaps in research. The systematic search will include a diverse range of technologies such as software to enhance care planning, tablets devices, smartphones, communication robots and social media platforms, rather than focussing on a specific design or interface. This will enable comparison between mechanisms of action, barriers and facilitators to implementation which will be useful for future research and intervention design. TRIAL REGISTRATION Open Science Framework https://doi.org/10.17605/OSF.IO/7UDM2.
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Affiliation(s)
- Nicholas Luscombe
- The Centre for Research in Ageing and Cognitive Health (REACH), University of Exeter Medical School, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
| | - Sarah Morgan-Trimmer
- Institute of Health Research, College House, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Sharon Savage
- School of Psychology, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Louise Allan
- The Centre for Research in Ageing and Cognitive Health (REACH), University of Exeter Medical School, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
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21
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Schultz T, Putze F, Steinert L, Mikut R, Depner A, Kruse A, Franz I, Gaerte P, Dimitrov T, Gehrig T, Lohse J, Simon C. I-CARE-An Interaction System for the Individual Activation of People with Dementia. Geriatrics (Basel) 2021; 6:geriatrics6020051. [PMID: 34068284 PMCID: PMC8162342 DOI: 10.3390/geriatrics6020051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 12/31/2022] Open
Abstract
I-CARE is a hand-held activation system that allows professional and informal caregivers to cognitively and socially activate people with dementia in joint activation sessions without special training or expertise. I-CARE consists of an easy-to-use tablet application that presents activation content and a server-based backend system that securely manages the contents and events of activation sessions. It tracks various sources of explicit and implicit feedback from user interactions and different sensors to estimate which content is successful in activating individual users. Over the course of use, I-CARE's recommendation system learns about the individual needs and resources of its users and automatically personalizes the activation content. In addition, information about past sessions can be retrieved such that activations seamlessly build on previous sessions while eligible stakeholders are informed about the current state of care and daily form of their protegees. In addition, caregivers can connect with supervisors and professionals through the I-CARE remote calling feature, to get activation sessions tracked in real time via audio and video support. In this way, I-CARE provides technical support for a decentralized and spontaneous formation of ad hoc activation groups and fosters tight engagement of the social network and caring community. By these means, I-CARE promotes new care infrastructures in the community and the neighborhood as well as relieves professional and informal caregivers.
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Affiliation(s)
- Tanja Schultz
- Cognitive Systems Lab, University of Bremen, 28215 Bremen, Germany;
- Correspondence: (T.S.); (F.P.)
| | - Felix Putze
- Cognitive Systems Lab, University of Bremen, 28215 Bremen, Germany;
- Correspondence: (T.S.); (F.P.)
| | - Lars Steinert
- Cognitive Systems Lab, University of Bremen, 28215 Bremen, Germany;
| | - Ralf Mikut
- Karlsruhe Institute of Technology, Institute for Automation and Applied Informatics, 76344 Eggenstein-Leopoldshafen, Germany;
| | - Anamaria Depner
- Institute of Gerontology, University of Heidelberg, 69115 Heidelberg, Germany; (A.D.); (A.K.)
| | - Andreas Kruse
- Institute of Gerontology, University of Heidelberg, 69115 Heidelberg, Germany; (A.D.); (A.K.)
| | - Ingo Franz
- Diakonische Hausgemeinschaften Heidelberg e.V., 69126 Heidelberg, Germany;
| | | | | | - Tobias Gehrig
- Videmo Intelligent Video Analysis GmbH & Co. KG, 76131 Karlsruhe, Germany;
| | - Jana Lohse
- AWO Karlsruhe Gemeinnützige GmbH, 76131 Karlsruhe, Germany; (J.L.); (C.S.)
| | - Clarissa Simon
- AWO Karlsruhe Gemeinnützige GmbH, 76131 Karlsruhe, Germany; (J.L.); (C.S.)
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22
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Neal D, van den Berg F, Planting C, Ettema T, Dijkstra K, Finnema E, Dröes RM. Can Use of Digital Technologies by People with Dementia Improve Self-Management and Social Participation? A Systematic Review of Effect Studies. J Clin Med 2021; 10:604. [PMID: 33562749 PMCID: PMC7915697 DOI: 10.3390/jcm10040604] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 12/22/2022] Open
Abstract
There is increasing interest in the use of technology to support social health in dementia. The primary objective of this systematic review was to synthesize evidence of effectiveness of digital technologies used by people with dementia to improve self-management and social participation. Records published from 1 January 2007 to 9 April 2020 were identified from Pubmed, PsycInfo, Web of Science, CINAHL, and the Cochrane Central Register of Controlled Trials. Controlled interventional studies evaluating interventions based on any digital technology were included if: primary users of the technology had dementia or mild cognitive impairment (MCI); and the study reported outcomes relevant to self-management or social participation. Studies were clustered by population, intervention, and outcomes, and narrative synthesis was undertaken. Of 1394 records identified, nine met the inclusion criteria: two were deemed to be of poor methodological quality, six of fair quality, and one of good quality. Three clusters of technologies were identified: virtual reality, wearables, and software applications. We identified weak evidence that digital technologies may provide less benefit to people with dementia than people with MCI. Future research should address the methodological limitations and narrow scope of existing work. In the absence of strong evidence, clinicians and caregivers must use their judgement to appraise available technologies on a case-by-case basis.
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Affiliation(s)
- David Neal
- Department of Psychiatry, Amsterdam University Medical Centre, Location VUMC, 1081 HJ Amsterdam, The Netherlands;
| | - Floor van den Berg
- Department of Linguistics and English as a Second Language, University of Groningen, 9712 EK Groningen, The Netherlands;
| | - Caroline Planting
- Department of Research and Innovation, GGZ inGeest, 1070 BB Amsterdam, The Netherlands;
| | - Teake Ettema
- Department of Psychiatry, Amsterdam University Medical Centre, Location VUMC, 1081 HJ Amsterdam, The Netherlands;
| | - Karin Dijkstra
- Research Group Nursing, Saxion University of Applied Sciences, 7417 DH Deventer, The Netherlands;
| | - Evelyn Finnema
- Health Sciences-Nursing Research, University Medical Centre Groningen, 9713 GZ Groningen, The Netherlands;
- Department of Healthcare, NHL Stenden University of Applied Sciences, 8917 DD Leeuwarden, The Netherlands
- School of Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Centre, Location VUMC, 1081 HJ Amsterdam, The Netherlands;
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23
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Fares N, Sherratt RS, Elhajj IH. Directing and Orienting ICT Healthcare Solutions to Address the Needs of the Aging Population. Healthcare (Basel) 2021; 9:147. [PMID: 33540510 PMCID: PMC7912863 DOI: 10.3390/healthcare9020147] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND With an aging population, it is essential to maintain good health and autonomy for as long as possible. Instead of hospitalisation or institutionalisation, older people with chronic conditions can be assisted in their own home with numerous "smart" devices that support them in their activities of daily living, manage their medical conditions, and prevent fall incidents. Information and Communication Technology (ICT) solutions facilitate the monitoring and management of older people's health to improve quality of life and physical activity with a decline in caregivers' burden. METHOD The aim of this paper was to conduct a systematic literature review to analyse the state of the art of ICT solutions for older people with chronic conditions, and the impact of these solutions on their quality of life from a biomedical perspective. RESULTS By analysing the literature on the available ICT proposals, it is shown that different approaches have been deployed by noticing that the more cross-interventions are merged then the better the results are, but there is still no evidence of the effects of ICT solutions on older people's health outcomes. Furthermore, there are still unresolved ethical and legal issues. CONCLUSION While there has been much research and development in healthcare ICT solutions for the aging population, ICT solutions still need significant development in order to be user-oriented, affordable, and to manage chronic conditions in the aging wider population.
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Affiliation(s)
- Nada Fares
- Department of Biomedical Engineering, School of Biological Sciences, University of Reading, Berkshire RG6 6AY, UK;
| | - R. Simon Sherratt
- Department of Biomedical Engineering, School of Biological Sciences, University of Reading, Berkshire RG6 6AY, UK;
| | - Imad H. Elhajj
- Department of Electrical and Computer Engineering, American University of Beirut, Beirut 1107 2020, Lebanon;
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24
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Prabhash K, Rao A, Gattani S, Castelino R, Kumar S, Dhekale R, Krishnamurthy J, Ramaswamy A, Noronha V, Gota V, Banavali S, Badwe R. Utilization of technology among older Indian patients with cancer: A cross-sectional study. CANCER RESEARCH, STATISTICS, AND TREATMENT 2021. [DOI: 10.4103/crst.crst_290_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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25
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Lazarou I, Stavropoulos TG, Meditskos G, Andreadis S, Kompatsiaris IY, Tsolaki M. Long-Term Impact of Intelligent Monitoring Technology on People with Cognitive Impairment: An Observational Study. J Alzheimers Dis 2020; 70:757-792. [PMID: 31256141 DOI: 10.3233/jad-190423] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Interactive smart home systems are particularly useful for people with cognitive impairment. OBJECTIVE To investigate the long-term effects of Assistive Technology (AT) combined with tailored non-pharmacological interventions for people with cognitive impairment. METHODS 18 participants (12 with mild cognitive impairment and 6 with Alzheimer's disease) took part in the study that we evenly allocated in one of three groups: 1) experimental group (EG), 2) control group 1 (CG1), and 3) control group 2 (CG2). EG received the system installed at home for 4 to 12 months, during which they received tailored non-pharmacological interventions according to system observations. CG1 received tailored interventions for the same period, but only according to state-of-the-art self-reporting methods. Finally, CG2 neither had a system installation nor received interventions. All groups underwent neuropsychological assessment before and after the observational period. RESULTS After several months of continuously monitoring at home and deployment of tailored interventions, the EG showed statistically significant improvement in cognitive function, compared to the CG1 and CG2. Moreover, EG participants, who received the sensor-based system, have shown improvement in domains such as sleep quality and daily activity, as measured by the multi-sensor system. In addition, the feedback collected from the participants concludes that the long-term use of the multi-sensor system by people with cognitive impairment can be both feasible and beneficial. CONCLUSION Deploying a sensor-based system at real home settings of people with cognitive limitations living alone and maintaining its use long-term is not only possible, but also beneficial for clinical decision making in order to tackle cognitive, functional, and behavioral related problems.
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Affiliation(s)
- Ioulietta Lazarou
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece.,1st Department of Neurology, U.H. "AHEPA", Medical School, Faculty of Healthy Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Macedonia, Greece
| | - Thanos G Stavropoulos
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Georgios Meditskos
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Stelios Andreadis
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Ioannis Yiannis Kompatsiaris
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Magda Tsolaki
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece.,1st Department of Neurology, U.H. "AHEPA", Medical School, Faculty of Healthy Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Macedonia, Greece.,Greek Association of Alzheimer's Disease and Related Disorders (GAADRD - Alzheimer Hellas), Thessaloniki, Macedonia, Greece
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26
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Vullings I, Labrie N, Wammes JD, de Bekker-Grob EW, MacNeil-Vroomen J. Important components for Dutch in-home care based on qualitative interviews with persons with dementia and informal caregivers. Health Expect 2020; 23:1412-1419. [PMID: 33026139 PMCID: PMC7752200 DOI: 10.1111/hex.13118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 06/08/2020] [Accepted: 07/21/2020] [Indexed: 11/30/2022] Open
Abstract
Background Dementia care in the Netherlands is increasingly dependent on informal care and has the aim to keep persons with dementia at home for as long as possible. However, little is known about the preferences and needs of people with dementia living at home. Including people with dementia and their informal caregivers in research and policy creation could help to identify necessary forms of support, and tailor care to their personal preferences and needs. Objective To identify important components of in‐home care for persons with dementia and their informal caregivers in the Netherlands. Design Semi‐structured interviews across the Netherlands, between March and June 2019 using thematic analysis. Setting and participants Persons with dementia (n = 5) and informal caregivers (n = 14) were primarily recruited through dementia care organizations. Additionally, a case manager was recruited to reflect upon the semi‐structured interviews findings. Results Five themes concerning important care components were identified including the need for: a social network, formal care, information, emotional support and easier access to care. The complexity of the dementia care system posed a common difficulty for persons with dementia and informal caregivers. Conclusion This study suggests that a dementia care package should be developed that includes both informal and formal care, the provision of information and emotional support, and help with access to care. The creation of this care package could help to tailor dementia care to the preferences and needs of the persons with dementia and their informal caregivers.
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Affiliation(s)
- Isabelle Vullings
- Section Geriatrics, Department of Internal Medicine, Location Academic Medical Center, Amsterdam University Medical Center, The Netherlands.,Faculty of Sciences, Athena Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Nanon Labrie
- Faculty of Sciences, Athena Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Joost D Wammes
- Section Geriatrics, Department of Internal Medicine, Location Academic Medical Center, Amsterdam University Medical Center, The Netherlands.,Faculty of Sciences, Athena Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Esther W de Bekker-Grob
- Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Janet MacNeil-Vroomen
- Section Geriatrics, Department of Internal Medicine, Location Academic Medical Center, Amsterdam University Medical Center, The Netherlands
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Feasibility-Usability Study of a Tablet App Adapted Specifically for Persons with Cognitive Impairment-SMART4MD (Support Monitoring and Reminder Technology for Mild Dementia). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186816. [PMID: 32961993 PMCID: PMC7557766 DOI: 10.3390/ijerph17186816] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/10/2020] [Accepted: 09/16/2020] [Indexed: 12/18/2022]
Abstract
Population ageing within Europe has major social and economic consequences. One of the most devastating conditions that predominantly affects older people is dementia. The SMART4MD (Support Monitoring and Reminder Technology for Mild Dementia) project aims to develop and test a health application specifically designed for people with mild dementia. The aim of this feasibility study was to evaluate the design of the SMART4MD protocol, including recruitment, screening, baseline examination and data management, and to test the SMART4MD application for functionality and usability before utilization in a full-scale study. The feasibility study tested the protocol and the app in Spain and Sweden. A total of nineteen persons with cognitive impairment, and their informal caregivers, individually performed a task-based usability test of the SMART4MD app model in a clinical environment, followed by four-week testing of the app in the home environment. By employing a user-centered design approach, the SMART4MD application proved to be an adequate and feasible interface for an eHealth intervention. In the final usability test, a score of 81% satisfied users was obtained. The possibility to test the application in all the procedures included in the study generated important information on how to present the technology to the users and how to improve these procedures.
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28
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Lauriks S, Meiland F, Osté JP, Hertogh C, Dröes RM. Effects of Assistive Home Technology on quality of life and falls of people with dementia and job satisfaction of caregivers: Results from a pilot randomized controlled trial. Assist Technol 2020; 32:243-250. [PMID: 30592439 DOI: 10.1080/10400435.2018.1531952] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Determine the effects of the implementation of Assistive Home Technology (AHT) in group homes on the quality of life (QoL) of people with dementia and on job satisfaction of caregivers. METHOD Pilot randomized controlled trial in nine in-patient care group homes (group homes with vs. without AHT). Participants were 54 people with dementia and 25 professionals. Outcome measurements were QoL, fall incidents, needs, use of restraints, job satisfaction, workload, and general health. RESULTS Living in a group home with AHT had a positive effect on four QoL domains: 'social isolation', 'having things to do', 'esthetics', and 'quality of life appreciation'. No effects were found on 12 other QoL domains. Fall incidents during bathroom visits were significantly reduced by the application of AHT. During this implementation phase, in the AHT group home, a moderate negative effect was found on caregiver's appreciation of work circumstances. No effects on other outcome measures were found. CONCLUSION Positive effects were found on aspects of QoL and fall incidents in the bathroom. The lower caregiver appreciation of work circumstances in the AHT group confirms the importance of intensive support and guidance of personnel during the implementation of AHT.
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Affiliation(s)
- Steve Lauriks
- Amsterdam Public Health Service (GGD Amsterdam), Department of Epidemiology, Health promotion and Care innovation, Amsterdam , The Netherlands
| | - Franka Meiland
- Amsterdam University Medical Centers, location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute , Amsterdam, The Netherlands
| | - Johan P Osté
- Amsterdam Public Health Service (GGD Amsterdam), Department of Epidemiology, Health promotion and Care innovation, Amsterdam , The Netherlands
| | - Cees Hertogh
- Amsterdam University Medical Centers, location VUmc, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute , Amsterdam, The Netherlands
| | - Rose-Marie Dröes
- Amsterdam University Medical Centers, location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute , Amsterdam, The Netherlands
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29
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Grossi G, Lanzarotti R, Napoletano P, Noceti N, Odone F. Positive technology for elderly well-being: A review. Pattern Recognit Lett 2020. [DOI: 10.1016/j.patrec.2019.03.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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30
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Designing ICTs for Users with Mild Cognitive Impairment: A Usability Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145153. [PMID: 32708861 PMCID: PMC7399939 DOI: 10.3390/ijerph17145153] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 01/08/2023]
Abstract
Background: Research has supported the cost-effectiveness of cognitive training tools enhanced by information and communication technologies (ICT) in several populations, including individuals with mild cognitive impairment (MCI) and age-related cognitive decline. The implementation of ICTs in this population, however, is sometimes challenging to their cognitive and age characteristics. Ultimately, this might compromise the effectiveness of ICT-enhanced therapies in this population. The aim of this study is to test the usability and acceptability of a European project prototype for elderly care, in an attempt to explore the ICT design needs of users with MCI. Methods: Participants were 28 individuals aged 58–95 years and with a diagnosis of MCI. Results: The results showed a low perception of peripheral elements and the need to place main interaction elements in the centre of the screen. The correlation between the general level of autonomy (daily life activities) and the ICT autonomy level was significant and positive. The speed of audio help had a significant impact on performance. Conclusion: The present work contributes to the literature on ICT usability needs of users with MCI. Some usability recommendations for designing interfaces for this type of user are provided in the text.
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Schüssler S, Zuschnegg J, Paletta L, Fellner M, Lodron G, Steiner J, Pansy-Resch S, Lammer L, Prodromou D, Brunsch S, Holter M, Carnevale L, Russegger S. Effects of a Humanoid Socially Assistive Robot Versus Tablet Training on Psychosocial and Physical Outcomes of Persons With Dementia: Protocol for a Mixed Methods Study. JMIR Res Protoc 2020; 9:e14927. [PMID: 32022697 PMCID: PMC7055795 DOI: 10.2196/14927] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/12/2019] [Accepted: 09/29/2019] [Indexed: 12/12/2022] Open
Abstract
Background New technologies, like socially assistive robots (SARs), may have the potential to support caregivers at home. Still, the evidence for people with dementia in home care is unclear because a lot of studies are performed in a laboratory or institutional setting, and mainly use robots in prototype stages. Objective This study aims to explore the effects of the refined, commercially-available, humanoid SAR Pepper combined with a tablet PC–based dementia training program (Coach Pepper) versus an exclusively tablet PC–based dementia training program on psychosocial and physical outcomes of people with dementia living at home, including caregivers and dementia trainers. We hypothesize that Coach Pepper has a more positive effect on the primary outcome motivation (stable or decreased apathy) of people with dementia. Methods A mixed methods study will be performed, including a randomized controlled, parallel, 2-arm study with a complementary qualitative part. This sample includes 40 PWD living at home and 40 relatives, each complemented with five professional caregivers and dementia trainers. The intervention group will receive Coach Pepper (a SAR connected with a tablet PC–based dementia training program), and the control group will receive exclusively tablet PC–based training without the SAR. The duration of the intervention will be three weeks per household. Data will be collected at baseline and during and after the intervention by standardized questionnaires, sensor data of the robot, and tablet PC, as well as semistructured interviews, focus groups, and observation. Results To date, no results are available for this study protocol. The study intervention started in May 2019 and will end in Spring 2020. Conclusions The intervention of this study can be seen as a nonpharmacological intervention, including cognitive and physical training by a robot. This study will help to further refine SAR for the specific needs of people with dementia living at home. International Registered Report Identifier (IRRID) DERR1-10.2196/14927
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Affiliation(s)
- Sandra Schüssler
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Julia Zuschnegg
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Lucas Paletta
- Institut Digital, Joanneum Research Forschungsgesellschaft mbH, Graz, Austria
| | - Maria Fellner
- Institut Digital, Joanneum Research Forschungsgesellschaft mbH, Graz, Austria
| | - Gerald Lodron
- Institut Digital, Joanneum Research Forschungsgesellschaft mbH, Graz, Austria
| | - Josef Steiner
- Sozialverein Deutschlandsberg, Deutschlandsberg, Austria
| | | | - Lara Lammer
- Humanizing Technologies GmbH, Vienna, Austria
| | | | | | - Magdalena Holter
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | | | - Silvia Russegger
- Institut Digital, Joanneum Research Forschungsgesellschaft mbH, Graz, Austria
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Costanzo MC, Arcidiacono C, Rodolico A, Panebianco M, Aguglia E, Signorelli MS. Diagnostic and interventional implications of telemedicine in Alzheimer's disease and mild cognitive impairment: A literature review. Int J Geriatr Psychiatry 2020; 35:12-28. [PMID: 31617247 DOI: 10.1002/gps.5219] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 09/15/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Worldwide, life expectancy, and aging-related disorders as mild cognitive impairment (MCI) and Alzheimer disease (AD) are increasing, having a rising impact on patients' quality of life and caregivers' distress. Telemedicine offers many possibilities, such as remote diagnosing and monitoring of patients. OBJECTIVE The purpose of this study is to provide a narrative synthesis of the literature about the implementation of telemedicine for diagnosis, treatment, and follow-up of patients with AD and MCI and their caregivers. METHODS A systematic literature review was conducted on MEDLINE, EMBASE, and the Cochrane Library databases up to September 2018. MCI or AD diagnoses were the conditions of interest. We excluded other dementias. RESULTS Fifty-six articles met inclusion criteria. We identified two main categories: diagnosis group (DG) and follow-up/interventional group (FIG). Fifteen articles suggested how to make a remote or earlier diagnosis: four were case-control accuracy studies, nine were paired comparative accuracy studies, and two were prospective single-arm accuracy studies. Among these, four focused on MCI, six on AD, and five on both. Forty one focused on supporting patients during the stages of the disease (28 articles), patient's caregivers (nine articles), or both (four articles). CONCLUSIONS The rising use of telemedicine could actively improve AD and MCI patients' lives, reduce caregivers' burden, and facilitate an early diagnosis if patients live in remote places. However, as some studies report, it is relevant to take into account the emotional impact of telemedicine on patients and not only on the effectiveness.
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Affiliation(s)
- Maria Cristina Costanzo
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Chiara Arcidiacono
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Alessandro Rodolico
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Mariangela Panebianco
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
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Vermeer Y, Higgs P, Charlesworth G. What do we require from surveillance technology? A review of the needs of people with dementia and informal caregivers. J Rehabil Assist Technol Eng 2019; 6:2055668319869517. [PMID: 31832230 PMCID: PMC6891003 DOI: 10.1177/2055668319869517] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 07/22/2019] [Indexed: 11/16/2022] Open
Abstract
Introduction Dementia has become a major global concern and surveillance technology might
provide support for informal caregivers and people with dementia. However,
the needs of caregivers and people with dementia for surveillance technology
have not been reviewed. Method A scoping literature review was used to identify the needs of caregivers
and/or people with dementia towards surveillance technology. Electronic
database searching was undertaken on LexisNexis, PubMed, Scopus, EMBASE,
MEDLINE, Cumulative Index to Nursing, Allied Health Literature, PsycINFO,
Web of Science, Assistive Technology database, and Google Scholar. Eligible
studies were synthesized by theme. Results Twenty-eight eligible studies were identified, with the majority reporting
the needs of caregivers rather than people with dementia. The predominant
themes for caregivers were location accuracy, and increasing the safety of
the person with dementia. People with dementia wanted simple useful
technology that fits within their capacity and existing routines. Conclusions The needs of people with dementia must be considered when designing
surveillance products. Studies have mostly focused on caregivers and
discount ST product requirements. Further work is required to establish
effective use of surveillance technology in dementia care. Therefore,
further research should cross analyze these results by examining both the
needs of caregivers, and people with dementia.
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Affiliation(s)
- Yvette Vermeer
- Division of Psychiatry, University College London, London, UK
| | - Paul Higgs
- Division of Psychiatry, University College London, London, UK
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Benedetto S, Caldato C, Greenwood DC, Bartoli N, Pensabene V, Actis P. Remote heart rate monitoring - Assessment of the Facereader rPPg by Noldus. PLoS One 2019; 14:e0225592. [PMID: 31756239 PMCID: PMC6874325 DOI: 10.1371/journal.pone.0225592] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/23/2019] [Indexed: 11/18/2022] Open
Abstract
Remote photoplethysmography (rPPG) allows contactless monitoring of human cardiac activity through a video camera. In this study, we assessed the accuracy and precision for heart rate measurements of the only consumer product available on the market, namely the FacereaderTM rPPG by Noldus, with respect to a gold standard electrocardiograph. Twenty-four healthy participants were asked to sit in front of a computer screen and alternate two periods of rest with two stress tests (i.e. Go/No-Go task), while their heart rate was simultaneously acquired for 20 minutes using the ECG criterion measure and the FacereaderTM rPPG. Results show that the FacereaderTM rPPG tends to overestimate lower heart rates and underestimate higher heart rates compared to the ECG. The Facereader™ rPPG revealed a mean bias of 9.8 bpm, the 95% limits of agreement (LoA) ranged from almost -30 up to +50 bpm. These results suggest that whilst the rPPG FacereaderTM technology has potential for contactless heart rate monitoring, its predictions are inaccurate for higher heart rates, with unacceptable precision across the entire range, rendering its estimates unreliable for monitoring individuals.
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Affiliation(s)
| | | | - Darren C. Greenwood
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
- Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
| | | | - Virginia Pensabene
- School of Electronic and Electrical Engineering, University of Leeds, Leeds, West Yorkshire, United Kingdom
- School of Medicine, Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, West Yorkshire, United Kingdom
| | - Paolo Actis
- School of Electronic and Electrical Engineering, University of Leeds, Leeds, West Yorkshire, United Kingdom
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Koo BM, Vizer LM. Examining Mobile Technologies to Support Older Adults With Dementia Through the Lens of Personhood and Human Needs: Scoping Review. JMIR Mhealth Uhealth 2019; 7:e15122. [PMID: 31710305 PMCID: PMC6878101 DOI: 10.2196/15122] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/25/2019] [Accepted: 09/24/2019] [Indexed: 01/30/2023] Open
Abstract
Background With the world’s rapidly growing older adult population, there is an increase in the number of people living with dementia. This growth leads to a strain on their caregivers and our health care system and to an increased attention on mitigating strain by using mobile technology to sustain the independence of people with dementia. However, less attention is given to whether these technologies meet the stated and unstated needs of people with dementia. Objective The aim of this study was to provide an overview of the current research on mobile technologies for people with dementia, considering the current research through the lens of personhood and human needs, and to identify any gaps that represent research opportunities. Methods We performed a systematic search in Medical Literature Analysis and Retrieval System Online (MEDLINE), Web of Science, PsycINFO, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Excerpta Medica dataBASE (EMBASE), and the Cochrane Central Register of Controlled Trials (CENTRAL) in October 2018. We screened 5560 articles and identified 24 that met our inclusion and exclusion criteria. We then performed thematic analysis to organize the articles by the types of support mobile technologies provide and mapped those types of support to human needs to identify the gaps in support. Results Articles described research on mobile technologies that support people with dementia to (1) perform daily activities, (2) maintain social interaction, (3) aid memory, (4) engage in leisure activities, (5) track location, and (6) monitor health. At least one type of support mapped to each human need, with most supporting lower-level needs such as physiological and safety needs. Little attention seems to be paid to personhood. Conclusions Mobile technologies that support daily activities, relationships, memory, leisure activities, health, and safety can partially compensate for decreased function owing to dementia, but the human needs of people with dementia are often not adequately considered. Most technologies support basic physiological and safety needs, whereas many pay little attention to higher-level needs such as self-esteem and agency. Important research opportunities include using person-centered methods to develop technology to meet higher-level needs and to preserve personhood by incorporating human and psychological needs of people with dementia along with ethical considerations.
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Affiliation(s)
- Bon Mi Koo
- SSK Research Center for Mental Health and Communal Society, Kwangwoon University, Seoul, Republic of Korea
| | - Lisa M Vizer
- Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Howe D, Thorpe J, Dunn R, White C, Cunnah K, Platt R, Paulson K, Wolverson E. The CAREGIVERSPRO-MMD Platform as an Online Informational and Social Support Tool for People Living With Memory Problems and Their Carers: An Evaluation of User Engagement, Usability and Usefulness. J Appl Gerontol 2019; 39:1303-1312. [DOI: 10.1177/0733464819885326] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
People living with dementia or cognitive impairment (PwD) and their carers often have unmet needs for informational and social support postdiagnosis. Web-based platforms have the potential to address these needs, although few have been developed for use by both PwD and carers. The CAREGIVERSPRO-MMD platform was developed to provide both user groups with informational and peer-to-peer social support. Platform logging data were analyzed to assess the extent to which PwD ( n = 37) and carers ( n = 37) engaged with the platform and its social/informational features in their daily lives. Participants also provided feedback on the usefulness and usability of the platform. The majority of PwD and carers found the platform and its social/informational features useful and usable, and significant subsets of both groups utilized the platform regularly. However, carers engaged with the informational and social features to a greater extent than PwD, and users highlighted that PwD typically required regular support to use the platform.
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Characterizing the symptom of misplacing objects in people with dementia: findings from an online tracking tool. Int Psychogeriatr 2019; 31:1635-1641. [PMID: 30698122 DOI: 10.1017/s104161021800220x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Misplacing objects is often reported as a clinically important symptom in dementia. Here we explored misplacing objects in relation to dementia type and stage in an online sample of individuals with dementia and their caregivers. METHODS Participants were recruited from www.dementiaguide.com, a web-based tracker for common dementia symptoms. Users provided information about symptoms that they selected as important for monitoring. We analysed cross-sectional data from respondents who tracked at least three symptoms, which allowed for staging dementia severity. RESULTS Of 2,775 users with three-plus symptoms, 787 (28%) identified misplacing objects for symptom tracking. Misplacing objects was monitored by users across all stages of dementia, but was more prevalent in mild and severe dementia. Three common clinical subtypes of misplacing were investigated: lost & found (forgetting the location of items), hidden away (hiding items so others would not find them), and odd places (putting items in usual spots). Of the 787, 96% targeted lost & found, the most frequent type. Odd places (targeted in 56%) significantly increased with dementia severity (p < 0.001). Misplacing objects was most strongly associated with the symptoms of interaction with strangers (OR 4.60, 95% CI: 3.20-6.62), reading (3.68: 2.86-4.73), shopping (3.55: 2.73-4.61) and travel/vacationing (3.31: 2.54-4.31). CONCLUSIONS Misplacing objects was most often selected for tracking in mild and severe stages of dementia. As disease advances, misplacing more often reflects odd placement of objects rather than their simple loss. Misplacing objects may be a clinically important therapeutic target for improving patients' quality of life and lessening caregiver burden.
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Thorpe J, Forchhammer BH, Maier AM. Adapting Mobile and Wearable Technology to Provide Support and Monitoring in Rehabilitation for Dementia: Feasibility Case Series. JMIR Form Res 2019; 3:e12346. [PMID: 31625951 PMCID: PMC6913510 DOI: 10.2196/12346] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 06/07/2019] [Accepted: 07/21/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Mobile and wearable devices are increasingly being used to support our everyday lives and track our behavior. Since daily support and behavior tracking are two core components of cognitive rehabilitation, such personal devices could be employed in rehabilitation approaches aimed at improving independence and engagement among people with dementia. OBJECTIVE The aim of this work was to investigate the feasibility of using smartphones and smartwatches to augment rehabilitation by providing adaptable, personalized support and objective, continuous measures of mobility and activity behavior. METHODS A feasibility study comprising 6 in-depth case studies was carried out among people with early-stage dementia and their caregivers. Participants used a smartphone and smartwatch for 8 weeks for personalized support and followed goals for quality of life. Data were collected from device sensors and logs, mobile self-reports, assessments, weekly phone calls, and interviews. This data were analyzed to evaluate the utility of sensor data generated by devices used by people with dementia in an everyday life context; this was done to compare objective measures with subjective reports of mobility and activity and to examine technology acceptance focusing on usefulness and health efficacy. RESULTS Adequate sensor data was generated to reveal behavioral patterns, even for minimal device use. Objective mobility and activity measures reflecting fluctuations in participants' self-reported behavior, especially when combined, may be advantageous in revealing gradual trends and could provide detailed insights regarding goal attainment ratings. Personalized support benefited all participants to varying degrees by addressing functional, memory, safety, and psychosocial needs. A total of 4 of 6 (67%) participants felt motivated to be active by tracking their step count. One participant described a highly positive impact on mobility, anxiety, mood, and caregiver burden, mainly as a result of navigation support and location-tracking tools. CONCLUSIONS Smartphones and wearables could provide beneficial and pervasive support and monitoring for rehabilitation among people with dementia. These results substantiate the need for further investigation on a larger scale, especially considering the inevitable presence of mobile and wearable technology in our everyday lives for years to come.
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Affiliation(s)
- Julia Thorpe
- Engineering Systems Design, DTU Management, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | - Anja M Maier
- Engineering Systems Design, DTU Management, Technical University of Denmark, Kongens Lyngby, Denmark
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Physical Strength Perception of Older Caregivers in Rural Areas. ACTA ACUST UNITED AC 2019; 55:medicina55100692. [PMID: 31623256 PMCID: PMC6843900 DOI: 10.3390/medicina55100692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 10/02/2019] [Accepted: 10/14/2019] [Indexed: 01/19/2023]
Abstract
Background and objective: In an aging population, it is increasingly common for older adults to take care of other older adults. Caregiving tasks may be conditioned by the aging process. This study aims to analyze the perceived physical strength of older caregivers and its impact on the functional capacity to engage in caregiving activities. Methods: A discretionary sampling of caregivers (N = 107), ≥65 years old, in the rural health area of Badajoz (Spain) participated in this cross-sectional study. Measurements included questions about the caregiver’s role (experience, years, hours, difficulties, demands) and their perceived physical strength, ability to perform activities of daily living (ADL), need for help or difficulty for caring. Results: Older caregivers from rural areas perceived a lack of physical strength (71%). These caregivers need more help, have more difficulties, and show less ability to perform ADL. Furthermore, around 80% of the people who had a lack of strength were caring for people with severe or total dependence. There is a direct correlation between the perceived lack of physical strength and the ability to perform basic (r = 0.382, p < 0.01) and instrumental (r = 0.370, p < 0.01) activities. Conclusions: Therefore, the perception of strength and the characteristics of the cared for person may be crucial variables to successfully conduct caregiving tasks.
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Linking DemenTalent to Meeting Centers for people with dementia and their caregivers: a process analysis into facilitators and barriers in 12 Dutch Meeting Centers. Int Psychogeriatr 2019; 31:1433-1445. [PMID: 31455455 DOI: 10.1017/s1041610219001108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES There have been relatively few interventions on an individual level to support community-dwelling people with dementia to continue to fulfill their potential in society. This study investigated the implementation of DemenTalent, an intervention in which people with dementia become active as volunteers in society based on their talents. The intervention was linked to existing Meeting Centers for people with dementia and their informal caregivers. METHOD We conducted a qualitative multiple case study. Semi-structured interviews regarding experienced facilitators and barriers were conducted with 22 key figures/stakeholders in 12 Meeting Centers during the preparation, starting and continuation phases of the implementation of DemenTalent. RESULTS Several influencing factors were found on a micro level (e.g. Public Relations, training, management involvement), meso level (e.g. finances, collaborating with others) and macro level (e.g. laws and regulations, national and regional policy) during the different phases of the implementation process. Factors mentioned by most stakeholders were human and financial resources. Another important factor appeared to be the culture of the region. CONCLUSION The insight into facilitating and impeding factors in the implementation of DemenTalent provided by this study will inform and enable other Meeting Centers to adopt a fitting strategy to implement DemenTalent in their own center. This is expected to help disseminate the intervention further, giving more people with dementia the chance to fulfill their potential, find a meaningful and pleasant way of spending their time, and actively participate in society. This will contribute to a more inclusive society and less stigmatization of people with dementia.
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van Boekel LC, Wouters EJM, Grimberg BM, van der Meer NJM, Luijkx KG. Perspectives of Stakeholders on Technology Use in the Care of Community-Living Older Adults with Dementia: A Systematic Literature Review. Healthcare (Basel) 2019; 7:healthcare7020073. [PMID: 31141999 PMCID: PMC6628181 DOI: 10.3390/healthcare7020073] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 05/24/2019] [Accepted: 05/26/2019] [Indexed: 11/16/2022] Open
Abstract
Although technology has the potential to promote aging in place, the use of technology remains scarce among community-living older adults with dementia. A reason might be that many stakeholders are involved who all have a different perspective on technology use (i.e., needs, wishes, attitudes, possibilities, and difficulties). We systematically searched the literature in order to provide an overview of perspectives of different stakeholders on technology use among community-living older adults with dementia. After selection, 46 studies were included. We mainly found perspectives of informal caregivers and, to a lesser extent, of persons with dementia and formal caregivers. Perspectives of suppliers of technology were not present. Shared perspectives among persons with dementia and informal and formal caregivers were, among other things, ease of use, stability and flexibility of technology, importance of privacy, and confidentiality. We also found that among older persons, fun and pleasure, in addition to enhancing freedom and independence, facilitates technology use. Informal caregivers' peace of mind and relief of burden also appeared to be important in using technologies. Formal caregivers value the potential of technologies to improve monitoring and communication. Insight in shared, and conflicting perspectives of stakeholders are essential to enhance the use of technology.
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Affiliation(s)
- Leonieke C van Boekel
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands.
| | - Eveline J M Wouters
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands.
- Health Innovations and Technology, Fontys University of Applied Sciences School of Allied Health Professions, 5631 BN Eindhoven, The Netherlands.
| | - Bea M Grimberg
- Healthcare organization Azora,7061 AP Ter Borg, The Netherlands.
| | - Nardo J M van der Meer
- Department of Anesthesiology, Amphia Hospital 4818 CK Breda, The Netherlands.
- TIAS School for Business and Society, Tilburg University, 5037 AB Tilburg, The Netherlands.
| | - Katrien G Luijkx
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands.
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Kernebeck S, Holle D, Pogscheba P, Jordan F, Mertl F, Huldtgren A, Bader S, Kirste T, Teipel S, Holle B, Halek M. A Tablet App- and Sensor-Based Assistive Technology Intervention for Informal Caregivers to Manage the Challenging Behavior of People With Dementia (the insideDEM Study): Protocol for a Feasibility Study. JMIR Res Protoc 2019; 8:e11630. [PMID: 30806626 PMCID: PMC6412157 DOI: 10.2196/11630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/24/2018] [Accepted: 11/10/2018] [Indexed: 11/24/2022] Open
Abstract
Background Despite the enormous number of assistive technologies (ATs) in dementia care, the management of challenging behavior (CB) of persons with dementia (PwD) by informal caregivers in home care is widely disregarded. The first-line strategy to manage CB is to support the understanding of the underlying causes of CB to formulate individualized nonpharmacological interventions. App- and sensor-based approaches combining multimodal sensors (actimetry and other modalities) and caregiver information are innovative ways to support the understanding of CB for family caregivers. Objective The main aim of this study is to describe the design of a feasibility study consisting of an outcome and a process evaluation of a newly developed app- and sensor-based intervention to manage CB of PwD for family caregivers at home. Methods In this feasibility study, we perform an outcome and a process evaluation with a pre-post descriptive design over an 8-week intervention period. The Medical Research Council framework guides the design of this feasibility study. The data on 20 dyads (primary caregiver and PwD) are gathered through standardized questionnaires, protocols, and log files as well as semistructured qualitative interviews. The outcome measures (neuropsychiatric inventory and Cohen-Mansfield agitation inventory) are analyzed by using descriptive statistics and statistical tests relevant to the individual assessments (eg, chi-square test and Wilcoxon signed-rank test). For the analysis of the process data, the Unified Theory of Acceptance and Use of Technology is used. Log files are analyzed by using descriptive statistics, protocols are analyzed by using documentary analysis, and semistructured interviews are analyzed deductively using content analysis. Results The newly developed app- and sensor-based AT has been developed and was evaluated until July in 2018. The recruitment of dyads started in September 2017 and was concluded in March 2018. The data collection was completed at the end of July 2018. Conclusions This study presents the protocol of the first feasibility study to encompass an outcome and process evaluation to assess a complex app- and sensor-based AT combining multimodal actimetry sensors for informal caregivers to manage CB. The feasibility study will provide in-depth information about the study procedure and on how to optimize the design of the intervention and its delivery. International Registered Report Identifier (IRRID) DERR1-10.2196/11630
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Affiliation(s)
- Sven Kernebeck
- German Center for Neurodegenerative Diseases, Witten, Germany.,Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Daniela Holle
- German Center for Neurodegenerative Diseases, Witten, Germany.,Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Patrick Pogscheba
- Faculty of Media, Hochschule Düsseldorf, University of Applied Sciences, Düsseldorf, Germany
| | - Felix Jordan
- Faculty of Media, Hochschule Düsseldorf, University of Applied Sciences, Düsseldorf, Germany
| | - Fabian Mertl
- Faculty of Media, Hochschule Düsseldorf, University of Applied Sciences, Düsseldorf, Germany
| | - Alina Huldtgren
- Faculty of Media, Hochschule Düsseldorf, University of Applied Sciences, Düsseldorf, Germany
| | - Sebastian Bader
- Institute of Computer Science, University of Rostock, Rostock, Germany
| | - Thomas Kirste
- Institute of Computer Science, University of Rostock, Rostock, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases, Rostock/Greifswald, Germany
| | - Bernhard Holle
- German Center for Neurodegenerative Diseases, Witten, Germany.,Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Margareta Halek
- German Center for Neurodegenerative Diseases, Witten, Germany.,Faculty of Health, University of Witten/Herdecke, Witten, Germany
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Zucchella C, Sinforiani E, Tamburin S, Federico A, Mantovani E, Bernini S, Casale R, Bartolo M. The Multidisciplinary Approach to Alzheimer's Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment. Front Neurol 2018; 9:1058. [PMID: 30619031 PMCID: PMC6300511 DOI: 10.3389/fneur.2018.01058] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/21/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Alzheimer's disease (AD) and dementia are chronic diseases with progressive deterioration of cognition, function, and behavior leading to severe disability and death. The prevalence of AD and dementia is constantly increasing because of the progressive aging of the population. These conditions represent a considerable challenge to patients, their family and caregivers, and the health system, because of the considerable need for resources allocation. There is no disease modifying intervention for AD and dementia, and the symptomatic pharmacological treatments has limited efficacy and considerable side effects. Non-pharmacological treatment (NPT), which includes a wide range of approaches and techniques, may play a role in the treatment of AD and dementia. Aim: To review, with a narrative approach, current evidence on main NPTs for AD and dementia. Methods: PubMed and the Cochrane database of systematic reviews were searched for studies written in English and published from 2000 to 2018. The bibliography of the main articles was checked to detect other relevant papers. Results: The role of NPT has been largely explored in AD and dementia. The main NPT types, which were reviewed here, include exercise and motor rehabilitation, cognitive rehabilitation, NPT for behavioral and psychological symptoms of dementia, occupational therapy, psychological therapy, complementary and alternative medicine, and new technologies, including information and communication technologies, assistive technology and domotics, virtual reality, gaming, and telemedicine. We also summarized the role of NPT to address caregivers' burden. Conclusions: Although NPT is often applied in the multidisciplinary approach to AD and dementia, supporting evidence for their use is still preliminary. Some studies showed statistically significant effect of NPT on some outcomes, but their clinical significance is uncertain. Well-designed randomized controlled trials with innovative designs are needed to explore the efficacy of NPT in AD and dementia. Further studies are required to offer robust neurobiological grounds for the effect of NPT, and to examine its cost-efficacy profile in patients with dementia.
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Affiliation(s)
| | - Elena Sinforiani
- Alzheimer's Disease Assessment Unit, Laboratory of Neuropsychology, IRCCS Mondino Foundation, Pavia, Italy
| | - Stefano Tamburin
- Neurology Unit, University Hospital of Verona, Verona, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Angela Federico
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sara Bernini
- Alzheimer's Disease Assessment Unit, Laboratory of Neuropsychology, IRCCS Mondino Foundation, Pavia, Italy
| | - Roberto Casale
- Neurorehabilitation Unit, Department of Rehabilitation, HABILITA, Bergamo, Italy
| | - Michelangelo Bartolo
- Neurorehabilitation Unit, Department of Rehabilitation, HABILITA, Bergamo, Italy
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Chester H, Clarkson P, Davies L, Hughes J, Islam MS, Kapur N, Orrell M, Peconi J, Pitts R, Poland F, Russell I, Challis D. Cognitive aids for people with early stage dementia versus treatment as usual (Dementia Early Stage Cognitive Aids New Trial (DESCANT)): study protocol for a randomised controlled trial. Trials 2018; 19:546. [PMID: 30305153 PMCID: PMC6180589 DOI: 10.1186/s13063-018-2933-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 09/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a growing need for an evidence-based approach to home support for people with dementia and their carers following diagnosis but research on the effectiveness and cost-effectiveness of different approaches is sparse. The Dementia Early Stage Cognitive Aids New Trial (DESCANT) will evaluate the clinical and cost-effectiveness of a range of memory aids, training and support to people with mild to moderate dementia and their carers at home and compares that intervention with treatment as usual. METHODS/DESIGN This is a multi-site, pragmatic randomised trial preceded by a feasibility study and internal pilot. We aim to allocate at random 360 pairs comprising a person with mild to moderate dementia and an identified carer between the DESCANT intervention and treatment as usual. We assess participants at baseline, 13 and 26 weeks. The primary outcome measure is the Bristol Activities of Daily Living Scale; other participant outcomes include cognition, quality of life, activities of daily living and social networking; carer outcomes include quality of life, sense of competence and mental health. To enhance this quantitative evaluation we are conducting a qualitative component and a process evaluation to assess the implementation process and identify contextual factors associated with variation. DISCUSSION The DESCANT intervention reflects current policy to enhance the capabilities of people with dementia after diagnosis and their carers. If it is clinically and cost-effective, its modest nature and cost will enhance the likelihood of it being incorporated into mainstream practice. TRIAL REGISTRATION Current Controlled Trials, ISRCTN12591717 . Registered on 29 July 2016. Protocol number: 31288: North West - Haydock Research Ethics Committee, 20/06/2016, ref.: 16/NW/0389.
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Affiliation(s)
- Helen Chester
- Personal Social Services Research Unit, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
| | - Paul Clarkson
- Personal Social Services Research Unit, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Linda Davies
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Jane Hughes
- Personal Social Services Research Unit, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Muhammad Saiful Islam
- Swansea Trials Unit, Institute of Life Science 2, Medical School, Swansea University, Swansea, UK
| | - Narinder Kapur
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Martin Orrell
- Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Julie Peconi
- Swansea Trials Unit, Institute of Life Science 2, Medical School, Swansea University, Swansea, UK
| | - Rosa Pitts
- Personal Social Services Research Unit, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Fiona Poland
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Ian Russell
- Swansea Trials Unit, Institute of Life Science 2, Medical School, Swansea University, Swansea, UK
| | - David Challis
- Personal Social Services Research Unit, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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León-Campos MO, Slachevsky Chonchol A, Miranda-Castillo C. Afrontamiento, apoyo social y depresión en cuidadores informales y su relación con necesidades no cubiertas de personas con demencia. ANSIEDAD Y ESTRES-ANXIETY AND STRESS 2018. [DOI: 10.1016/j.anyes.2018.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Carotenuto A, Rea R, Traini E, Ricci G, Fasanaro AM, Amenta F. Cognitive Assessment of Patients With Alzheimer's Disease by Telemedicine: Pilot Study. JMIR Ment Health 2018; 5:e31. [PMID: 29752254 PMCID: PMC5970283 DOI: 10.2196/mental.8097] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/29/2017] [Accepted: 02/26/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Approximately 46.8 million people are living with dementia worldwide and their number will grow in the next years. Any potential treatment should be administered as early as possible because it is important to provide an early cognitive assessment and to regularly monitor the mental function of patients. Information and communication technologies can be helpful to reach and follow patients without displacing them, but there may be doubts about the reliability of cognitive tests performed by telemedicine. OBJECTIVE The purpose of this study was to evaluate the reliability of the Mini Mental State Examination (MMSE) and the Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-cog) tests administered in hospital by videoconference to patients with mild to moderate Alzheimer's disease. METHODS The tests were administered to 28 Alzheimer's disease outpatients (8 male, mean age 73.88, SD 7.45 years; 20 female mean age 76.00, SD 5.40 years) recruited and followed in the Alzheimer's Unit of the A Cardarelli National Hospital (Naples, Italy) at baseline and after 6, 12, 18, and 24 months of observation. Patients were evaluated first face-to-face by a psychologist and then, after 2 weeks, by another psychologist via videoconference in hospital. RESULTS This study showed no differences in the MMSE and ADAS-cog scores when the tests were administered face-to-face or by videoconference, except in patients with more pronounced cognitive deficits (MMSE<17), in which the assessment via videoconference overestimated the cognitive impairment (face to face, MMSE mean 13.9, SD 4.9 and ADAS-cog mean 9.0, SD 3.8; videoconference, MMSE mean 42.8, SD 12.5 and ADAS-cog mean 56.9, SD 5.5). CONCLUSIONS We found that videoconferencing is a reliable approach to document cognitive stability or decline, and to measure treatment effects in patients with mild to moderate dementia. A more extended study is needed to confirm these results.
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Affiliation(s)
- Anna Carotenuto
- Clinical Research, Telemedicine and Telepharmacy Centre, School of Pharmacy, University of Camerino, Camerino, Italy
| | - Raffaele Rea
- Clinical Research, Telemedicine and Telepharmacy Centre, School of Pharmacy, University of Camerino, Camerino, Italy
| | - Enea Traini
- Clinical Research, Telemedicine and Telepharmacy Centre, School of Pharmacy, University of Camerino, Camerino, Italy
| | - Giovanna Ricci
- Bioethics and Legal Medicine Centre, School of Law, University of Camerino, Camerino, Italy
| | | | - Francesco Amenta
- Clinical Research, Telemedicine and Telepharmacy Centre, School of Pharmacy, University of Camerino, Camerino, Italy
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Lazarou I, Karakostas A, Stavropoulos TG, Tsompanidis T, Meditskos G, Kompatsiaris I, Tsolaki M. A Novel and Intelligent Home Monitoring System for Care Support of Elders with Cognitive Impairment. J Alzheimers Dis 2018; 54:1561-1591. [PMID: 27636843 DOI: 10.3233/jad-160348] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Assistive technology, in the form of a smart home environment, is employed to support people with dementia. OBJECTIVES To propose a system for continuous and objective remote monitoring of problematic daily living activity areas and design personalized interventions based on system feedback and clinical observations for improving cognitive function and health-related quality of life. METHODS The assistive technology of the proposed system, including wearable, sleep, object motion, presence, and utility usage sensors, was methodically deployed at four different home installations of people with cognitive impairment. Detection of sleep patterns, physical activity, and activities of daily living, based on the collected sensor data and analytics, was available at all times through comprehensive data visualization solutions. Combined with clinical observation, targeted psychosocial interventions were introduced to enhance the participants' quality of life and improve their cognitive functions and daily functionality. Meanwhile, participants and their caregivers were able to visualize a reduced set of information tailored to their needs. RESULTS Overall, paired-sample t-test analysis of monitored qualities revealed improvement for all participants in neuropsychological assessment. Moreover, improvement was detected from the beginning to the end of the trial, in physical condition and in the domains of sleep. Detecting abnormalities via the system, for example in sleep quality, such as REM sleep, has proved to be critical to assess current status, drive interventions, and evaluate improvements in a reliable manner. CONCLUSION It has been proved that the proposed system is suitable to support clinicians to reliably drive and evaluate clinical interventions toward quality of life improvement of people with cognitive impairment.
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Affiliation(s)
- Ioulietta Lazarou
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece.,3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Anastasios Karakostas
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Thanos G Stavropoulos
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Theodoros Tsompanidis
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Georgios Meditskos
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Ioannis Kompatsiaris
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Magda Tsolaki
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece.,3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki, Greece.,Greek Alzheimer Association and Related Disorders, Thessaloníki, Greece
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48
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O'Sullivan JL, Gellert P, Hesse B, Jordan LM, Möller S, Voigt-Antons JN, Nordheim J. Exploring attitudes of healthcare professionals towards ICT-based interventions for nursing home residents with dementia: a mixed-methods approach. Contemp Nurse 2018; 54:13-25. [PMID: 29279003 DOI: 10.1080/10376178.2017.1421087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Information and Communication Technologies (ICTs) could be useful for delivering non-pharmacological therapies (NPTs) for dementia in nursing home settings. AIMS To identify technology-related expectations and inhibitions of healthcare professionals associated with the intention to use ICT-based NPTs. DESIGN Cross-sectional multi-method survey. METHODS N = 205 healthcare professionals completed a quantitative survey on usage and attitudes towards ICTs. Additionally, N = 11 semi-structured interviews were conducted. RESULTS Participants were classified as intenders to use ICTs (53%), non-intenders (14%) or ambivalent (32%). A MANCOVA revealed higher perceived usefulness for intenders compared to non-intenders and ambivalent healthcare professionals (V =.28, F(12, 292)= 3.94, p <.001). Qualitative interviews revealed generally high acceptance of ICTs in the workplace. Furthermore, benefits for residents emerged as a key requirement. CONCLUSION Staff trainings should stress specific benefits for residents and healthcare professionals to facilitate successful implementation and acceptance of ICTs in nursing home settings.
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Affiliation(s)
- Julie Lorraine O'Sullivan
- a Institute of Medical Sociology , Charité - Universitätsmedizin Berlin , Charitéplatz 1, 10117 Berlin , Germany
| | - Paul Gellert
- a Institute of Medical Sociology , Charité - Universitätsmedizin Berlin , Charitéplatz 1, 10117 Berlin , Germany
| | - Britta Hesse
- b Faculty IV Electrical Engineering and Computer Science, Quality and Usability Lab , Technische Universität Berlin , Ernst-Reuter-Platz 7, 10587 Berlin , Germany
| | - Laura-Maria Jordan
- a Institute of Medical Sociology , Charité - Universitätsmedizin Berlin , Charitéplatz 1, 10117 Berlin , Germany
| | - Sebastian Möller
- b Faculty IV Electrical Engineering and Computer Science, Quality and Usability Lab , Technische Universität Berlin , Ernst-Reuter-Platz 7, 10587 Berlin , Germany
| | - Jan-Niklas Voigt-Antons
- b Faculty IV Electrical Engineering and Computer Science, Quality and Usability Lab , Technische Universität Berlin , Ernst-Reuter-Platz 7, 10587 Berlin , Germany
| | - Johanna Nordheim
- a Institute of Medical Sociology , Charité - Universitätsmedizin Berlin , Charitéplatz 1, 10117 Berlin , Germany
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D'Onofrio G, Sancarlo D, Ricciardi F, Panza F, Seripa D, Cavallo F, Giuliani F, Greco A. Information and Communication Technologies for the Activities of Daily Living in Older Patients with Dementia: A Systematic Review. J Alzheimers Dis 2017; 57:927-935. [PMID: 28304297 DOI: 10.3233/jad-161145] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Significant innovations have been introduced in recent years in the application of information and communication technologies (ICTs) to support healthcare for patients with dementia. OBJECTIVE In the present systematic review, our goal is to keep track of ICT concepts and approaches to support the range of activities of daily living for people with dementia and to provide a snapshot of the effect that technology is having on patients' self-reliance. METHODS We reviewed the literature and identified systematic reviews of cohort studies and other authoritative reports. Our selection criteria included: (1) activities of daily living, (2) ICT, and (3) dementia. RESULTS We identified 56 studies published between 2000 and 2015, of which 26 met inclusion criteria. The present systematic review revealed many ICT systems that could purportedly support the range of activities of daily living for patients with dementia. The results showed five research bodies: 1) technologies used by patients with dementia, 2) technologies used by caregivers, 3) monitoring systems, 4) ambient assistive living with ICTs, and 5) tracking and wayfinding. CONCLUSIONS There is a potential for ICTs to support dementia care at home and to improve quality of life for caregivers, reducing healthcare costs and premature institutional care for these patients.
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Affiliation(s)
- Grazia D'Onofrio
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.,BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Daniele Sancarlo
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Francesco Ricciardi
- ICT, Innovation & Research Unit, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Francesco Panza
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.,Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Davide Seripa
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Filippo Cavallo
- BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Francesco Giuliani
- ICT, Innovation & Research Unit, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Antonio Greco
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
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50
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Moniz-Cook E, Hart C, Woods B, Whitaker C, James I, Russell I, Edwards RT, Hilton A, Orrell M, Campion P, Stokes G, Jones RSP, Bird M, Poland F, Manthorpe J. Challenge Demcare: management of challenging behaviour in dementia at home and in care homes – development, evaluation and implementation of an online individualised intervention for care homes; and a cohort study of specialist community mental health care for families. PROGRAMME GRANTS FOR APPLIED RESEARCH 2017. [DOI: 10.3310/pgfar05150] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BackgroundDementia with challenging behaviour (CB) causes significant distress for caregivers and the person with dementia. It is associated with breakdown of care at home and disruption in care homes. Challenge Demcare aimed to assist care home staff and mental health practitioners who support families at home to respond effectively to CB.ObjectivesTo study the management of CB in care homes (ResCare) and in family care (FamCare). Following a conceptual overview, two systematic reviews and scrutiny of clinical guidelines, we (1) developed and tested a computerised intervention; (2) conducted a cluster randomised trial (CRT) of the intervention for dementia with CB in care homes; (3) conducted a process evaluation of implementation of the intervention; and (4) conducted a longitudinal observational cohort study of the management of people with dementia with CB living at home, and their carers.Review methodsCochrane review of randomised controlled trials; systematic meta-ethnographic review of quantitative and qualitative studies.DesignResCare – survey, CRT, process evaluation and stakeholder consultations. FamCare – survey, longitudinal cohort study, participatory development design process and stakeholder consultations. Comparative examination of baseline levels of CB in the ResCare trial and the FamCare study participants.SettingsResCare – 63 care homes in Yorkshire. FamCare – 33 community mental health teams for older people (CMHTsOP) in seven NHS organisations across England.ParticipantsResCare – 2386 residents and 861 staff screened for eligibility; 555 residents with dementia and CB; 277 ‘other’ residents; 632 care staff; and 92 staff champions. FamCare – every new referral (n = 5360) reviewed for eligibility; 157 patients with dementia and CB, with their carer; and 26 mental health practitioners. Stakeholder consultations – initial workshops with 83 practitioners and managers from participating organisations; and 70 additional stakeholders using eight group discussions and nine individual interviews.InterventionAn online application for case-specific action plans to reduce CB in dementia, consisting of e-learning and bespoke decision support care home and family care e-tools.Main outcome measuresResCare – survey with the Challenging Behaviour Scale; measurement of CB with the Neuropsychiatric Inventory (NPI) and medications taken from prescriptions; implementation with thematic views from participants and stakeholders. FamCare – case identification from all referrals to CMHTsOP; measurement of CB with the Revised Memory and Behaviour Problems Checklist and NPI; medications taken from prescriptions; and thematic views from stakeholders. Costs of care calculated for both settings. Comparison of the ResCare trial and FamCare study participants used the NPI, Clinical Dementia Rating and prescribed medications.ResultsResCare – training with group discussion and decision support for individualised interventions did not change practice enough to have an impact on CB in dementia. Worksite e-learning opportunities were not readily taken up by care home staff. Smaller homes with a less hierarchical management appear more ready than others to engage in innovation. FamCare – home-dwelling people with dementia and CB are referred to specialist NHS services, but treatment over 6 months, averaging nine contacts per family, had no overall impact on CB. Over 60% of people with CB had mild dementia. Families bear the majority of the care costs of dementia with CB. A care gap in the delivery of post-diagnostic help for families supporting relatives with dementia and significant CB at home has emerged. Higher levels of CB were recorded in family settings; and prescribing practices were suboptimal in both care home and family settings.LimitationsFunctionality of the software was unreliable, resulting in delays. This compromised the feasibility studies and undermined delivery of the intervention in care homes. A planned FamCare CRT could not proceed because of insufficient referrals.ConclusionsA Cochrane review of individualised functional analysis-based interventions suggests that these show promise, although delivery requires a trained dementia care workforce. Like many staff training interventions, our interactive e-learning course was well received by staff when delivered in groups with facilitated discussion. Our e-learning and decision support e-tool intervention in care homes, in its current form, without ongoing review of implementation of recommended action plans, is not effective at reducing CB when compared with usual care. This may also be true for staff training in general. A shift in priorities from early diagnosis to early recognition of dementia with clinically significant CB could bridge the emerging gap and inequities of care to families. Formalised service improvements in the NHS, to co-ordinate such interventions, may stimulate better opportunities for practice models and pathways. Separate services for care homes and family care may enhance the efficiency of delivery and the quality of research on implementation into routine care.Future workThere is scope for extending functional analysis-based interventions with communication and interaction training for carers. Our clinical workbooks, video material of real-life episodes of CB and process evaluation tool resources require further testing. There is an urgent need for evaluation of interventions for home-dwelling people with dementia with clinically significant CB, delivered by trained dementia practitioners. Realist evaluation designs may illuminate how the intervention might work, and for whom, within varying service contexts.Trial registrationCurrent Controlled Trials ISRCTN02553381 (the ResCare trial) and ISRCTN58876649 (the FamCare study).FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 5, No. 15. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Esme Moniz-Cook
- Faculty of Health Sciences, University of Hull, Hull, UK
- Research and Development, Humber NHS Foundation Trust, Hull and East Yorkshire, UK
| | - Cathryn Hart
- Research and Development, Humber NHS Foundation Trust, Hull and East Yorkshire, UK
| | - Bob Woods
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - Chris Whitaker
- North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, UK
| | - Ian James
- Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ian Russell
- Swansea Trials Unit, Swansea University, Swansea, UK
| | | | - Andrea Hilton
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Martin Orrell
- Institute of Mental Health, The University of Nottingham, Nottingham, UK
| | - Peter Campion
- Faculty of Health Sciences, University of Hull, Hull, UK
| | | | - Robert SP Jones
- North Wales Clinical Psychology Programme, Bangor University, Bangor, UK
| | - Mike Bird
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - Fiona Poland
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Jill Manthorpe
- Social Care Workforce Research Unit, King’s College London, London, UK
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