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Katariya RA, Sammeta SS, Kale MB, Kotagale NR, Umekar MJ, Taksande BG. Agmatine as a novel intervention for Alzheimer's disease: Pathological insights and cognitive benefits. Ageing Res Rev 2024; 96:102269. [PMID: 38479477 DOI: 10.1016/j.arr.2024.102269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/01/2024] [Accepted: 03/08/2024] [Indexed: 03/24/2024]
Abstract
Alzheimer's disease (AD) is a devastating neurodegenerative disorder characterized by progressive cognitive decline and a significant societal burden. Despite extensive research and efforts of the multidisciplinary scientific community, to date, there is no cure for this debilitating disease. Moreover, the existing pharmacotherapy for AD only provides symptomatic support and does not modify the course of the illness or halt the disease progression. This is a significant limitation as the underlying pathology of the disease continues to progress leading to the deterioration of cognitive functions over time. In this milieu, there is a growing need for the development of new and more efficacious treatments for AD. Agmatine, a naturally occurring molecule derived from L-arginine, has emerged as a potential therapeutic agent for AD. Besides this, agmatine has been shown to modulate amyloid beta (Aβ) production, aggregation, and clearance, key processes implicated in AD pathogenesis. It also exerts neuroprotective effects, modulates neurotransmitter systems, enhances synaptic plasticity, and stimulates neurogenesis. Furthermore, preclinical and clinical studies have provided evidence supporting the cognition-enhancing effects of agmatine in AD. Therefore, this review article explores the promising role of agmatine in AD pathology and cognitive function. However, several limitations and challenges exist, including the need for large-scale clinical trials, optimal dosing, and treatment duration. Future research should focus on mechanistic investigations, biomarker studies, and personalized medicine approaches to fully understand and optimize the therapeutic potential of agmatine. Augmenting the use of agmatine may offer a novel approach to address the unmet medical need in AD and provide cognitive enhancement and disease modification for individuals affected by this disease.
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Affiliation(s)
- Raj A Katariya
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India
| | - Shivkumar S Sammeta
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India
| | - Mayur B Kale
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India
| | - Nandkishor R Kotagale
- Government College of Pharmacy, Kathora Naka, VMV Road, Amravati, Maharashtra 444604, India
| | - Milind J Umekar
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India
| | - Brijesh G Taksande
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India.
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Shabha G, Edwards DJ, Gaines K, Laycok P. Toward an Integrated Context-Based Design Approach for Dementia Residential Care Homes: A Review of Key Operational Design Problems. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:323-342. [PMID: 35833917 DOI: 10.1177/19375867221100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES, PURPOSE, OR AIM This article seeks to develop a context-based management system focusing on assessing key operational and design problems and affecting wayfinding in dementia residential care homes. BACKGROUND Dementia is multifaceted neurocognitive impairments largely attributed to cognitive deterioration manifested in memory loss and visuospatial deficit which have wider practical implications to both environmental safety and wayfinding and navigation of dementia user. Two key questions were addressed in this context: (1) How can cognitively facilitating assistive technology (AT) be made more user-focused to mitigate the impacts of cognitive impairments on environmental safety and wayfinding? (2) How can design intervention and changes in design topology, colors and texture, and internal finishing aid wayfinding, navigation, and orientation in dementia residential care homes? METHOD A systematic literature review and analysis was undertaken to assess the efficacy of key cognitively-related AT to support activities of daily living and environmental safety of dementia sufferers in a care home and aid wayfinding, navigation, and orientation. RESULTS Several key design variables to facilitate wayfinding and spatial orientation were identified which include design topology, floor finishing, signposting, and use of color and texture strengthened by meaning, emotional connection to places and cognitively focused intervention via memory cueing and objects-centered recognition. CONCLUSIONS Key operational and design guidelines were proposed to assist built environment, care home developers, clinicians and healthcare professionals, and care services providers. There is a need to move toward a dementia-centered design to address the challenges facing people living with dementia in care homes. This should be based on the interrelated behavioral, cognitive, and communication factors.
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Affiliation(s)
- Ghasson Shabha
- School of Engineering and the Built Environment, Birmingham City University, Birmingham, United Kingdom
| | - David J Edwards
- School of Engineering and the Built Environment, Birmingham City University, Birmingham, United Kingdom
| | - Kristi Gaines
- Department of Design, Texas Tech University (TTU), Lubbock, TX, USA
| | - Paul Laycok
- School of Engineering and the Built Environment, Birmingham City University, Birmingham, United Kingdom
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Warner L, Tipping L. "Can Everyday Assistive Technologies Provide Meaningful Support to Persons With Dementia and Their Informal Caregivers? Evaluation of Collaborative Community Program". J Appl Gerontol 2022; 41:2022-2032. [PMID: 35586889 DOI: 10.1177/07334648221101041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
One of the most challenging caregiving roles today is providing informal care to an individual with dementia. A new program, "AT-Home with Dementia," was created by three collaborative social service agencies to offer simple assistive technologies to persons with dementia and their informal caregivers. Staff, equipped with a traveling kit of everyday devices, offered items during home visits to enhance memory, functional activities, safety, and comfort of persons with dementia. A limited formative program review led to improvements in the new program's reach, service delivery, and data. The results showed that the program enhanced the home environment of the caregiving dyad and led to greater independence of persons with dementia (PWD) and self-assurance among caregivers. Existing community agencies may refer to this program to serve individuals with early-stage dementia. Finally, community agencies and funders may consider adapting this program to provide support to the informal care providers and PWD.
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Affiliation(s)
- Lora Warner
- Department of Public & Environmental Affairs, 14749University of Wisconsin - Green Bay, Green Bay, WI, USA
| | - LaReina Tipping
- Aging & Disability Resource Center of Brown County, formerly employed at Curative Connections, Inc, Green Bay, WI, USA
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Abstract
Internet-connected devices, including personal computers, smartphones, smartwatches, and voice assistants, have evolved into powerful multisensor technologies that billions of people interact with daily to connect with friends and colleagues, access and share information, purchase goods, play games, and navigate their environment. Digital phenotyping taps into the data streams captured by these devices to characterize and understand health and disease. The purpose of this article is to summarize opportunities for digital phenotyping in neurology, review studies using everyday technologies to obtain motor and cognitive information, and provide a perspective on how neurologists can embrace and accelerate progress in this emerging field.
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Affiliation(s)
- Anoopum S. Gupta
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Sultana M, Campbell K, Jennings M, Montero-Odasso M, Orange JB, Knowlton J, St George A, Bryant D. Virtual Reality Experience Intervention May Reduce Responsive Behaviors in Nursing Home Residents with Dementia: A Case Series. J Alzheimers Dis 2021; 84:883-893. [PMID: 34602467 DOI: 10.3233/jad-210010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND People with advanced dementia often exhibit responsive behaviors such as apathy, depression, agitation, aggression, and psychosis. Non-pharmacological approaches (e.g., listening to music, watching television, doing arts and crafts) are now considered as a first-line strategy to manage responsive behaviors in clinical practice due to the potential risks associated with the antipsychotic medications. To date, no evaluations of immersive non-head mounted virtual reality (VR) experience as a non-pharmacologic approach for people with advanced dementia living in nursing homes have been reported. OBJECTIVE To evaluate the feasibility (acceptance and safety) of VR experience. METHODS A single site case series (nonrandomized and unblinded) with a convenience sample (N = 24; age = 85.8±8.6 years; Cognitive Performance Scale score = 3.4±0.6) measuring depression and agitation before and after the intervention. The intervention was a 30-min long research coordinator- facilitated VR experience for two weeks (10 sessions). RESULTS The intervention was feasible (attrition rate = 0% ; adverse events = 0). A reduction in depression and in agitation was observed after the intervention. However, we suggest extreme caution in interpreting this result considering the study design and small sample size. CONCLUSION This study provides the basis for conducting a randomized controlled trial to evaluate the effect of VR experience on responsive behaviors in nursing homes. Since our intervention uses a smart remote-controlled projector without a headset, infectious exposure can be avoided following the COVID-19 pandemic-induced physical distancing policy in care homes.
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Affiliation(s)
- Munira Sultana
- Health and Rehabilitation Sciences, Western University, London, ON, Canada.,Gait & Brain Lab, Parkwood Institute, London, ON, Canada
| | - Karen Campbell
- International Skin Tear Advisory Panel, Ottawa, ON, Canada.,Primacare Living Solutions Inc.TM, Toronto, ON, Canada.,Master of Clinical Science - Advanced Health Care Practice, Western University, London, ON, Canada
| | - Morgan Jennings
- Health and Rehabilitation Sciences, Western University, London, ON, Canada
| | - Manuel Montero-Odasso
- Gait & Brain Lab, Parkwood Institute, London, ON, Canada.,Department of Medicine and Department of Epidemiology & Biostatistics, Western University, London, ON, Canada.,Geriatric Medicine, St. Joseph's Health Care, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - J B Orange
- Lawson Health Research Institute, London, ON, Canada
| | - Jill Knowlton
- Primacare Living Solutions Inc.TM, Toronto, ON, Canada
| | | | - Dianne Bryant
- Lawson Health Research Institute, London, ON, Canada.,School of Physical Therapy and Schulich School of Medicine & Dentistry (Orthopaedic Surgery), Western University, London, ON, Canada.,Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
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Rampioni M, Stara V, Felici E, Rossi L, Paolini S. Embodied Conversational Agents for Patients With Dementia: Thematic Literature Analysis. JMIR Mhealth Uhealth 2021; 9:e25381. [PMID: 34269686 PMCID: PMC8325086 DOI: 10.2196/25381] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/27/2021] [Accepted: 03/10/2021] [Indexed: 01/04/2023] Open
Abstract
Background As the world’s population rapidly ages, the number of older adults with cognitive impairment will also increase. Several studies have identified numerous complex needs of people with dementia, which assistive technologies still fail to support. Recent trends have led to an increasing focus on the use of embodied conversational agents (ECAs) as virtual entities able to interact with a person through natural and familiar verbal and nonverbal communication. The use of ECAs could improve the accessibility and acceptance of assistive technologies matching those high-level needs that are not well covered to date. Objective The aim of this thematic literature analysis was to map current studies in the field of designing ECAs for patients with dementia in order to identify the existing research trend and possible gaps that need to be covered in the near future. The review questions in this study were as follows: (1) what research frameworks are used to study the interaction between patients with dementia and ECAs? (2) what are the findings? and (3) what are the barriers reported in these studies? Methods Separate literature searches were conducted in PubMed, Web of Science, Scopus, and Embase databases by using specific umbrella phrases to target the population (patients with dementia) and the technology-based intervention (embodied conversational agent). Studies that met the inclusion criteria were appraised through the Mixed Methods Appraisal Tool and then discussed in a thematic analysis. Results The search process identified 115 records from the databases and study references. After duplicates (n=45) were removed, 70 papers remained for the initial screening. A total of 7 studies were finally included in the qualitative synthesis. A thematic analysis of the reviewed studies identified major themes and subthemes: the research frameworks used to gather users’ perspectives on ECAs (theme 1), the insights shared by the 7 studies as well as the value of user involvement in the development phases and the challenge of matching the system functionalities with the users’ needs (theme 2), and the main methodological and technical problems faced by each study team (theme 3). Conclusions Our thematic literature analysis shows that the field of ECAs is novel and poorly discussed in the scientific community and that more sophisticated study designs and proofs of efficacy of the approach are required. Therefore, by analyzing the main topic of the narrative review, this study underscores the challenge of synchronizing and harmonizing knowledge, efforts, and challenges in the dementia care field and its person-centered paradigm through the user-centered design approach. Enabling strict collaboration between interdisciplinary research networks, medical scientists, technology developers, patients, and their formal and informal caregivers is still a great challenge in the field of technologies for older adults.
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Affiliation(s)
- Margherita Rampioni
- Model of Care and New Technologies, IRCCS INRCA - National Institute of Health and Science on Aging, Ancona, Italy
| | - Vera Stara
- Model of Care and New Technologies, IRCCS INRCA - National Institute of Health and Science on Aging, Ancona, Italy
| | - Elisa Felici
- Model of Care and New Technologies, IRCCS INRCA - National Institute of Health and Science on Aging, Ancona, Italy
| | - Lorena Rossi
- Model of Care and New Technologies, IRCCS INRCA - National Institute of Health and Science on Aging, Ancona, Italy
| | - Susy Paolini
- Unit of Neurology, IRCCS INRCA - National Institute of Health and Science on Aging, Ancona, Italy
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Fowler-Davis S, Barnett D, Kelley J, Curtis D. Potential for Digital Monitoring to Enhance Wellbeing at Home for People with Mild Dementia and Their Family Carers. J Alzheimers Dis 2021; 73:867-872. [PMID: 31884471 PMCID: PMC7081090 DOI: 10.3233/jad-190844] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Digital technologies have the potential to assist people with dementia to monitor day to day activities and mitigate the risks of living independently. This purposive pilot study surveyed participants for frailty, wellbeing, and perceived carer burden using the 3Rings™ digital plug. 30 paired participants used the digital device for four months. People with dementia reported a decline in wellbeing and increased frailty. Family carers reported a decline in wellbeing but 18 reported a reduction in burden. The use of digital monitoring by family carers demonstrated a reduction in their perceived burden and the device was acceptable to people with mild dementia living alone.
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Affiliation(s)
- Sally Fowler-Davis
- Faculty of Health and Wellbeing Sheffield Hallam University, Sheffield, UK
| | - Deborah Barnett
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - John Kelley
- Centre for Sports Engineering Research (CSER), Sheffield Hallam University, Sheffield, UK
| | - David Curtis
- Centre for Sports Engineering Research (CSER), Sheffield Hallam University, Sheffield, UK
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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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Wearable Technology for Detecting Significant Moments in Individuals with Dementia. BIOMED RESEARCH INTERNATIONAL 2019; 2019:6515813. [PMID: 31662986 PMCID: PMC6778872 DOI: 10.1155/2019/6515813] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 08/05/2019] [Accepted: 08/19/2019] [Indexed: 12/12/2022]
Abstract
The detection of significant moments can support the care of individuals with dementia by making visible what is most meaningful to them and maintaining a sense of interpersonal connection. We present a novel intelligent assistive technology (IAT) for the detection of significant moments based on patterns of physiological signal changes in individuals with dementia and their caregivers. The parameters of the IAT are tailored to each individual's idiosyncratic physiological response patterns through an iterative process of incorporating subjective feedback on videos extracted from candidate significant moments identified through the IAT algorithm. The IAT was tested on three dyads (individual with dementia and their primary caregiver) during an eight-week movement program. Upon completion of the program, the IAT identified distinct, personal characteristics of physiological responsiveness in each participant. Tailored algorithms could detect moments of significance experienced by either member of the dyad with an agreement with subjective reports of 70%. These moments were constituted by both physical and emotional significances (e.g., experiences of pain or anxiety) and interpersonal significance (e.g., moments of heighted connection). We provide a freely available MATLAB toolbox with the IAT software in hopes that the assistive technology community can benefit from and contribute to these tools for understanding the subjective experiences of individuals with dementia.
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Ricci G. Social Aspects of Dementia Prevention from a Worldwide to National Perspective: A Review on the International Situation and the Example of Italy. Behav Neurol 2019; 2019:8720904. [PMID: 31583024 PMCID: PMC6754867 DOI: 10.1155/2019/8720904] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 08/05/2019] [Accepted: 08/23/2019] [Indexed: 11/17/2022] Open
Abstract
At the moment, dementia is affecting around 47 million people worldwide, with a forecast amount of 135 million affected people in 2050. Dementia is a growing health concern worldwide with no treatment currently available, but only symptomatic medication. Effective interventions in the prevention and management of dementia are urgently needed to contain direct and indirect costs of this disease. Indeed, the economic impact of dementia is a vast and continually growing figure, but it is still difficult to quantify. Due to an increase in both the disease spreading and its direct and indirect costs, national and international action plans have to be implemented. As a virtuous example, the Italian national plan for dementia has been summarized. Faced with an increasingly less sustainable disease impact at national and international levels, the plan suggests that it is certainly the entire welfare model that should be rethought, strengthening the network of services and providing interventions to support affected people and their caregivers. Alongside this synergistic approach, scientific research could play a crucial role for pharmacological and nonpharmacological treatments capable of delaying the state of loss of self-sufficiency of the patient, with a significant impact on social and health costs.
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Astell AJ, Bouranis N, Hoey J, Lindauer A, Mihailidis A, Nugent C, Robillard JM. Technology and Dementia: The Future is Now. Dement Geriatr Cogn Disord 2019; 47:131-139. [PMID: 31247624 PMCID: PMC6643496 DOI: 10.1159/000497800] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Technology has multiple potential applications to dementia from diagnosis and assessment to care delivery and supporting ageing in place. OBJECTIVES To summarise key areas of technology development in dementia and identify future directions and implications. METHOD Members of the US Alzheimer's Association Technology Professional Interest Area involved in delivering the annual pre-conference summarised existing knowledge on current and future technology developments in dementia. RESULTS The main domains of technology development are as follows: (i) diagnosis, assessment and monitoring, (ii) maintenance of functioning, (iii) leisure and activity, (iv) caregiving and management. CONCLUSIONS The pace of technology development requires urgent policy, funding and practice change, away from a narrow medical approach, to a holistic model that facilitates future risk reduction and prevention strategies, enables earlier detection and supports implementation at scale for a meaningful and fulfilling life with dementia.
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Affiliation(s)
- Arlene J. Astell
- Department of Occupational Sciences and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Toronto Rehabilitation Institute, Toronto, Toronto, Ontario, Canada,School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom,*Arlene J. Astell, School of Psychology & Clinical Language Sciences, University of Reading, Reading (UK), E-Mail
| | - Nicole Bouranis
- Layton Aging and Alzheimer's Disease Center, Oregon Health and Science University, Portland, Oregon, USA
| | - Jesse Hoey
- David R. Cheriton School of Computer Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Allison Lindauer
- Oregon Roybal Center for Aging and Technology (ORCATECH), Oregon Health and Science University, Portland, Oregon, USA
| | - Alex Mihailidis
- Department of Occupational Sciences and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Chris Nugent
- School of Computing, Ulster University, Northern Ireland, United Kingdom
| | - Julie M. Robillard
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Sallinen M, Hentonen O, Teeri S. Ethical dilemmas related to the use of safety technology in service house environments. Scand J Caring Sci 2019; 34:199-205. [PMID: 31250937 DOI: 10.1111/scs.12721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/14/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The use of technology in care of older adults has increased rapidly in recent years and is anticipated to increase further in the future. Technological devices and appliances have been developed to promote the safety and independence of older adults living in different settings. However, technology may also be perceived as a threat, and using technology could involve characteristics that may restrict especially patients' autonomy. AIMS AND METHODS The aim of this study was to explore ethical dilemmas as experienced and expressed by older adults living in service house environment and their family members. The study was carried out in two service house units in Southwest Finland by conducting thematic interviews of service home residents aged 80-92 years (n = 12) and their relatives (n = 5). The interview data were analysed using inductive content analysis to identify similarities and differences across the data. The findings were categorised under three categories: supervision vs. privacy, fear of losing human contact, autonomy and freedom. FINDINGS The participants appreciated the homely environment they had and preferred increasing the amount of staff over increasing technological surveillance. However, the residents were willing to accept also technological systems and solutions if they strengthened one's feeling of security. Fear of losing human contacts and one's privacy due to implementation technological systems was expressed by the older adults. Both the residents and their relatives emphasised the autonomy of the older adult in decision-making concerning the use of technological services. CONCLUSIONS In conclusion, thorough discussion about autonomy, freedom and privacy is needed before applying new technologies to service house environments. Possibilities for drafting a 'technological will' where the resident could define under what circumstances technology can be used in his/her case and who can decide about it should be explored in the future.
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Affiliation(s)
- Merja Sallinen
- Faculty of Health and Welfare, Satakunta University of Applied Sciences, Pori, Finland
| | - Outi Hentonen
- Faculty of Health and Welfare, Satakunta University of Applied Sciences, Pori, Finland
| | - Sari Teeri
- Faculty of Health and Welfare, Satakunta University of Applied Sciences, Pori, Finland
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Asghar I, Cang S, Yu H. Impact evaluation of assistive technology support for the people with dementia. Assist Technol 2018; 31:180-192. [PMID: 29701503 DOI: 10.1080/10400435.2017.1411405] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
This study explores important factors of assistive technology (AT) and evaluates their relative impact on AT effectiveness and retention. Questionnaire based survey is used for data collection from 327 people with dementia (PWD). This empirical study uses statistical techniques including exploratory factor analysis for factor identification, linear regression for impact study, Kruskal Wallis H and Mann Whitney U tests for the statistical significant study in terms of demographic and characteristics. The exploratory factor analysis results into 11 factors: operational support, physical support, psychological support, social support, cultural match, reduced external help, affordability, travel help, compatibility, effectiveness and retention. The results reveal that social support, psychological support and travel help and reduced external help strongly impact on AT effectiveness and retention. The users are motivated by socialization support through using AT without any external help. The use of AT during travelling improves confidence of the PWD and helps them psychologically.
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Affiliation(s)
- Ikram Asghar
- Faculty of Science and Technology, Bournemouth University , Poole , UK
| | - Shuang Cang
- Newcastle Business School, Northumbria University , Newcastle , UK
| | - Hongnian Yu
- Faculty of Science and Technology, Bournemouth University , Poole , UK
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Asghar I, Cang S, Yu H. Usability evaluation of assistive technologies through qualitative research focusing on people with mild dementia. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2017.08.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Doraiswamy PM, Narayan VA, Manji HK. Mobile and pervasive computing technologies and the future of Alzheimer's clinical trials. NPJ Digit Med 2018; 1:1. [PMID: 31304287 PMCID: PMC6550135 DOI: 10.1038/s41746-017-0008-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/12/2017] [Accepted: 09/12/2017] [Indexed: 12/16/2022] Open
Abstract
The rapid growth of mobile phones, automated speech recognizing personal assistants, and internet access among the elderly provides new opportunities for incorporating such technologies into clinical research and personalized medical care. Alzheimer's disease is a good test case given the need for early detection, the high rate of clinical trial failures, the need to more efficiently recruit patients for trials, and the need for sensitive and ecologically valid trial outcomes.
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Affiliation(s)
- P. Murali Doraiswamy
- Neurocognitive Disorders Program, Department of Psychiatry, Duke University Health System, and the Duke Institute for Brain Sciences, Durham, NC 27710 USA
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Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, Ballard C, Banerjee S, Burns A, Cohen-Mansfield J, Cooper C, Fox N, Gitlin LN, Howard R, Kales HC, Larson EB, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N. Dementia prevention, intervention, and care. Lancet 2017; 390:2673-2734. [PMID: 28735855 DOI: 10.1016/s0140-6736(17)31363-6] [Citation(s) in RCA: 3419] [Impact Index Per Article: 488.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 01/20/2017] [Accepted: 01/25/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Gill Livingston
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
| | | | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Jonathan Huntley
- Division of Psychiatry, University College London, London, UK; Department of Old Age Psychiatry, King's College London, London, UK
| | - David Ames
- National Ageing Research Institute, Parkville, VIC, Australia; Academic Unit for Psychiatry of Old Age, University of Melbourne, Kew, VIC, Australia
| | | | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Alistair Burns
- Centre for Dementia Studies, University of Manchester, Manchester, UK
| | - Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Heczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel; Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Nick Fox
- Dementia Research Centre, University College London, Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Laura N Gitlin
- Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD, USA
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Helen C Kales
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; VA Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA
| | - Karen Ritchie
- Inserm, Unit 1061, Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, University of Montpellier, Montpellier, France; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Kenneth Rockwood
- Centre for the Health Care of Elderly People, Geriatric Medicine Dalhousie University, Halifax, NS, Canada
| | - Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Quincy Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, Johns Hopkins University, Baltimore, MD, USA
| | - Lon S Schneider
- Department of Neurology and Department of Psychiatry and the Behavioural Sciences, Keck School of Medicine, Leonard Davis School of Gerontology of the University of Southern California, Los Angeles, CA, USA
| | - Geir Selbæk
- Norwegian National Advisory Unit on Aging and Health, Vestfold Health Trust, Tønsberg, Norway; Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Linda Teri
- Department Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, WA, USA
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK
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Asghar I, Cang S, Yu H. Assistive technology for people with dementia: an overview and bibliometric study. Health Info Libr J 2017; 34:5-19. [DOI: 10.1111/hir.12173] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 01/08/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Ikram Asghar
- Faculty of Science and Technology; Bournemouth University (BU); Poole Dorset UK
| | - Shuang Cang
- Faculty of Management; Bournemouth University (BU); Poole Dorset UK
| | - Hongnian Yu
- Faculty of Science and Technology; Bournemouth University (BU); Poole Dorset UK
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19
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Jiancaro T, Jaglal SB, Mihailidis A. Technology, design and dementia: an exploratory survey of developers. Disabil Rehabil Assist Technol 2016; 12:573-584. [DOI: 10.1080/17483107.2016.1187671] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Tizneem Jiancaro
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
- Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
| | - Susan B. Jaglal
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Alex Mihailidis
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
- Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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20
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Cavallo F, Aquilano M, Arvati M. An ambient assisted living approach in designing domiciliary services combined with innovative technologies for patients with Alzheimer's disease: a case study. Am J Alzheimers Dis Other Demen 2015; 30:69-77. [PMID: 24951634 PMCID: PMC10852970 DOI: 10.1177/1533317514539724] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is one of the most disabling diseases to affect large numbers of elderly people worldwide. Because of the characteristics of this disease, patients with AD require daily assistance from service providers both in nursing homes and at home. Domiciliary assistance has been demonstrated to be cost effective and efficient in the first phase of the disease, helping to slow down the course of the illness, improve the quality of life and care, and extend independence for patients and caregivers. In this context, the aim of this work is to demonstrate the technical effectiveness and acceptability of an innovative domiciliary smart sensor system for providing domiciliary assistance to patients with AD which has been developed with an Ambient Assisted Living (AAL) approach. METHODS The design, development, testing, and evaluation of the innovative technological solution were performed by a multidisciplinary team. In all, 15 sociomedical operators and 14 patients with AD were directly involved in defining the end-users' needs and requirements, identifying design principles with acceptability and usability features and evaluating the technological solutions before and after the real experimentation. RESULTS A modular technological system was produced to help caregivers continuously monitor the health status, safety, and daily activities of patients with AD. During the experimentation, the acceptability, utility, usability, and efficacy of this system were evaluated as quite positive. CONCLUSION The experience described in this article demonstrated that AAL technologies are feasible and effective nowadays and can be actively used in assisting patients with AD in their homes. The extensive involvement of caregivers in the experimentation allowed to assess that there is, through the use of the technological system, a proven improvement in care performance and efficiency of care provision by both formal and informal caregivers and consequently an increase in the quality of life of patients, their relatives, and their caregivers.
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Affiliation(s)
- Filippo Cavallo
- The BioRobotics Institute - Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Michela Aquilano
- The BioRobotics Institute - Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Marco Arvati
- A.S.P. e F. Azienda Servizi alla Persona e alla Famiglia, Mantova, Italy
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21
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Evans J, Brown M, Coughlan T, Lawson G, Craven MP. A Systematic Review of Dementia Focused Assistive Technology. HUMAN-COMPUTER INTERACTION: INTERACTION TECHNOLOGIES 2015. [DOI: 10.1007/978-3-319-20916-6_38] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Gibson G, Newton L, Pritchard G, Finch T, Brittain K, Robinson L. The provision of assistive technology products and services for people with dementia in the United Kingdom. DEMENTIA 2014; 15:681-701. [PMID: 24803646 DOI: 10.1177/1471301214532643] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this review we explore the provision of assistive technology products and services currently available for people with dementia within the United Kingdom. A scoping review of assistive technology products and services currently available highlighted 171 products or product types and 331 services. In addition, we assimilated data on the amount and quality of information provided by assistive technology services alongside assistive technology costs. We identify a range of products available across three areas: assistive technology used 'by', 'with' and 'on' people with dementia. Assistive technology provision is dominated by 'telecare' provided by local authorities, with services being subject to major variations in pricing and information provision; few currently used available resources for assistive technology in dementia. We argue that greater attention should be paid to information provision about assistive technology services across an increasingly mixed economy of dementia care providers, including primary care, local authorities, private companies and local/national assistive technology resources.
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Affiliation(s)
- Grant Gibson
- Institute of Health and Society, Newcastle University
| | - Lisa Newton
- Institute of Health and Society, Newcastle University
| | | | - Tracy Finch
- Institute of Health and Society, Newcastle University
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23
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Considering People Living with Dementia When Designing Interfaces. LECTURE NOTES IN COMPUTER SCIENCE 2014. [DOI: 10.1007/978-3-319-07638-6_12] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Engaging Older Adults with Dementia in Creative Occupations Using Artificially Intelligent Assistive Technology. Assist Technol 2013; 25:72-9. [DOI: 10.1080/10400435.2012.715113] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Boise L, Wild K, Mattek N, Ruhl M, Dodge HH, Kaye J. Willingness of older adults to share data and privacy concerns after exposure to unobtrusive in-home monitoring. ACTA ACUST UNITED AC 2013; 11:428-435. [PMID: 23525351 DOI: 10.4017/gt.2013.11.3.001.00] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Older adult participants in the Intelligent Systems for Assessment of Aging Changes study (ISAAC) carried out by the Oregon Center for Aging and Technology (ORCATECH) were surveyed regarding their attitudes about unobtrusive home monitoring and computer use at baseline and after one year (n=119). The survey was part of a longitudinal study using in-home sensor technology to detect cognitive changes and other health problems. Our primary objective was to measure willingness to share health or activity data with one's doctor or family members and concerns about privacy or security of monitoring over one year of study participation. Differences in attitudes of participants with Mild Cognitive Impairment (MCI) compared to those with normal cognition were also examined. A high proportion (over 72%) of participants reported acceptance of in-home and computer monitoring and willingness to have data shared with their doctor or family members. However, a majority (60%) reported concerns related to privacy or security; these concerns increased after one year of participation. Few differences between participants with MCI and those with normal cognition were identified. Findings suggest that involvement in this unobtrusive in-home monitoring study may have raised awareness about the potential privacy risks of technology. Still, results show high acceptance, stable over time, of sharing information from monitoring systems with family members and doctors. Our findings have important implications for the deployment of technologies among older adults in research studies as well as in the general community.
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Affiliation(s)
- Linda Boise
- Dept. of Neurology, Oregon Health & Science University, C. Rex & Ruth H. Layton Aging & Alzheimer's Disease Center, Portland, Oregon, USA
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Abstract
PURPOSE OF REVIEW To identify and review the latest research in the use of low and high technology in the areas of mood disorders, psychosis, normal ageing, mild cognitive impairment and dementia. RECENT FINDINGS Technology use varied in type and extent of use across the different areas that have been reviewed. Telepsychiatry, internet-delivered therapy programs and bright-light therapy were used in managing symptoms associated with depression. In psychosis, multisensory therapy, reminiscence and virtual cognitive stimulation showed some benefits. Navigation aids and computerized diaries assisted in maintaining independence in the normally ageing and mildly cognitively impaired, although the benefits of cognitive stimulation are yet to be consistently established. By far, dementia technology received the most research attention. Benefits in this population included reductions in behavioural and psychological symptoms and carer burden and increased independence, task engagement and safety. SUMMARY Research in the use of low and high technology in late-life mental disorders continues to evolve in its scope and innovation. To progress the accessibility and acceptability of technology, involvement of stakeholders and users in the design and application, as well as examination of cost-effectiveness and robust methodologically designed studies are necessary.
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Gitlin LN, Winter L, Dennis MP. Assistive devices caregivers use and find helpful to manage problem behaviors of dementia. GERONTECHNOLOGY : INTERNATIONAL JOURNAL ON THE FUNDAMENTAL ASPECTS OF TECHNOLOGY TO SERVE THE AGEING SOCIETY 2010; 9:408-414. [PMID: 25429254 PMCID: PMC4241973 DOI: 10.4017/gt.2010.09.03.006.00] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Use of assistive devices in caring for individuals with dementia has not been systematically examined, particularly as it concerns managing behavioral symptoms. We tested a nonpharmacologic intervention to manage behaviors that involved instructing families in effective communication techniques, simplifying tasks and the home environment and using assistive devices. This paper describes the assistive devices provided to families assigned to intervention, extent of use of issued devices, their perceived helpfulness, and cost. DESIGN AND METHODS Following each treatment session, occupational therapists (OT) documented time spent training in the use of strategies to manage problem behaviors. For families receiving assistive devices, OTs asked caregivers after 4 months whether they continued to use the device (yes/no), and extent to which it helped manage the targeted problems (not at all, somewhat, very helpful). We also tracked the costs associated with ordering, delivering and installing devices. RESULTS Of 272 caregiver-patient dyads enrolled in the original trial, 136 were randomized to the intervention group, of whom 63 received one or more assistive devices. Of 13 intervention sessions, an average of 4 (31%) involved discussing or training caregivers in using assistive devices. A total of 197 devices (3 per dyad) were issued of which 87.6% were reported in use at 4 months. Caregivers reported that overall, devices were somewhat to very helpful. Devices ranged in cost from US$4.80 to US$282.93 with an average cost per dyad of US$152.52(SD=US$102.70) which included the device, its ordering, delivery and installation.
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Affiliation(s)
- Laura N. Gitlin
- Jefferson Center for Applied Research on Aging and Health, Thomas Jefferson University, Philadelphia, USA
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