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Minnis M, Burton JK, Kelbling E, Gallacher KI, Quinn TJ. Not daily, sometimes not ever - mixed methods exploration of the contemporary relevance of tasks contained in extended activities of daily living scales. Age Ageing 2024; 53:afae185. [PMID: 39171388 PMCID: PMC11339544 DOI: 10.1093/ageing/afae185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Assessment of functional status is an integral part of older adult healthcare and research. Therefore, it is essential that tools to capture function are contextually appropriate. Many tools designed to evaluate extended Activities of Daily Living (eADLs) were developed decades ago. OBJECTIVE Our aim was to explore which eADL tasks are commonly performed by older adults and map these tasks to popular eADL scales, seeking stakeholder perspectives to inform recommendations on scale content. DESIGN Online survey with quantitative questions and free text followed-by semi-structured interviews. SUBJECTS Older adults (≥60-years), carers and health, social care and voluntary/community professionals. METHODS We extracted eADL tasks from existing scales to develop a survey on frequency of performance, with space for additional comment. The survey was disseminated via Join Dementia Research and other clinical and professional networks. Online semi-structured interviews were undertaken with thematic analysis of verbatim transcripts. RESULTS From 2244 online survey responses, 87% came from older people and two-thirds of respondents were female. Some eADL tasks were never performed by many participants. Tasks not part of existing tools included online banking and mobile phone use. From fifteen interviews, a recurring theme was that technological and societal changes have altered daily tasks. CONCLUSIONS Commonly used eADL scales contain obsolete tasks and omit tasks older people consider part of their everyday lives. There is a need to work collaboratively to update eADL tools to reflect the priorities and activities of older people to ensure these remain valid measures for use in practice and research. To complement this abstract, a video abstract is available online. A more detailed video-based summary of the content is also available as supplemental material.
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Affiliation(s)
- Meghan Minnis
- Academic Geriatric Medicine, School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jennifer Kirsty Burton
- Academic Geriatric Medicine, School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Eline Kelbling
- Academic Geriatric Medicine, School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Katie I Gallacher
- General Practice & Primary Care, School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Terence J Quinn
- Academic Geriatric Medicine, School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Johnsson C, Malinowsky C, Leavy B. Everyday technology use among people with Parkinson's disease. Aging Ment Health 2023; 27:2430-2437. [PMID: 37139925 DOI: 10.1080/13607863.2023.2202628] [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: 12/16/2022] [Accepted: 04/03/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To explore the relevance of and ability to use everyday technology (ET) among people with Parkinson's Disease (PD) and to explore associations between ET use and global cognition and motor ability. MATERIALS AND METHODS Cross-sectional data was collected from 34 people with PD using the Short Everyday Technology Use Questionnaire+ (S-ETUQ+), the Movement Disorder Society-Unified Parkinson's Disease Rating Scale and the Montreal Cognitive Assessment (MoCA). RESULTS Out of 41 ETs in the S-ETUQ+, the mean number perceived as relevant was 27.5 (min-max 19-35, SD 3.6). A good ability to use ET was reported where many ETs had a challenge measure below participants' ability to use them. A strong positive correlation between the ability to use ET and global cognition (MoCA) (r = .676, p = <0.01) was shown. CONCLUSIONS ET use has become integrated into everyday life and is important for participation. This study showed a high relevance of and good ability to use ET and a correlation between ET use and global cognition among people with mild-moderate PD. Evaluation and support to use ET in PD are important for maintaining independence and participation, especially among those with cognitive decline.
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Affiliation(s)
- Cecilia Johnsson
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholms Sjukhem Foundation, Stockholm, Sweden
| | - Camilla Malinowsky
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Breiffni Leavy
- Stockholms Sjukhem Foundation, Stockholm, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Kim SY, Park J, Choi H, Loeser M, Ryu H, Seo K. Digital Marker for Early Screening of Mild Cognitive Impairment Through Hand and Eye Movement Analysis in Virtual Reality Using Machine Learning: First Validation Study. J Med Internet Res 2023; 25:e48093. [PMID: 37862101 PMCID: PMC10625097 DOI: 10.2196/48093] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/07/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND With the global rise in Alzheimer disease (AD), early screening for mild cognitive impairment (MCI), which is a preclinical stage of AD, is of paramount importance. Although biomarkers such as cerebrospinal fluid amyloid level and magnetic resonance imaging have been studied, they have limitations, such as high cost and invasiveness. Digital markers to assess cognitive impairment by analyzing behavioral data collected from digital devices in daily life can be a new alternative. In this context, we developed a "virtual kiosk test" for early screening of MCI by analyzing behavioral data collected when using a kiosk in a virtual environment. OBJECTIVE We aimed to investigate key behavioral features collected from a virtual kiosk test that could distinguish patients with MCI from healthy controls with high statistical significance. Also, we focused on developing a machine learning model capable of early screening of MCI based on these behavioral features. METHODS A total of 51 participants comprising 20 healthy controls and 31 patients with MCI were recruited by 2 neurologists from a university hospital. The participants performed a virtual kiosk test-developed by our group-where we recorded various behavioral data such as hand and eye movements. Based on these time series data, we computed the following 4 behavioral features: hand movement speed, proportion of fixation duration, time to completion, and the number of errors. To compare these behavioral features between healthy controls and patients with MCI, independent-samples 2-tailed t tests were used. Additionally, we used these behavioral features to train and validate a machine learning model for early screening of patients with MCI from healthy controls. RESULTS In the virtual kiosk test, all 4 behavioral features showed statistically significant differences between patients with MCI and healthy controls. Compared with healthy controls, patients with MCI had slower hand movement speed (t49=3.45; P=.004), lower proportion of fixation duration (t49=2.69; P=.04), longer time to completion (t49=-3.44; P=.004), and a greater number of errors (t49=-3.77; P=.001). All 4 features were then used to train a support vector machine to distinguish between healthy controls and patients with MCI. Our machine learning model achieved 93.3% accuracy, 100% sensitivity, 83.3% specificity, 90% precision, and 94.7% F1-score. CONCLUSIONS Our research preliminarily suggests that analyzing hand and eye movements in the virtual kiosk test holds potential as a digital marker for early screening of MCI. In contrast to conventional biomarkers, this digital marker in virtual reality is advantageous as it can collect ecologically valid data at an affordable cost and in a short period (5-15 minutes), making it a suitable means for early screening of MCI. We call for further studies to confirm the reliability and validity of this approach.
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Affiliation(s)
- Se Young Kim
- Department of Applied Artificial Intelligence, Seoul National University of Science and Technology, Seoul, Republic of Korea
| | - Jinseok Park
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hojin Choi
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Martin Loeser
- Department of Computer Science, Electrical Engineering and Mechatronics, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Hokyoung Ryu
- Graduate School of Technology and Innovation Management, Hanyang University, Seoul, Republic of Korea
| | - Kyoungwon Seo
- Department of Applied Artificial Intelligence, Seoul National University of Science and Technology, Seoul, Republic of Korea
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Chen LH, Huang YC, Zhao RQ. Product Interfaces for Older Adult Users With Cognitive Impairment. ERGONOMICS IN DESIGN 2022. [DOI: 10.1177/10648046221117906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study is to explore the usability of multiple forms of television remote control interfaces for older adult users and users with mild cognitive impairment (MCI) to clarify the operation performance requirements of these two user groups. The test interfaces were constructed through programming and were capable of recording participants’ task completion time, operation errors, and the locations of their taps. The results show that users with MCI could not perform their initial action quickly and accurately; buttons with larger sizes provided greater operation performance for older adult users and users with MCI.
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Ikeda Y, Maruta M, Shimokihara S, Nakamura A, Han G, Tabira T. Difficulties in the Use of Everyday Technology among Older Adults with Subjective Memory Complaint and Cognitive Decline. Gerontology 2022; 68:655-663. [PMID: 34515123 DOI: 10.1159/000518390] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/09/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The ability to use everyday technology (ET) is becoming increasingly necessary for maintaining domestic and social lives. For older adults, difficulties with using ETs can begin at the mild cognitive impairment (MCI) state and may indicate increasing cognitive decline. The aim of this study was to conduct a detailed investigation into the ability to use ETs among Japanese older community-dwelling adults at 3 stages of cognitive function and the ability to carry out daily activities. METHOD We analyzed family members' responses to questions about older adults with cognitive decline in their families. A total of 168 older adults with subjective memory complaints (SMC) or cognitive decline and inconvenience in daily life were analyzed. A questionnaire was used to assess the characteristics, ability to use ETs, and ability to manage refrigerator contents, all of which can be early signs of dementia. Participants were divided 3 groups by the type of dementia: SMC (n = 77), MCI (n = 36), and Alzheimer's disease (AD) (n = 55) for comparison. RESULT The observation list of early signs of dementia (OLD) total score indicated a significant positive correlation with the number of ET errors (r = 0.37, p < 0.001) and number of difficulties with refrigerator management (r = 0.18, p = 0.031). Regarding number of ET errors, there was a significant main effect for the 3 groups, and the SMC group made significantly fewer errors than the AD group (p = 0.02). In 7 of the 11 ET categories, errors with using ETs were associated with all 3 groups, with the SMC group making fewer errors, and the AD group making more. Regarding difficulties with refrigerator management, 2 out of 9 problems were associated with the 3 groups, with the SMC group having fewer difficulties and the AD group having more. DISCUSSION/CONCLUSION The results indicated that the ability to use ETs and to manage refrigerator contents begins to decline at the SMC stage. Further evaluation of the ability to use ETs is needed for older adults with SMC so that adequate support in the context of the individual can be provided.
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Affiliation(s)
- Yuriko Ikeda
- Department of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, Kagoshima, Japan
| | - Michio Maruta
- Department of Rehabilitation, Medical Corporation, Sanshukai, Okatsu Hospital, Kagoshima, Japan
| | - Suguru Shimokihara
- Department of Rehabilitation, Medical Corporation, Nissyokai, Minamikagoshima Sakura Hospital, Kagoshima, Japan
| | - Atsushi Nakamura
- National Institute for Minamata Disease, Minamata, Japan.,Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Gwanghee Han
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Takayuki Tabira
- Department of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, Kagoshima, Japan
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Chen LH, Liu YC. Interface Design for Products for Users with Advanced Age and Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042466. [PMID: 35206653 PMCID: PMC8872458 DOI: 10.3390/ijerph19042466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/05/2022] [Accepted: 02/16/2022] [Indexed: 11/24/2022]
Abstract
The aim of this study is to investigate the problems and needs of users with advanced age and cognitive impairment regarding the design and operation of daily living products. Television remote controls and an electric rice cooker were applied as the research tools, and focus group interviews with control older adults and interviews with individuals with MCI or mild dementia were conducted regarding the operation of the products. The control participants stressed that the operating procedures should not be excessively complex, the number of functions and buttons should not be overly high, and buttons and text should be enlarged. For those with MCI or mild dementia, in addition to the size and number of buttons, text size, and functions, their operation of product interfaces was affected by the complexity of the operating procedures. The solutions recommended by the participants included interface design involving direct operation and voice control.
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Affiliation(s)
- Li-Hao Chen
- Department of Applied Arts, Fu Jen Catholic University, New Taipei City 24205, Taiwan
- Correspondence: ; Tel.: +886-229053313
| | - Yi-Chien Liu
- Neurology Department, Cardinal Tien Hospital, New Taipei City 23148, Taiwan;
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Bernstein JPK, Dorociak KE, Mattek N, Leese M, Beattie ZT, Kaye JA, Hughes A. Passively-Measured Routine Home Computer Activity and Application Use Can Detect Mild Cognitive Impairment and Correlate with Important Cognitive Functions in Older Adulthood. J Alzheimers Dis 2021; 81:1053-1064. [PMID: 33843682 DOI: 10.3233/jad-210049] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Computer use is a cognitively complex instrumental activity of daily living (IADL) that has been linked to cognitive functioning in older adulthood, yet little work has explored its capacity to detect incident mild cognitive impairment (MCI). OBJECTIVE To examine whether routine home computer use (general computer use as well as use of specific applications) could effectively discriminate between older adults with and without MCI, as well as explore associations between use of common computer applications and cognitive domains known to be important for IADL performance. METHODS A total of 60 community-dwelling older adults (39 cognitively healthy, 21 with MCI) completed a neuropsychological evaluation at study baseline and subsequently had their routine home computer use behaviors passively recorded for three months. RESULTS Compared to those with MCI, cognitively healthy participants spent more time using the computer, had a greater number of computer sessions, and had an earlier mean time of first daily computer session. They also spent more time using email and word processing applications, and used email, search, and word processing applications on a greater number of days. Better performance in several cognitive domains, but in particular memory and language, was associated with greater frequency of browser, word processing, search, and game application use. CONCLUSION Computer and application use are useful in identifying older adults with MCI. Longitudinal studies are needed to determine whether decreases in overall computer use and specific computer application use are predictors of incident cognitive decline.
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Affiliation(s)
| | | | - Nora Mattek
- Oregon Center for Aging & Technology, Portland, OR, USA
| | - Mira Leese
- Minneapolis VA Healthcare System, Minneapolis, MN, USA
| | | | | | - Adriana Hughes
- Minneapolis VA Healthcare System, Minneapolis, MN, USA.,University of Minnesota, Department of Psychiatry, Minneapolis, MN, USA
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Abstract
OBJECTIVE Commonly used measures of instrumental activities of daily living (IADL) do not capture activities for a technologically advancing society. This study aimed to adapt the proxy/informant-based Amsterdam IADL Questionnaire (A-IADL-Q) for use in the UK and develop a self-report version. DESIGN An iterative mixed method cross-cultural adaptation of the A-IADL-Q and the development of a self-report version involving a three-step design: (1) interviews and focus groups with lay and professional stakeholders to assess face and content validity; (2) a questionnaire to measure item relevance to older adults in the U.K.; (3) a pilot of the adapted questionnaire in people with cognitive impairment. SETTING Community settings in the UK. PARTICIPANTS One hundred and forty-eight participants took part across the three steps: (1) 14 dementia professionals; 8 people with subjective cognitive decline (SCD), mild cognitive impairment (MCI), or dementia due to Alzheimer's disease; and 6 relatives of people with MCI or dementia; (2) 92 older adults without cognitive impairment; and (3) 28 people with SCD or MCI. MEASUREMENTS The cultural relevance and applicability of the A-IADL-Q scale items were assessed using a 6-point Likert scale. Cognitive and functional performance was measured using a battery of cognitive and functional measures. RESULTS Iterative modifications to the scale resulted in a 55-item adapted version appropriate for UK use (A-IADL-Q-UK). Pilot data revealed that the new and revised items performed well. Four new items correlated with the weighted average score (Kendall's Tau -.388, -.445, -.497, -.569). An exploratory analysis of convergent validity found correlations in the expected direction with cognitive and functional measures. CONCLUSION The A-IADL-Q-UK provides a measurement of functional decline for use in the UK that captures culturally relevant activities. A new self-report version has been developed and is ready for testing. Further evaluation of the A-IADL-Q-UK for construct validity is now needed.
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Jakobsson E, Nygård L, Kottorp A, Bråkenhielm Olsson C, Malinowsky C. Does the purpose matter? A comparison of everyday information and communication technologies between eHealth use and general use as perceived by older adults with cognitive impairment. Disabil Rehabil Assist Technol 2020; 17:897-906. [PMID: 32954891 DOI: 10.1080/17483107.2020.1821103] [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: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Everyday information and communication technologies (EICTs) are increasingly being used in our society, for both general and health-related purposes. This study aims to compare how older adults with cognitive impairment perceive relevance and level of EICT challenge between eHealth use and general use. METHODS This cross-sectional study includes 32 participants (65-85 years of age) with cognitive impairment of different origins (due to e.g., stroke or dementia). The Short Everyday Technology Use Questionnaire+ (S-ETUQ+) was used, providing information about the relevance of EICTs and measuring the EICT level of challenge. Data were analysed with descriptive statistics, standardized z-tests and Fisher's exact tests. The significance level was set to p < .05. RESULTS The result shows that the perceived amount of relevant EICTs for eHealth use was lower in all 16 EICTs compared to those of general use. About the perceived level of challenge, a significant difference was detected in one of the seven included EICTs between eHealth use and general use. CONCLUSIONS In this sample, all EICTs were perceived as having lower relevance for eHealth use compared to general use, suggesting that the purpose of using an EICT affects the perceived relevance of it. Also, once an EICT is perceived as relevant and used for eHealth purposes, there seem to be little to no differences in perceived challenge compared to the same EICT used for general purposes.Implications for rehabilitationAll stakeholders, including health care providers, need to be aware of the hindrances that come with digitalization, making it challenging to many citizens to make use of digital solutions.It is of great importance that social services including eHealth services be tailored to suit the individual/target group.Older adults may need support and an introduction to EICTs to discover the potential relevance of the specific device and/or service.
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Affiliation(s)
- Elin Jakobsson
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Louise Nygård
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Anders Kottorp
- Faculty of Health and Society, Malmö University, Malmö, Sweden
| | | | - Camilla Malinowsky
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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de Mendonça A, Cardoso S, Maroco J, Guerreiro M, Carmo JC. The update of semantic memories in amnestic mild cognitive impairment. J Neuropsychol 2020; 15 Suppl 1:27-40. [PMID: 32542952 DOI: 10.1111/jnp.12217] [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] [Received: 07/18/2019] [Revised: 04/01/2020] [Indexed: 12/19/2022]
Abstract
It is still controversial to what extent neocortical consolidated memories are susceptible of change by processes of reconsolidation and transformation throughout experience, and whether the medial temporal lobes are necessary for this update of semantic consolidated memories, as they are for episodic remembering. We hypothesize that patients with amnestic mild cognitive impairment (aMCI) who have deficits in episodic memory may also have difficulties in updating information on added new features of objects. Sixteen participants with aMCI and 20 healthy control participants performed a semantic word-to-picture task, in which they were asked to identify as belonging to a given semantic category NEW objects, that have incorporated novel features, as well as OLD items, semantically and visually SIMILAR items and UNRELATED items. Patients with aMCI made a greater percentage of errors than healthy controls. Participants globally made greater percentages of errors in difficult types of items, namely NEW and SIMILAR, as compared to easier ones, OLD and UNRELATED. Importantly, an item by diagnostic group interaction effect was observed, and post hoc analysis showed that patients with aMCI made a higher percentage of errors than controls in NEW items only. In conclusion, patients with aMCI had a particular difficulty in identifying the NEW items of the word-to-picture task as compared to the control participants, supporting the concept of a flexible and dynamic conceptual knowledge system, involving the update of semantic memories and the integration of new attributes in a constant transformation process, which is impaired in these patients.
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Affiliation(s)
| | | | - João Maroco
- Instituto Superior de Psicologia Aplicada, Lisboa, Portugal
| | | | - Joana C Carmo
- Faculdade de Psicologia, Universidade de Lisboa, Portugal
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Wallcook S, Malinowsky C, Nygård L, Charlesworth G, Lee J, Walsh R, Gaber S, Kottorp A. The perceived challenge of everyday technologies in Sweden, the United States and England: Exploring differential item functioning in the everyday technology use questionnaire. Scand J Occup Ther 2020; 27:554-566. [PMID: 32150507 DOI: 10.1080/11038128.2020.1723685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: The changing technological environment is reflected in regular updates made to the everyday technology (ET) use questionnaire (ETUQ). Newly added ETs may not present comparable challenges across countries and diagnoses.Aims: To identify whether country context, or dementia diagnosis, impact ETs' challenge level.Material and methods: 315 older adults from three countries were included; Sweden (n = 73), United States (n = 114), England (n = 128), and had a confirmed diagnosis of mild dementia (n = 99) or no known cognitive impairment (n = 216). Differential Items Functioning (DIF) analysis was performed on 88 ETs included in the ETUQ by country and diagnosis. The impact of DIF was evaluated in a Differential Test Functioning (DTF) analysis.Results: Nine items (10.2%) in the ETUQ showed statistically significant DIF between countries; five of which were public space ETs and none of which were information and communication technologies (ICTs). Three ICT items, and no others, showed significant DIF by diagnosis. The items' DIF was shown to have no impact upon person measures of ability to use ET in the DTF.Conclusions and significance: The utility of the ETUQ in occupational therapy practice and research internationally is highlighted through the stability of the challenge hierarchy and lack of impact on person measures.
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Affiliation(s)
- Sarah Wallcook
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.,Faculty of Brain Sciences, University College London, London, UK
| | - Camilla Malinowsky
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - Louise Nygård
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - Georgina Charlesworth
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Jenica Lee
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Ryan Walsh
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Sophie Gaber
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.,Faculty of Brain Sciences, University College London, London, UK
| | - Anders Kottorp
- Faculty of Health and Society, Malmö University, Malmö, Sweden
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Anderberg P, Barnestein-Fonseca P, Guzman-Parra J, Garolera M, Quintana M, Mayoral-Cleries F, Lemmens E, Sanmartin Berglund J. The Effects of the Digital Platform Support Monitoring and Reminder Technology for Mild Dementia (SMART4MD) for People With Mild Cognitive Impairment and Their Informal Carers: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e13711. [PMID: 31228177 PMCID: PMC6611150 DOI: 10.2196/13711] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/09/2019] [Accepted: 05/25/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Many countries are witnessing a trend of growth in the number and proportion of older adults within the total population. In Europe, population aging has had and will continue to have major social and economic consequences. This is a fundamentally positive development where the added life span is of great benefit for both the individual and the society. Yet, the risk for the individual to contract noncommunicable diseases and disability increases with age. This may adversely affect the individual's ability to live his or her life in the way that is desired. Cognitive conditions constitute a group of chronic diseases that predominantly affects older people. Recent technology advancements can help support the day-to-day living activities at home for people with cognitive impairments. OBJECTIVE A digital platform (Support Monitoring and Reminder for Mild Dementia; SMART4MD) is created to improve or maintain the quality of life for people with mild cognitive impairment (PwMCI) and their carers. The platform will provide reminders, information, and memory support in everyday life, with the purpose of giving structure and lowering stress. In the trial, we will include participants with a diagnosed neurocognitive disorder as well as persons with an undiagnosed subjective memory problem and cognitive impairment, that is, 20 to 28 points on the Mini-Mental State Examination. METHODS A pragmatic, multicenter RCT is being conducted in Spain, Sweden, and Belgium. The targets for recruitment are 1200 dyads-split into an intervention group and a control group that are in usual care. Intervention group participants will be provided with a data-enabled computer tablet with the SMART4MD app. Its core functionalities, intended to be used daily at home, are based on reminders, cognitive supporting activities, and sharing health information. RESULTS Inclusion of participants started in December 2017, and recruitment is expected to end in February 2019. Furthermore, there will be 3 follow-up visits at 6, 12, and 18 months after the baseline visit. CONCLUSIONS This RCT is expected to offer benefits at several levels including in-depth knowledge of the possibilities of introducing a holistic multilayered information and communication technology solution for this group. SMART4MD has been developed in a process involving the structured participation of PwMCI, their informal carers, and clinicians. The adoption of SMART4MD faces the challenge of this age group's relative unfamiliarity with digital devices and services. However, this challenge can also be an opportunity for developing a digital device tailored to a group at risk of digital exclusion. This research responds to the wider call for the development of digital devices which are accessible and affordable to older people and this full scale RCT can hopefully serve as a model for further studies in this field. TRIAL REGISTRATION ClinicalTrials.gov NCT03325699; https://clinicaltrials.gov/ct2/show/NCT03325699. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/13711.
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Affiliation(s)
- Peter Anderberg
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Pilar Barnestein-Fonseca
- Research Unit, La Unidad de Gestión Clínica de Mental Health, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario Málaga, Malaga, Spain
| | - Jose Guzman-Parra
- Research Unit, La Unidad de Gestión Clínica de Mental Health, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario Málaga, Malaga, Spain
| | - Maite Garolera
- Brain, Cognition and Behavior - Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain
| | - María Quintana
- Brain, Cognition and Behavior - Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain
| | - Fermin Mayoral-Cleries
- Research Unit, La Unidad de Gestión Clínica de Mental Health, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario Málaga, Malaga, Spain
| | - Evi Lemmens
- University Colleges Leuven-Limburg, Genk, Belgium
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Abstract
There is no doubt that the term mild cognitive impairment (MCI) has become popular in the last decades (Flicker et al., 1991; Petersen et al., 1997). A superficial quantification of the publications that include said term in the title in the Web of Science yields 9,334 citations, including 6,553 articles, 667 reviews, 187 editorials, 37 books, and 249 patents.
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The concept of mild cognitive impairment: a victim of its ubiquity. Int Psychogeriatr 2018; 30:1423-1425. [PMID: 30426915 DOI: 10.1017/s1041610218001850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Mild cognitive impairment (MCI) is a term used to describe individuals with cognitive impairment that is not severe enough to affect daily functioning (e.g. Petersen, 2004; Winblad et al., 2004). Although MCI has been used to describe cognitive abnormality due to any number of causes that can be progressive, stable, or reversible, it is most often considered to be a transition phase between normal cognition and dementia.
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Abstract
Mild cognitive impairment (MCI) is a clinical condition conceptualized as a stage between normal cognition and dementia. To diagnose it requires subjective cognitive impairment, evidence of cognitive impairment on cognitive testing but no abnormality in a person's functioning and no evidence of dementia (American Psychiatric Association, 2013). There has been growing interest in the condition over the past two decades or so because people with MCI are much more likely than people with no cognitive impairment to progress to dementia (Roberts et al., 2013). However, a significant percentage of people with MCI will not progress to dementia and some will revert to having normal cognition. Rates of progression and reversion to normal cognition vary widely in different studies (Manly et al., 2008). People with MCI experience worry about their symptoms and this is partly alleviated by receiving a diagnosis of MCI and being reassured they do not have dementia (Gomersall et al., 2017). The benefits of diagnosis also include gaining a greater understanding of their symptoms and accessing clinical support but a significant amount of uncertainty remains with regards to the risk of progression and recipients of the diagnosis remain frustrated at the lack of treatments for MCI (Gomersall et al., 2017). There has been much interest in improving the prediction of progression to dementia from MCI but to date, the best predictors of progression remain structured clinical and functional assessments, with some additional benefit from measures of cortical volume/thickness from brain imaging (Korolev et al., 2016). As yet, however, there are no interventions that can prevent (Kane et al., 2017) or treat (Cooper et al., 2013) MCI so it seems set to remain an important clinical entity for the foreseeable future.
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