Everyday technology use among older adults in Sweden and Japan: A comparative study

Use and benefit of information, communication, and assistive technology among community-dwelling older adults - a cross-sectional study

BACKGROUND

Technology can support healthy aging and empower older adults to live independently. However, technology adoption by older adults, particularly assistive technology (AT), is limited and little is known about the types of AT used among older adults. This study explored the use of key information and communication technologies (ICT) and AT among community-dwelling adults aged ≥ 65.

METHODS

A cross-sectional study was conducted among community-dwelling adults aged ≥ 65 in southern Germany using a paper-based questionnaire. The questionnaire included questions on the three domains sociodemographic aspects, health status, and technology use. Technology use was considered separately for key ICT (smartphone, computer/laptop, and tablet) and a range of 31 different AT. Data were analyzed using descriptive statistics, univariate analyses, and Bernoulli Naïve Bayes modelling.

RESULTS

The questionnaire was answered by 616 participants (response rate: 24.64%). ICT were used by 497 (80.68%) participants and were associated with lower age, higher level of education, living together with someone, availability of internet connection, higher interest in technology, and better health status (p < .05). No association was found with sex and size of the hometown. The most frequently owned AT were a landline phone, a body scale, and a blood pressure monitor. Several AT related to functionality, (instrumental) activities of daily living- (IADL), and morbidity were used more frequently among non-ICT users compared to ICT-users: senior mobile phone (19.33% vs. 3.22%), in-house emergency call (13.45% vs. 1.01%), hearing aid (26.89% vs. 16.7%), personal lift (7.56% vs. 1.61%), electronic stand-up aid (4.2% vs. 0%). Those with higher interest in technology reported higher levels of benefit from technology use.

CONCLUSIONS

Despite the benefits older adults can gain from technology, its use remains low, especially among those with multimorbidity. Particularly newer, more innovative and (I)ADL-related AT appear underutilized. Considering the potential challenges in providing adequate care in the future, it may be crucial to support the use of these specific AT among older and frailer populations. To focus scientific and societal work, AT with a high impact on autonomy ((I)ADL/disease-related) should be distinguished from devices with a low impact on autonomy (household-/ comfort-related).

Test-retest reliability of the short version of the everyday technology use questionnaire (S-ETUQ)

Background: Everyday technologies (ET) such as smart phones, and internet banking are increasingly incorporated into daily activities. Therefore, valid assessments are needed to identify ability in ET use and to design and evaluate interventions.Aims: To evaluate and compare the stability over time (test-retest reliability) of measures generated with the short version of the Everyday Technology Use Questionnaire (S-ETUQ) in older adults with cognitive impairment or mild dementia.Materials and Methods: Data was collected with S-ETUQ at two occasions (m = 20.9 days in between) in a sample of (n = 73) older adults with cognitive impairment of different origin (n = 38) or mild dementia (n = 35). Stability of each participant's S-ETUQ measure was examined using standardised difference z-comparisons. The test-retest reliability coefficient of the S-ETUQ measures was determined by Intraclass Correlation Coefficients. Comparisons were performed using Mann-Whitney u-tests.Results: The S-ETUQ measures were statistically stable between the two occasions. Hence, the group of persons with cognitive impairment demonstrated slightly higher stability and fewer differences compared to the group with mild dementia. The ICCs (0.82-0.90) indicated good to excellent agreement.Conclusions: S- ETUQ can be used with older people with cognitive impairments of varying degree to gather reliable and precise information regarding their use of ET.

The perceived challenge of everyday technologies in Sweden, the United States and England: Exploring differential item functioning in the everyday technology use questionnaire

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.

Effectiveness of using assistive technology for time orientation and memory, in older adults with or without dementia

AIMS

The purposes of this study were to reveal the effectiveness of an electric calendar, showing the date and schedule automatically for older people, and to prove the characteristics of appropriate users.

MATERIAL AND METHODS

The participants were 27 older adults with or without dementia (9 men and 18 women, mean age: 81.5 ± 6.9 years, range: 72-94 years). The study design was a cross-over randomized controlled trial, with 15 participants (55.6%) allocated to the first group to use the electric calendar, and 12 participants (44.4%) to the second intervention group. The outcome measures are daily behaviors and cognitive function assessed by the Mini-Mental State Examination and Neurobehavioral Cognitive Status Examination.

RESULTS

Participants showed significant increase in total Mini-Mental State Examination score (p = 0.020, a paired t-test) after intervention period, whereas there was no significant difference after no intervention. Daily activities related healthcare were improved. The participants with positive outcomes showed higher motivations, and around 18 points in Mini-Mental State Examination. Most healthy older adults mentioned that electric calendars were useful, but unnecessary.

CONCLUSION AND SIGNIFICANCE

Using the electric calendar was effective in improving global cognitive function and daily activities. The target users are older people, who (1) might have mild dementia, (2) have difficulties in daily activities, (3) can be supported by caregivers, and (4) have positive motivation to new technologies.IMPLICATIONS FOR REHABILITATIONAn electric calendar is effective on grovel cognitive function, and activities of daily living related to healthcare in older adults, as well as reality orientation therapy.The electric calendar can be useful for older people with mild dementia or mild cognitive impairment, having difficulties activities of daily living, supported by caregivers at regular intervals.