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Chien SY, Zaslavsky O, Berridge C. Technology Usability for People Living With Dementia: Concept Analysis. JMIR Aging 2024; 7:e51987. [PMID: 38959053 PMCID: PMC11255540 DOI: 10.2196/51987] [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: 08/20/2023] [Revised: 01/04/2024] [Accepted: 04/30/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Usability is a key indicator of the quality of technology products. In tandem with technological advancements, potential use by individuals with dementia is increasing. However, defining the usability of technology for individuals with dementia remains an ongoing challenge. The diverse and progressive nature of dementia adds complexity to the creation of universal usability criteria, highlighting the need for focused deliberations. Technological interventions offer potential benefits for people living with dementia and caregivers. Amid COVID-19, technology's role in health care access is growing, especially among older adults. Enabling the diverse population of people living with dementia to enjoy the benefits of technologies requires particular attention to their needs, desires, capabilities, and vulnerabilities to potential harm from technologies. Successful technological interventions for dementia require meticulous consideration of technology usability. OBJECTIVE This concept analysis aims to examine the usability of technology in the context of individuals living with dementia to establish a clear definition for usability within this specific demographic. METHODS The framework by Walker and Avant was used to guide this concept analysis. We conducted a literature review spanning 1984 to 2024, exploring technology usability for people with dementia through the PubMed, Web of Science, and Google Scholar databases using the keywords "technology usability" and "dementia." We also incorporated clinical definitions and integrated interview data from 29 dyads comprising individuals with mild Alzheimer dementia and their respective care partners, resulting in a total of 58 older adults. This approach aimed to offer a more comprehensive portrayal of the usability needs of individuals living with dementia, emphasizing practical application. RESULTS The evidence from the literature review unveiled that usability encompasses attributes such as acceptable learnability, efficiency, and satisfaction. The clinical perspective on dementia stages, subtypes, and symptoms underscores the importance of tailored technology usability assessment. Feedback from 29 dyads also emphasized the value of simplicity, clear navigation, age-sensitive design, personalized features, and audio support. Thus, design should prioritize personalized assistance for individuals living with dementia, moving away from standardized technological approaches. Synthesized from various sources, the defined usability attributes for individuals living with dementia not only encompass the general usability properties of effectiveness, efficiency, and satisfaction but also include other key factors: adaptability, personalization, intuitiveness, and simplicity, to ensure that technology is supportive and yields tangible benefits for this demographic. CONCLUSIONS Usability is crucial for people living with dementia when designing technological interventions. It necessitates an understanding of user characteristics, dementia stages, symptoms, needs, and tasks, as well as consideration of varied physical requirements, potential sensory loss, and age-related changes. Disease progression requires adapting to evolving symptoms. Recommendations include versatile, multifunctional technology designs; accommodating diverse needs; and adjusting software functionalities for personalization. Product feature classification can be flexible based on user conditions.
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Affiliation(s)
- Shao-Yun Chien
- School of Nursing, University of Washington, Seattle, WA, United States
| | - Oleg Zaslavsky
- School of Nursing, University of Washington, Seattle, WA, United States
| | - Clara Berridge
- School of Social Work, University of Washington, Seattle, WA, United States
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Jutai JW, Hatoum F, Bhardwaj D, Hosseini M. Implementation of digital health technologies for older adults: a scoping review. FRONTIERS IN AGING 2024; 5:1349520. [PMID: 38784681 PMCID: PMC11112488 DOI: 10.3389/fragi.2024.1349520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/17/2024] [Indexed: 05/25/2024]
Abstract
The critical importance of technological innovation in home care for older adults is indisputable. Less well understood is the question of how to measure its performance and impact on the delivery of healthcare to older adults who are living with chronic illness and disability. Knowing how well digital technologies, such as smartphones, tablets, wearable devices, and Ambient Assisted Living Technologies (AAL) systems "work" should certainly include assessing their impact on older adults' health and ability to function in daily living but that will not guarantee that it will necessarily be adopted by the user or implemented by a healthcare facility or the healthcare system. Technology implementation is a process of planned and guided activities to launch, introduce and support technologies in a certain context to innovate or improve healthcare, which delivers the evidence for adoption and upscaling a technology in healthcare practices. Factors in addition to user acceptance and clinical effectiveness require investigation. Failure to appreciate these factors can result in increased likelihood of technology rejection or protracted procurement decision at the "adoption decision" stage or delayed or incomplete implementation or discontinuance (following initial adoption) during implementation. The aim of our research to analyze research studies on the effectiveness of digital health technologies for older adults to answer the question, "How well do these studies address factors that affect the implementation of technology?" We found common problems with the conceptualization, design, and methodology in studies of digital technology that have contributed to the slow pace of implementation in home care and long-term care. We recommend a framework for improving the quality of research in this critical area. Systematic Review Registration: https://archive.org/details/osf-registrations-f56rb-v1, identifier osf-registrations-f56rb-v1.
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Affiliation(s)
- Jeffrey W. Jutai
- Interdisciplinary School of Health Sciences and AGE-WELL Network of Centres of Excellence, University of Ottawa, Ottawa, ON, Canada
| | - Farah Hatoum
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Devvrat Bhardwaj
- School of Electrical Engineering and Computer Science, University of Ottawa, Ottawa, ON, Canada
| | - Marjan Hosseini
- School of Rehabilitation Sciences and AGE-WELL Network of Centres of Excellence, University of Ottawa, Ottawa, ON, Canada
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Tian YJA, Felber NA, Pageau F, Schwab DR, Wangmo T. Benefits and barriers associated with the use of smart home health technologies in the care of older persons: a systematic review. BMC Geriatr 2024; 24:152. [PMID: 38355464 PMCID: PMC10865618 DOI: 10.1186/s12877-024-04702-1] [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: 11/05/2022] [Accepted: 01/11/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Smart home health technologies (SHHTs) have been discussed in the frame of caregiving to enable aging-in-place and independence. A systematic review was conducted in accordance with the PRISMA guidelines to gather the up-to-date knowledge on the benefits and barriers of using SHHTs in the care of older persons from the perspective of older persons and their caregivers. METHODS Ten electronic databases were reviewed for empirical peer-reviewed literature published from 01.01.2000 to 31.12.2021 in English, German, and French reporting on experimental, qualitative, quantitative, and other empirical study designs were included. Included studies contained user-feedback from older persons over 65 years of age or their caregivers (formal and informal). We used an extraction document to collect relevant data from all included studies and applied narrative synthesis to analyze data related to benefits and barriers of SHHTs. RESULTS 163 empirical peer-reviewed articles were included, the majority of those published between 2014 and 2021. Five first-order categories of benefits and five of barriers were found with individual sub-themes. SHHTs could be useful in the care context where continuous monitoring is needed. They improve self-management and independent living of older persons. Barriers currently exist with respect to ease of usability, social acceptance, and cost. CONCLUSIONS SHHTs could be useful in the care context but are not without concerns. Researchers and policy makers can use the information as a starting point to better understand how the roles and outcomes of SHHTs could be improved for the care of older persons, while caregivers of older adults could use our findings to comprehend the scope of SHHTs and to decide when and where such technology could best address their individual family needs. Limitations lie in the possible exclusion of relevant articles published outside the inclusion criteria as well as the fact that due to digital divide, our review represents opinions of those who could and wanted to participate in the included 163 studies. TRIAL REGISTRATION This review has been registered as PROSPERO CRD42021248543. A protocol was completed in March 2021 with the PRISMA-P guidance. We have extended the review period from 2000 to 2020 since the registration of the protocol to 2000-2021.
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Affiliation(s)
| | | | - Félix Pageau
- Centre d'excellence sur le vieillissement de Québec, VITAM- Research Center on Sustainable Health, Laval University, Quebec City, QC, Canada
- Division of Geriatrics, Department of Medicine, Laval University, Quebec City, QC, Canada
| | - Delphine Roulet Schwab
- School of nursing sciences, La Source, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, 4056, Switzerland
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Tsertsidis A, Kolkowska E, Rapado I. Consumer direction in the field of digital technologies and people with dementia: a literature review. Disabil Rehabil Assist Technol 2023; 18:1364-1376. [PMID: 34927508 DOI: 10.1080/17483107.2021.2008529] [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: 02/09/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Digital technologies have a great potential to improve the quality of life of people with dementia. However, this group is usually not involved in their development and dissemination. A consumer-directed role in the delivery of digital technologies could allow this group to regain autonomy and certain independence. This article aims to conceptualise the components of the Consumer Direction theory in the context of digital technologies and people with dementia. METHOD A literature review was conducted. We searched for studies within the aforementioned context in five relevant databases, covering the years 2012-2020. Identified studies were screened and assessed for inclusion. The data were categorised using two-stage qualitative content analysis. RESULTS Forty articles were included. The results provide definitions of the four components of the Consumer Direction theory in the context of this study. Namely, what it means for people with dementia to be (1) in control of technology use, (2) offered a variety of technological options, (3) informed and supported regarding the use and training of digital technologies, and (4) actively participating in systems design. These can lead to the empowerment of people with dementia. CONCLUSION The four theoretical components of the Consumer Direction theory are conceptualised differently in the context of this study. By providing new definitions, this paper contributes to research and practice. We expect the definitions to be deployed by researchers, practitioners, and policymakers for the creation of a more consumer-directed delivery of digital technologies to people with dementia.Implications for rehabilitationDigital technologies have a great potential to improve the quality of life of people with dementia.A consumer-directed role in the delivery of digital technologies could empower people with dementia and give them the opportunity to take control over the offered services as well as maintain a degree of independence.The Consumer Direction theory and its components should be conceptualised differently in the context of digital technologies and people with dementia than in previous contexts that used the theory.The new definitions can be utilised by researchers, practitioners and policymakers for the creation of a more consumer-directed delivery of digital technologies to people with dementia.
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Affiliation(s)
| | - Ella Kolkowska
- Department of Informatics, Örebro University, Örebro, Sweden
| | - Irene Rapado
- Department of Philosophy, Linguistics and Theory of Science, Gothenburg University, Gothenburg, Sweden
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Xavier Macedo de Azevedo F, Heimgärtner R, Nebe K. Development of a metric to evaluate the ergonomic principles of assistive systems, based on the DIN 92419. ERGONOMICS 2023; 66:821-848. [PMID: 36137226 DOI: 10.1080/00140139.2022.2127920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/18/2022] [Indexed: 05/24/2023]
Abstract
The DIN 92419 defines six principles for assistive systems' ergonomic design. There is, however, a lack of measurement tools to evaluate assistive systems considering these principles. Consequently, this study developed a measurement tool for the quantitative evaluation of the fulfilment of each principle for assistive systems. A systematic literature review was performed to identify dimensions belonging to the principles, identify how previous research evaluated these dimensions, and develop a measurement tool for assistive systems. Findings show that scales commonly used for evaluating assistive systems disregard several aspects highlighted as relevant by research, implying the need for considering the DIN 92419 principles. Based on established scales and theoretical findings, a questionnaire, and a checklist for evaluating assistive systems were developed. The work provides a grounding for measuring relevant aspects of assistive systems. Further development is needed to substantiate the reliability and validity of the proposed questionnaire scales and items. Practitioner Summary: Responding to the gap of a holistic measurement tool to evaluate assistive systems, a systematic literature review was performed considering the DIN 92419 principles. This resulted in a comprehensive summary of relevant aspects of assistive systems that were made numerically measurable, which proposes better criteria to assess assistive systems. Abbreviations: IoT: internet of things; RQ: research question; TAM: technology acceptance model; UTAUT: unified theory of acceptance and use of technology; AaaS: adaptivity as a service; SAR: socially assistive robots; SEEV: salience, effort, expectancy, and value; PRISMA: preferred reporting items for systematic reviews and meta-analyses; HMI: human-machine interaction; HRI: human-robot interaction; BCI: brain-computer interface; QUEST: Quebec user evaluation of satisfaction with assistive technology; SUS: system usability scale; NASA-TLX: NASA task load index; ATD PA: assistive technology device predisposition assessment; Wheel Con: wheelchair use confidence scale; CATOM: caregiver assistive technology outcome measure; CBI: caregiver burden inventory; RoSAS: robotic social attributes scale; WheelCon: wheelchair use confidence scale; IMI: intrinsic motivation inventory; ATD PA: assistive technology device predisposition assessment; UEQ: User experience questionnaire; USEUQ: usefulness satisfaction and ease of use questionnaire; USPW: usability scale for power wheelchairs; UES: user engagement scale; SUTAQ: service user technology acceptability questionnaire; QUEAD: questionnaire for the evaluation of physical assistive devices; FATCAT: functional assessment tool for cognitive assistive technology; SE-HRI: human-robot interaction scale; SART: situation awareness rating technique; TSQ;WT: tele-healthcare satisfaction questionnaire-wearable technology; PAIF: participants' assessment of the intervention's feasibility; SWAT: subjective workload assessment technique; MARS-HA: measure of audiologic rehabilitation self-efficacy for hearing aids; IOI-HA: International outcome inventory for hearing aids; FMA: functional mobility assessment; FBIS: familiarity and behavioural intention survey; CSQ: client satisfaction questionnaire; COPM: canadian occupational performance measure; ATCS: assistive technology confidence scale; ACC: acceptance; SSP: safety, security and privacy; OPT: optimisation of resultant internal load; CTRL: controllability; ADAPT: adaptability; P&I: perceptibility and identifiability; AAL: ambient assisted living; VR: virtual reality; AS: assistive system; WEIRD: Western, educated, industrialised, rich, and democratic; HEART: horizontal european activities of rehabilitation technology; AAATE: advancement of assistive technology in Europe's; GATE: global collaboration on assistive technology; ATA-C: assistive technology assessment toolkit.
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Affiliation(s)
| | - Rüdiger Heimgärtner
- Faculty of Communication and Environment, Rhine-Waal University of Applied Sciences, Kamp-Lintfort, Germany
| | - Karsten Nebe
- Faculty of Communication and Environment, Rhine-Waal University of Applied Sciences, Kamp-Lintfort, Germany
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Felber NA, Tian YJ, Pageau F, Elger BS, Wangmo T. Mapping ethical issues in the use of smart home health technologies to care for older persons: a systematic review. BMC Med Ethics 2023; 24:24. [PMID: 36991423 PMCID: PMC10061702 DOI: 10.1186/s12910-023-00898-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/02/2023] [Indexed: 03/31/2023] Open
Abstract
Abstract
Background
The worldwide increase in older persons demands technological solutions to combat the shortage of caregiving and to enable aging in place. Smart home health technologies (SHHTs) are promoted and implemented as a possible solution from an economic and practical perspective. However, ethical considerations are equally important and need to be investigated.
Methods
We conducted a systematic review according to the PRISMA guidelines to investigate if and how ethical questions are discussed in the field of SHHTs in caregiving for older persons.
Results
156 peer-reviewed articles published in English, German and French were retrieved and analyzed across 10 electronic databases. Using narrative analysis, 7 ethical categories were mapped: privacy, autonomy, responsibility, human vs. artificial interactions, trust, ageism and stigma, and other concerns.
Conclusion
The findings of our systematic review show the (lack of) ethical consideration when it comes to the development and implementation of SHHTs for older persons. Our analysis is useful to promote careful ethical consideration when carrying out technology development, research and deployment to care for older persons.
Registration
We registered our systematic review in the PROSPERO network under CRD42021248543.
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Manchanda N, Aggarwal A, Setya S, Talegaonkar S. Digital Intervention For The Management Of Alzheimer's Disease. Curr Alzheimer Res 2023; 19:CAR-EPUB-129308. [PMID: 36744687 DOI: 10.2174/1567205020666230206124155] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/08/2023] [Accepted: 01/12/2023] [Indexed: 02/07/2023]
Abstract
Alzheimer's disease (AD) is a progressive, multifactorial, chronic, neurodegenerative disease with high prevalence and limited therapeutic options, making it a global health crisis. Being the most common cause of dementia, AD erodes the cognitive, functional, and social abilities of the individual and causes escalating medical and psychosocial needs. As yet, this disorder has no cure and current treatment options are palliative in nature. There is an urgent need for novel therapy to address this pressing challenge. Digital therapeutics (Dtx) is one such novel therapy that is gaining popularity globally. Dtx provides evidence based therapeutic interventions driven by internet and software, employing tools such as mobile devices, computers, videogames, apps, sensors, virtual reality aiding in the prevention, management, and treatment of ailments like neurological abnormalities and chronic diseases. Dtx acts as a supportive tool for the optimization of patient care, individualized treatment and improved health outcomes. Dtx uses visual, sound and other non-invasive approaches for instance-consistent therapy, reminiscence therapy, computerised cognitive training, semantic and phonological assistance devices, wearables and computer-assisted rehabilitation environment to find applications in Alzheimer's disease for improving memory, cognition, functional abilities and managing motor symptom. A few of the Dtx-based tools employed in AD include "Memory Matters", "AlzSense", "Alzheimer Assistant", "smart robotic dog", "Immersive virtual reality (iVR)" and the most current gamma stimulation. The purpose of this review is to summarize the current trends in digital health in AD and explore the benefits, challenges, and impediments of using Dtx as an adjunctive therapy for the management of AD.
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Affiliation(s)
- Namish Manchanda
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences & Research University, Govt. of NCT of Delhi, New Delhi-110017, India
| | - Akanksha Aggarwal
- Delhi Institute of Pharmaceutical Sciences And Research, Delhi Pharmaceutical Sciences & Research University, Govt. of NCT of Delhi, New Delhi-110017, India
| | - Sonal Setya
- Department of Pharmacy Practice, SGT College of Pharmacy, SGT University, Gurugram, Haryana-122505, India
| | - Sushama Talegaonkar
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences & Research University, Govt. of NCT of Delhi, New Delhi-110017, India
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Facchinetti G, Petrucci G, Albanesi B, De Marinis MG, Piredda M. Can Smart Home Technologies Help Older Adults Manage Their Chronic Condition? A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1205. [PMID: 36673957 PMCID: PMC9859495 DOI: 10.3390/ijerph20021205] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/23/2022] [Accepted: 01/01/2023] [Indexed: 05/26/2023]
Abstract
The management of chronic diseases requires personalized healthcare that allows older adults to manage their diseases at home. This systematic review aimed to describe the smart home technologies used in the management of chronic diseases in older people. A systematic literature review was conducted on four databases and was reported following the PRISMA statement. Nineteen articles were included. The intervention technologies were classified into three groups: smart home, characterized by environmental sensors detecting motion, contact, light, temperature, and humidity; external memory aids, characterized by a partnership between mobile apps and smart home-based activity learning; and hybrid technology, with the integration of multiple technologies, such as devices installed at patients' homes and telemedicine. The health outcomes evaluated are vital signs, medication management, ADL-IADL, mobility, falls, and quality of life. Smart homes show great potential in the management of chronic diseases by favouring the control of exacerbations and increasing patients' safety by providing support in disease management, including support for cognitively impaired older people. The use of smart homes in the community could bring numerous benefits in terms of continuity of care, allowing the constant monitoring of older people by local and hospital health services.
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Affiliation(s)
- Gabriella Facchinetti
- Research Unit of Nursing Science, Department of Medicine and Surgery, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 00128 Rome, Italy
| | - Giorgia Petrucci
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 00128 Rome, Italy
| | - Beatrice Albanesi
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5 bis, 10126 Turin, Italy
| | - Maria Grazia De Marinis
- Research Unit of Nursing Science, Department of Medicine and Surgery, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 00128 Rome, Italy
- Campus Bio-Medico University Hospital Foundation, Via Alvaro del Portillo, 00128 Rome, Italy
| | - Michela Piredda
- Research Unit of Nursing Science, Department of Medicine and Surgery, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 00128 Rome, Italy
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Dixon E, Michaels R, Xiao X, Zhong Y, Clary P, Narayanan A, Brewer R, Lazar A. Mobile Phone Use by People with Mild to Moderate Dementia: Uncovering Challenges and Identifying Opportunities: Mobile Phone Use by People with Mild to Moderate Dementia. ASSETS. ANNUAL ACM CONFERENCE ON ASSISTIVE TECHNOLOGIES 2022; 2022:38. [PMID: 37283282 PMCID: PMC10202486 DOI: 10.1145/3517428.3544809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
With the rising usage of mobile phones by people with mild dementia, and the documented barriers to technology use that exist for people with dementia, there is an open opportunity to study the specifics of mobile phone use by people with dementia. In this work we provide a first step towards filling this gap through an interview study with fourteen people with mild to moderate dementia. Our analysis yields insights into mobile phone use by people with mild to moderate dementia, challenges they experience with mobile phone use, and their ideas to address these challenges. Based on these findings, we discuss design opportunities to help achieve more accessible and supportive technology use for people with dementia. Our work opens up new opportunities for the design of systems focused on augmenting and enhancing the abilities of people with dementia.
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Ottaviani AC, Monteiro DQ, Oliveira D, Gratão ACM, Jacinto AF, Campos CRF, Barham EJ, de Souza Orlandi F, da Cruz KCT, Corrêa L, Zazzetta MS, Pavarini SCI. Usability and acceptability of internet-based interventions for family carers of people living with dementia: systematic review. Aging Ment Health 2022; 26:1922-1932. [PMID: 34511028 DOI: 10.1080/13607863.2021.1975095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectives: Internet-based interventions can help carers of people living with dementia to cope with care-related challenges and can help improve their wellbeing. This systematic review aimed at investigating the criteria of usability and acceptability of self-guided internet-based interventions for family carers of people living with dementia. Method: Searches were conducted on PubMed, Virtual Health Library Regional Portal (Americas), MEDLINE, PsycINFO, Scopus, and Cochrane. Studies published up to December 2019, in English, Portuguese, or Spanish, were eligible. We followed the definition/criteria from ISO ISO-9241-11 for usability (efficiency, effectiveness, and satisfaction) and acceptability (barriers for using and utility). Methodological quality was evaluated using specific tools according to each study design. Results: Ten studies were included, all of which had high methodological quality. Carers of people living with dementia indicated that internet-based interventions were mostly effective, efficient, and satisfactory. They considered these to be informative, relevant, and functional, highlighting the utility and intention of using the resource in the future. The high heterogeneity in the terms and methods used to evaluate usability and acceptability hindered cross-study comparisons, however internet-based interventions were considered useful and acceptable by most carers. Conclusion: Future research should consider expanding the criteria of usability and acceptability to better reflect the needs of this population.
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Affiliation(s)
- Ana Carolina Ottaviani
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Diana Quirino Monteiro
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Déborah Oliveira
- Department of Psychiatry, School of Medicine, Universidade Federal de São Paulo, São Paul, Brazil
| | - Aline Cristina Martins Gratão
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.,Department of Gerontology, Universidade Federal de São Carlos, São Paulo, Brazil
| | | | | | - Elizabeth Joan Barham
- Graduate Program in Psychology, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.,Department of Psychology, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Fabiana de Souza Orlandi
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.,Department of Gerontology, Universidade Federal de São Carlos, São Paulo, Brazil
| | | | - Larissa Corrêa
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Marisa Silvana Zazzetta
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.,Department of Gerontology, Universidade Federal de São Carlos, São Paulo, Brazil
| | - Sofia Cristina Iost Pavarini
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.,Department of Gerontology, Universidade Federal de São Carlos, São Paulo, Brazil
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Yoon JH, Seo Y, Jo YS, Lee S, Cho E, Cazenave-Gassiot A, Shin YS, Moon MH, An HJ, Wenk MR, Suh PG. Brain lipidomics: From functional landscape to clinical significance. SCIENCE ADVANCES 2022; 8:eadc9317. [PMID: 36112688 PMCID: PMC9481132 DOI: 10.1126/sciadv.adc9317] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/01/2022] [Indexed: 05/23/2023]
Abstract
Lipids are crucial components of cellular function owing to their role in membrane formation, intercellular signaling, energy storage, and homeostasis maintenance. In the brain, lipid dysregulations have been associated with the etiology and progression of neurodegeneration and other neurological pathologies. Hence, brain lipids are emerging as important potential targets for the early diagnosis and prognosis of neurological diseases. This review aims to highlight the significance and usefulness of lipidomics in diagnosing and treating brain diseases. We explored lipid alterations associated with brain diseases, paying attention to organ-specific characteristics and the functions of brain lipids. As the recent advances in brain lipidomics would have been impossible without advances in analytical techniques, we provide up-to-date information on mass spectrometric approaches and integrative analysis with other omic approaches. Last, we present the potential applications of lipidomics combined with artificial intelligence techniques and interdisciplinary collaborative research for treating brain diseases with clinical heterogeneities.
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Affiliation(s)
- Jong Hyuk Yoon
- Neurodegenerative Diseases Research Group, Korea Brain Research Institute, Daegu 41062, Republic of Korea
| | - Youngsuk Seo
- Neurodegenerative Diseases Research Group, Korea Brain Research Institute, Daegu 41062, Republic of Korea
| | - Yeon Suk Jo
- Neurodegenerative Diseases Research Group, Korea Brain Research Institute, Daegu 41062, Republic of Korea
- Department of Brain Sciences, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Seulah Lee
- Neurodegenerative Diseases Research Group, Korea Brain Research Institute, Daegu 41062, Republic of Korea
| | - Eunji Cho
- Neurodegenerative Diseases Research Group, Korea Brain Research Institute, Daegu 41062, Republic of Korea
| | - Amaury Cazenave-Gassiot
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
- Singapore Lipidomics Incubator (SLING), Life Sciences Institute, National University of Singapore, Singapore 119077, Singapore
| | - Yong-Seung Shin
- Laboratory Solutions Sales, Agilent Technologies Korea Ltd., Seoul, 06621, Republic of Korea
| | - Myeong Hee Moon
- Department of Chemistry, Yonsei University, Seoul 03722, Republic of Korea
| | - Hyun Joo An
- Graduate School of Analytical Science and Technology, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Markus R. Wenk
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
- Singapore Lipidomics Incubator (SLING), Life Sciences Institute, National University of Singapore, Singapore 119077, Singapore
| | - Pann-Ghill Suh
- Korea Brain Research Institute, Daegu 41062, Republic of Korea
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Davitt JK, Brown J. Using Voice and Touchscreen Controlled Smart Speakers to Protect Vulnerable Clients in Long Term Care Facilities. Innov Aging 2022; 6:igac024. [PMID: 35712325 PMCID: PMC9196695 DOI: 10.1093/geroni/igac024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Objectives
The Centers for Medicare and Medicaid Services (CMS) restricted long term care (LTC) facility visitation to only essential personnel during the COVID-19 pandemic. The Maryland Department of Human Services distributed Amazon Echoshow 8 voice and touchscreen controlled smart speakers (VTCSS) to a sample of their institutionalized guardianship clients to enhance caseworker access during the pandemic.
Research Design and Methods
This pilot study focused on understanding VTCSS use challenges and the effects on clients’ safety and well-being. Two focus groups were conducted with caseworkers (N=16) who piloted the devices. The interviews were recorded, transcribed, and analyzed using open and axial coding.
Results
Four themes were identified, including challenges to providing casework during the pandemic (e.g. facility technology gaps), challenges to device installation and use (e.g. privacy concerns), strategies for overcoming challenges (e.g. alert features), and benefits (e.g. stimulation, care monitoring) and uses (e.g. enhanced access, entertainment).
Discussion and Implications
VTCSS show great promise to engage the client, maintain visual access, and monitor quality of care. However, facilitating access to such technology requires planning and training before installation.
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Affiliation(s)
- Joan K Davitt
- School of Social Work, University of Maryland, Baltimore, Maryland, USA
| | - Jocelyn Brown
- School of Social Work & School of Medicine, University of Maryland, Baltimore, Maryland, USA
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13
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Holthe T, Halvorsrud L, Lund A. Digital Assistive Technology to Support Everyday Living in Community-Dwelling Older Adults with Mild Cognitive Impairment and Dementia. Clin Interv Aging 2022; 17:519-544. [PMID: 35464157 PMCID: PMC9031989 DOI: 10.2147/cia.s357860] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/30/2022] [Indexed: 12/04/2022] Open
Abstract
Objective The objective of this review was to explore whether knowledge about and practice of technology for older adults with mild cognitive impairment (MCI) and dementia (D) had developed since our 2017 review. Furthermore, we wanted to explore the usability and acceptability of technology in the newer trials, and how these may impact quality of life, occupational performance and human dignity. Materials and Methods We searched for primary studies published between 2017 and 2020 reusing medical subject heading (MeSH) terms in five databases – Medline, PsycINFO, Embase, Amed and Cinahl – and obtained 1452 titles. The titles were divided in six piles, two for each of the three authors. The titles were sorted utilizing the Rayyan web tool. Fourteen studies were included in this review. The Mixed Method Appraisal Tool (MMAT) was used to assess the quality of the studies examined. Results This review included almost twice as many participants as in the 2007–2017 review. Since 2017, a shift seems to have occurred toward technologies that can be worn on the body to monitor body functions and report states, or imbalances. Moreover, research interest is now focused on mobile phone apps and wearables providing reminders and timely support, rather than on separate devices at home. Conclusion The studies conducted since 2017 report on wearable and environmental digital assistive technologies and often with multiple purposes. Three strategies for support seem evident: prompting and reminding people with dementia, monitoring people with dementia at home using environmental sensors and biosensors and providing safety outdoors. Thus, there is still a need for further research on the impact of technologies promoting occupational performance, quality of life, and human dignity for independent living.
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Affiliation(s)
- Torhild Holthe
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Correspondence: Torhild Holthe, Faculty of Health Sciences, Oslo Metropolitan University, PO Box 4 St. Olavs plass, Oslo, 0130, Norway, Tel +47 911 34 088, Email
| | - Liv Halvorsrud
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health and Welfare, Østfold University College, Halden, Norway
| | - Anne Lund
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Iwashita M, Ishida K, Ishikawa M. Effect of User Personality on Efficacy of a Mental Support System Based on Ambient Intelligence: A Case Study. FRONTIERS IN COMPUTER SCIENCE 2021. [DOI: 10.3389/fcomp.2021.702069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
One solution supporting a healthy mental state for humans is controlling the environment with ambient intelligence technology. We are developing a mental support system for healthy people that automatically changes environmental conditions, such as sound volume and light color, depending on the user’s mental state, which is monitored according to physiological signals such as sympathetic nerve activity. In our previous basic study under laboratory-controlled conditions, the system was applied to improve the user’s concentration level as they performed calculation tasks. Results indicated that the system improved the task performance, but individual variations existed, with some users improving greatly but others much less. For the future practical application of the system, determining the causes of the variation in efficacy is important. Considering that the brain structure and activity differ according to an individual’s personality, we investigated the relationship between the user’s personality and task performance with our system’s support. The results showed a clear correlation between the extraversion score and task performance. Our study presents an example where the system’s efficacy is sensitive to the user’s personality and indicates the importance of considering the user’s personality when designing a mental support system based on ambient intelligence.
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15
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Gillani N, Arslan T. Intelligent Sensing Technologies for the Diagnosis, Monitoring and Therapy of Alzheimer's Disease: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2021; 21:4249. [PMID: 34205793 PMCID: PMC8234801 DOI: 10.3390/s21124249] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 12/16/2022]
Abstract
Alzheimer's disease is a lifelong progressive neurological disorder. It is associated with high disease management and caregiver costs. Intelligent sensing systems have the capability to provide context-aware adaptive feedback. These can assist Alzheimer's patients with, continuous monitoring, functional support and timely therapeutic interventions for whom these are of paramount importance. This review aims to present a summary of such systems reported in the extant literature for the management of Alzheimer's disease. Four databases were searched, and 253 English language articles were identified published between the years 2015 to 2020. Through a series of filtering mechanisms, 20 articles were found suitable to be included in this review. This study gives an overview of the depth and breadth of the efficacy as well as the limitations of these intelligent systems proposed for Alzheimer's. Results indicate two broad categories of intelligent technologies, distributed systems and self-contained devices. Distributed systems base their outcomes mostly on long-term monitoring activity patterns of individuals whereas handheld devices give quick assessments through touch, vision and voice. The review concludes by discussing the potential of these intelligent technologies for clinical practice while highlighting future considerations for improvements in the design of these solutions for Alzheimer's disease.
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Affiliation(s)
- Nazia Gillani
- School of Engineering, University of Edinburgh, Edinburgh EH9 3FF, UK;
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16
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Leese MI, Dorociak KE, Noland M, Gaugler JE, Mattek N, Hughes A. Use of in-home activity monitoring technologies in older adult veterans with mild cognitive impairment: The impact of attitudes and cognition. GERONTECHNOLOGY : INTERNATIONAL JOURNAL ON THE FUNDAMENTAL ASPECTS OF TECHNOLOGY TO SERVE THE AGEING SOCIETY 2021; 20:1-12. [PMID: 34305492 PMCID: PMC8298015 DOI: 10.4017/gt.2021.20.2.10.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND As researchers incorporate in-home technologies to identify and track changes in older adults' cognitive and daily functioning that could lead to early interventions, the attitudes of older adults across the continuum from normal cognitive aging to mild cognitive impairment (MCI) must be assessed to ensure technology adoption and adherence in each unique group. OBJECTIVE This exploratory pilot study incorporated both quantitative and qualitative approaches to examine mild cognitive impairment (MCI) and cognitively intact older adults' attitudes (i.e., usability, acceptability, digital readiness, barriers) and adherence to in-home technologies after undergoing 7 months of in-home activity monitoring. METHOD Participants were 30 older adult veterans who were classified as cognitively intact (n = 15) or having mild cognitive impairment (MCI) (n = 15) and participated in a longitudinal aging and technology study that monitored their physical activity and computer use. RESULTS While MCI older adults endorsed reduced digital readiness (p =.041) and required more in-home technology maintenance visits (p =.041) from staff as compared to cognitively intact older adults, there was no difference in adherence to the study technology (p >.05). Usability and acceptability attitudes in the entire sample predicted adherence to the physical activity monitoring technology employed in the study (p =.008). CONCLUSION Findings highlight the potential gap between technology developers and older adult end users, and technologies designed specifically for older adults with MCI should be developed with direct input from older adults with MCI to promote usability and long-term adoption in this clinical population. Larger studies are needed to replicate and increase the generalizability of the current findings.
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Affiliation(s)
- Mira I. Leese
- Rosalind Franklin University of Medicine and Science, Department of Psychology, North Chicago, IL, USA
| | | | | | | | - Nora Mattek
- Oregon Health & Science University, Department of Neurology, Portland, OR, USA
- Oregon Center for Aging & Technology, Portland, OR, USA
| | - Adriana Hughes
- University of Minnesota, Minneapolis, MN, USA
- Oregon Center for Aging & Technology, Portland, OR, USA
- Minneapolis VA Health Care System, Minneapolis, MN, USA
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17
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Choukou MA, Shortly T, Leclerc N, Freier D, Lessard G, Demers L, Auger C. Evaluating the acceptance of ambient assisted living technology (AALT) in rehabilitation: A scoping review. Int J Med Inform 2021; 150:104461. [PMID: 33892446 DOI: 10.1016/j.ijmedinf.2021.104461] [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] [Received: 07/31/2020] [Revised: 03/05/2021] [Accepted: 04/06/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Ambient assisted living technologies (AALTs) are being used to help community-dwelling older adults (OAs) age in place. Although many AALT are available, their acceptance (perceived usefulness, ease of use, intention to use and actual usage) is needed to improve their design and impact. This study aims to 1) identify AALTs that underwent an acceptance evaluation in rehabilitation contexts, 2) identify methodological tools and approaches to measure acceptance in ambient assisted living (AAL) in rehabilitation research, and 3) summarize AALT acceptance results in existing rehabilitation literature with a focus on peer-reviewed scientific articles. METHODS A scoping review was conducted in the following databases: Medline, Embase, Cinahl, and PsycInfo, following the Arksey and O'Malley framework (2009). Four acceptance attributes were extracted: 'user acceptance', 'perceived usefulness', 'ease of use', and 'intention to use'. Data regarding AALT, participants, acceptance evaluation methods and results were extracted. RESULTS A total of 21 articles were included among 634 studies retrieved from the literature. We identified 51 AALTs dedicated to various rehabilitation contexts, most of which focused on monitoring OAs' activities and environmental changes. Acceptance of AALT was evaluated using interviews, questionnaires, focus groups, informal feedback, observation, card sort tasks, and surveys. Although OAs intend to use - or can perceive the usefulness of - AALTs, they are hesitant to accept the technology and have concerns about its adoption. DISCUSSION AND CONCLUSIONS The assessment of AALT acceptance in contexts of rehabilitation requires more comprehensive and standardized methodologies. The use of mixed-methods research is encouraged to cover the needs of particular studies. The timing of acceptance assessment should be considered throughout technology development phases to maximize AALT implementation.
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Affiliation(s)
- Mohamed-Amine Choukou
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada; Centre on Aging, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada.
| | - Taylor Shortly
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada
| | - Nicole Leclerc
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada
| | - Derek Freier
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada
| | - Genevieve Lessard
- Centre for Interdisciplinary Research in Rehabilitation of the Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6363 Hudson Road, Montreal, Quebec, H3S 1M9, Canada
| | - Louise Demers
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, C.P. 6128, succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada; Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre Intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, 4565 Queen Mary Road, Montreal, Quebec, H3W 1W5, Canada
| | - Claudine Auger
- Centre for Interdisciplinary Research in Rehabilitation of the Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6363 Hudson Road, Montreal, Quebec, H3S 1M9, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, C.P. 6128, succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada
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18
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Fares N, Sherratt RS, Elhajj IH. Directing and Orienting ICT Healthcare Solutions to Address the Needs of the Aging Population. Healthcare (Basel) 2021; 9:147. [PMID: 33540510 PMCID: PMC7912863 DOI: 10.3390/healthcare9020147] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND With an aging population, it is essential to maintain good health and autonomy for as long as possible. Instead of hospitalisation or institutionalisation, older people with chronic conditions can be assisted in their own home with numerous "smart" devices that support them in their activities of daily living, manage their medical conditions, and prevent fall incidents. Information and Communication Technology (ICT) solutions facilitate the monitoring and management of older people's health to improve quality of life and physical activity with a decline in caregivers' burden. METHOD The aim of this paper was to conduct a systematic literature review to analyse the state of the art of ICT solutions for older people with chronic conditions, and the impact of these solutions on their quality of life from a biomedical perspective. RESULTS By analysing the literature on the available ICT proposals, it is shown that different approaches have been deployed by noticing that the more cross-interventions are merged then the better the results are, but there is still no evidence of the effects of ICT solutions on older people's health outcomes. Furthermore, there are still unresolved ethical and legal issues. CONCLUSION While there has been much research and development in healthcare ICT solutions for the aging population, ICT solutions still need significant development in order to be user-oriented, affordable, and to manage chronic conditions in the aging wider population.
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Affiliation(s)
- Nada Fares
- Department of Biomedical Engineering, School of Biological Sciences, University of Reading, Berkshire RG6 6AY, UK;
| | - R. Simon Sherratt
- Department of Biomedical Engineering, School of Biological Sciences, University of Reading, Berkshire RG6 6AY, UK;
| | - Imad H. Elhajj
- Department of Electrical and Computer Engineering, American University of Beirut, Beirut 1107 2020, Lebanon;
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19
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Unobtrusive Health Monitoring in Private Spaces: The Smart Home. SENSORS 2021; 21:s21030864. [PMID: 33525460 PMCID: PMC7866106 DOI: 10.3390/s21030864] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/08/2021] [Accepted: 01/23/2021] [Indexed: 12/19/2022]
Abstract
With the advances in sensor technology, big data, and artificial intelligence, unobtrusive in-home health monitoring has been a research focus for decades. Following up our research on smart vehicles, within the framework of unobtrusive health monitoring in private spaces, this work attempts to provide a guide to current sensor technology for unobtrusive in-home monitoring by a literature review of the state of the art and to answer, in particular, the questions: (1) What types of sensors can be used for unobtrusive in-home health data acquisition? (2) Where should the sensors be placed? (3) What data can be monitored in a smart home? (4) How can the obtained data support the monitoring functions? We conducted a retrospective literature review and summarized the state-of-the-art research on leveraging sensor technology for unobtrusive in-home health monitoring. For structured analysis, we developed a four-category terminology (location, unobtrusive sensor, data, and monitoring functions). We acquired 912 unique articles from four relevant databases (ACM Digital Lib, IEEE Xplore, PubMed, and Scopus) and screened them for relevance, resulting in n=55 papers analyzed in a structured manner using the terminology. The results delivered 25 types of sensors (motion sensor, contact sensor, pressure sensor, electrical current sensor, etc.) that can be deployed within rooms, static facilities, or electric appliances in an ambient way. While behavioral data (e.g., presence (n=38), time spent on activities (n=18)) can be acquired effortlessly, physiological parameters (e.g., heart rate, respiratory rate) are measurable on a limited scale (n=5). Behavioral data contribute to functional monitoring. Emergency monitoring can be built up on behavioral and environmental data. Acquired physiological parameters allow reasonable monitoring of physiological functions to a limited extent. Environmental data and behavioral data also detect safety and security abnormalities. Social interaction monitoring relies mainly on direct monitoring of tools of communication (smartphone; computer). In summary, convincing proof of a clear effect of these monitoring functions on clinical outcome with a large sample size and long-term monitoring is still lacking.
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20
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Palmdorf S, Stark AL, Nadolny S, Eliaß G, Karlheim C, Kreisel SH, Gruschka T, Trompetter E, Dockweiler C. Technology-Assisted Home Care for People With Dementia and Their Relatives: Scoping Review. JMIR Aging 2021; 4:e25307. [PMID: 33470935 PMCID: PMC7857954 DOI: 10.2196/25307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/09/2020] [Accepted: 12/12/2020] [Indexed: 12/30/2022] Open
Abstract
Background Assistive technologies for people with dementia and their relatives have the potential to ensure, improve, and facilitate home care and thereby enhance the health of the people caring or being cared for. The number and diversity of technologies and research have continuously increased over the past few decades. As a result, the research field has become complex. Objective The goal of this scoping review was to provide an overview of the research on technology-assisted home care for people with dementia and their relatives in order to guide further research and technology development. Methods A scoping review was conducted following a published framework and by searching 4 databases (MEDLINE, CINAHL, PsycInfo, and CENTRAL) for studies published between 2013 and 2018. We included qualitative and quantitative studies in English or German focusing on technologies that support people with dementia or their informal carers in the home care setting. Studies that targeted exclusively people with mild cognitive impairment, delirium, or health professionals were excluded as well as studies that solely consisted of assessments without implication for the people with dementia or their relatives and prototype developments. We mapped the research field regarding study design, study aim, setting, sample size, technology type, and technology aim, and we report relative and absolute frequencies. Results From an initial 5328 records, we included 175 studies. We identified a variety of technology types including computers, telephones, smartphones, televisions, gaming consoles, monitoring devices, ambient assisted living, and robots. Assistive technologies were most commonly used by people with dementia (77/175, 44.0%), followed by relatives (68/175, 38.9%), and both target groups (30/175, 17.1%). Their most frequent goals were to enable or improve care, provide therapy, or positively influence symptoms of people with dementia (eg, disorientation). The greatest proportions of studies were case studies and case series (72/175, 41.1%) and randomized controlled trials (44/175, 25.1%). The majority of studies reported small sample sizes of between 1 and 50 participants (122/175, 69.7%). Furthermore, most of the studies analyzed the effectiveness (85/233, 36.5%) of the technology, while others targeted feasibility or usability or were explorative. Conclusions This review demonstrated the variety of technologies that support people with dementia and their relatives in the home care setting. Whereas this diversity provides the opportunity for needs-oriented technical solutions that fit individual care arrangements, it complicates the choice of the right technology. Therefore, research on the users’ informational needs is required. Moreover, there is a need for larger studies on the technologies’ effectiveness that could contribute to a higher acceptance and thus to a transition of technologies from research into the daily lives of people with dementia and their relatives.
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Affiliation(s)
- Sarah Palmdorf
- Institute for Educational and Health-care Research in the Health Sector, Bielefeld University of Applied Sciences, Bielefeld, Germany
| | - Anna Lea Stark
- Centre for ePublic Health Research, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Stephan Nadolny
- Institute for History and Ethics of Medicine, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-Wittenberg, Halle, Germany.,Nursing Science Staff Unit, Franziskus-Hospital Harderberg, Niels-Stensen-Kliniken, Georgsmarienhütte, Germany
| | - Gerrit Eliaß
- Innovation & Research, Executive Department, Evangelisches Klinikum Bethel, University Hospital OWL - Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Christoph Karlheim
- Innovation & Research, Executive Department, Evangelisches Klinikum Bethel, University Hospital OWL - Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Stefan H Kreisel
- Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, University Hospital OWL - Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Tristan Gruschka
- Faculty of Social Studies, Bielefeld University of Applied Sciences, Bielefeld, Germany
| | - Eva Trompetter
- Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, University Hospital OWL - Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Christoph Dockweiler
- Centre for ePublic Health Research, School of Public Health, Bielefeld University, Bielefeld, Germany
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21
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Lang C, Roessler M, Schmitt J, Bergmann A, Holthoff-Detto V. Health-related quality of life in elderly, multimorbid individuals with and without depression and/or mild cognitive impairment using a telemonitoring application. Qual Life Res 2021; 30:2829-2841. [PMID: 33983617 PMCID: PMC8481145 DOI: 10.1007/s11136-021-02848-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE Multimorbidity leads to decreasing health-related quality of life (HRQoL). Telemedicine may help to improve HRQoL. The present study was conducted to show (I) differences in HRQoL and changes in HRQoL over time in elderly, multimorbid individuals with and without depression and/or mild cognitive impairment (MCI) using a telemonitoring application (TMA) and (II) associations between engagement with measurements by study participants using a TMA and changes in their HRQoL. METHODS The present feasibility study was part of a longitudinal intervention study. Recruited general practitioners (GPs) enrolled individuals and assigned them to risk groups according to absence/presence of depression and/or MCI. Depression was assessed using the Geriatric Depression Scale (GDS-15), MCI using the Mini-Mental State Examination (MMSE), and HRQoL using the SF-12. The TMA consisted of tablets, software, and measuring devices. Measured vital data were transferred to a care and case manager for monitoring and possible intervention. RESULTS Nine GPs recruited 177 individuals, 97 of whom were included in the HRQoL analysis. Significantly lower physical and mental component summary (PCS/MCS) scores were revealed in study participants with depression, and with both depression and MCI, compared to participants with no mental disorders. PCS scores did not differ between study dates, but MCS scores had significantly increased over time. Participants' engagement with measurements was significantly associated with an increased MCS score, but not with the PCS score. DISCUSSION Depression and/or MCI are negatively associated with the HRQoL of elderly, multimorbid people using a TMA. Engagement of individuals with vital data measurements via a TMA may increase their mental HRQoL. Mentally impaired people should be closely involved as co-designers and experts in development processes of TMAs to benefit from tailored solutions. An individual's increased mental HRQoL can be a decisive factor in their engagement with a GP treatment regimen and telemonitoring processes.
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Affiliation(s)
- Caroline Lang
- Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Martin Roessler
- Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Antje Bergmann
- Department of General Practice, Medical Clinic III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Vjera Holthoff-Detto
- Department of Psychiatry, Psychotherapy and Psychosomatics, Alexianer Hospital Hedwigshöhe, St. Hedwig Hospital Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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22
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Miguel Cruz A, Daum C, Comeau A, Salamanca JDG, McLennan L, Neubauer N, Liu L. Acceptance, adoption, and usability of information and communication technologies for people living with dementia and their care partners: a systematic review. Disabil Rehabil Assist Technol 2020; 18:443-457. [PMID: 33378627 DOI: 10.1080/17483107.2020.1864671] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE This review aims to examine the instruments, approaches, scales, or assessment tools used to evaluate technology acceptance, technology adoption, and usability of information and communication technologies (ICTs) for people living with dementia and their care partners. METHODS A systematic literature review was conducted. Studies that explored the use of instruments, approaches, scales, or assessment tools to evaluate the technology acceptance and usability of ICTs for people living with dementia and their care partners were identified through five databases: Medline, EMBASE, CINAHL, Web of Science, and Scopus. RESULTS We included 74 out of 2182 papers. The most common scales used included the System Usability Scale (SUS) (11%), the ISONORM 9241/10 Questionnaire (4%), and the Post-Study System Usability Questionnaire (PSSUQ) (4%). Most (59%) of the included approaches, however, were bespoke (i.e., created by the authors for a particular study) and were not named. The approaches or tools used to assess technology acceptance, technology adoption, and usability of ICTs that applied to people living with dementia had an average of 15 items and used an average of 5.23 scale points. CONCLUSION There is no clear, standardised approach for assessing the technology acceptance, technology adoption, and usability of ICTs for people living with dementia and their care partners. The findings of this review may be used by academics to design and implement improved and more consistent assessment tools to assess technology acceptance, technology adoption, and usability of ICTs for people living with dementia and their care partners.IMPLICATIONS FOR REHABILITATIONThe number of ICTs for people with dementia and their care partners that can be used for rehabilitation is increasingThe most commonly recognized assessment tools used in this study were the SUS, ISONORM 9241/10, and PSSUQ questionnaires.For the custom assessment tools, the average number of items included in this study was 15 with five-point bidirectional labelling.There is no clear, standardized approach for assessing the technology acceptance, technology adoption, or usability of ICTs for people with dementia and their care partners.
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Affiliation(s)
- Antonio Miguel Cruz
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.,Glenrose Rehabilitation Research, Innovation & Technology (GRRIT) Hub, Glenrose Rehabilitation Hospital, Edmonton, Canada.,Faculty of Health, University of Waterloo, Waterloo, Canada
| | - Christine Daum
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.,Faculty of Health, University of Waterloo, Waterloo, Canada
| | - Aidan Comeau
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Juan David Guevara Salamanca
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.,Department of Sociology, Faculty of Arts, University of Alberta, Edmonton, Canada
| | | | - Noelannah Neubauer
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.,Faculty of Health, University of Waterloo, Waterloo, Canada
| | - Lili Liu
- Faculty of Health, University of Waterloo, Waterloo, Canada
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Lazarou I, Stavropoulos TG, Meditskos G, Andreadis S, Kompatsiaris IY, Tsolaki M. Long-Term Impact of Intelligent Monitoring Technology on People with Cognitive Impairment: An Observational Study. J Alzheimers Dis 2020; 70:757-792. [PMID: 31256141 DOI: 10.3233/jad-190423] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Interactive smart home systems are particularly useful for people with cognitive impairment. OBJECTIVE To investigate the long-term effects of Assistive Technology (AT) combined with tailored non-pharmacological interventions for people with cognitive impairment. METHODS 18 participants (12 with mild cognitive impairment and 6 with Alzheimer's disease) took part in the study that we evenly allocated in one of three groups: 1) experimental group (EG), 2) control group 1 (CG1), and 3) control group 2 (CG2). EG received the system installed at home for 4 to 12 months, during which they received tailored non-pharmacological interventions according to system observations. CG1 received tailored interventions for the same period, but only according to state-of-the-art self-reporting methods. Finally, CG2 neither had a system installation nor received interventions. All groups underwent neuropsychological assessment before and after the observational period. RESULTS After several months of continuously monitoring at home and deployment of tailored interventions, the EG showed statistically significant improvement in cognitive function, compared to the CG1 and CG2. Moreover, EG participants, who received the sensor-based system, have shown improvement in domains such as sleep quality and daily activity, as measured by the multi-sensor system. In addition, the feedback collected from the participants concludes that the long-term use of the multi-sensor system by people with cognitive impairment can be both feasible and beneficial. CONCLUSION Deploying a sensor-based system at real home settings of people with cognitive limitations living alone and maintaining its use long-term is not only possible, but also beneficial for clinical decision making in order to tackle cognitive, functional, and behavioral related problems.
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Affiliation(s)
- Ioulietta Lazarou
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece.,1st Department of Neurology, U.H. "AHEPA", Medical School, Faculty of Healthy Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Macedonia, Greece
| | - Thanos G Stavropoulos
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Georgios Meditskos
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Stelios Andreadis
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Ioannis Yiannis Kompatsiaris
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Magda Tsolaki
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece.,1st Department of Neurology, U.H. "AHEPA", Medical School, Faculty of Healthy Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Macedonia, Greece.,Greek Association of Alzheimer's Disease and Related Disorders (GAADRD - Alzheimer Hellas), Thessaloniki, Macedonia, Greece
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A dual-factor theory of WTs adoption in aged care service operations – a cross-country analysis. INFORMATION TECHNOLOGY & PEOPLE 2020. [DOI: 10.1108/itp-10-2018-0449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study focuses on the adoption of wearable technologies in a context where care-providing organizations can offer, in collaboration with caregivers, better care. Drawing on dual-factor theory and from the caregiver perspective, this study identifies and examines factors of technology adoption in four developing countries.Design/methodology/approachThis study was undertaken using a quantitative approach. A survey was distributed among 1,013 caregivers in four developing countries in Asia including Iran, Azerbaijan, Turkmenistan and Iraq and collected quantitative data for model validation and hypotheses analysis. Building on the technology adoption literature, we identified six constructs that impact the behavioral intention of caregivers to use wearable technologies in aged care-providing organizations.FindingsOur dual-factor model was successfully validated, and all hypotheses were supported. However, different results were found in the selected countries within the cross-country analysis.Originality/valueThis study has significant implications for the study of emerging technologies in aged care service operations. It provides a theoretical framework that may be adapted for future research, enabling practitioners in aged care to better understand the crucial role of technology adoption in service operations. Less attention was paid to the adoption of wearable technologies in aged care, particularly in developing countries, where healthcare services in aged care impose heavy costs on care providers.
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De Vito AN, Sawyer RJ, LaRoche A, Arredondo B, Mizuki B, Knoop C. Acceptability and Feasibility of a Multicomponent Telehealth Care Management Program in Older Adults With Advanced Dementia in a Residential Memory Care Unit. Gerontol Geriatr Med 2020; 6:2333721420924988. [PMID: 32577434 PMCID: PMC7288813 DOI: 10.1177/2333721420924988] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 04/06/2020] [Accepted: 04/17/2020] [Indexed: 11/17/2022] Open
Abstract
The aim of the current study was to examine the acceptability and feasibility of
a multicomponent care management program in older adults with advanced dementia
in a long-term memory care unit. Eighteen older adults with moderate to severe
dementia were asked to wear an activity monitor (Fitbit Charge 2 HR) and
participate in a once monthly telehealth intervention via iPads over a 6-month
period. Activity monitor data were used to assess compliance. Acceptability was
assessed through qualitative interviews conducted with the caregiving staff on
the memory unit. The care management program was acceptable to residents and
their caregivers. Results indicated that the care management program is feasible
in older adults with advanced dementia although activity monitor adherence was
better during the day than at night. Telehealth session compliance was excellent
throughout the study. A long-term multicomponent dementia care program is
acceptable and feasible in individuals with advanced dementia. Future studies
should aim to evaluate whether data received from activity monitors can be used
in a dementia care intervention program.
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Affiliation(s)
- Alyssa N De Vito
- Department of Psychology, Louisiana State University, Baton Rouge, USA
| | - R John Sawyer
- Department of Neurology, Ochsner Medical Center, Jefferson, LA, USA
| | - Ashley LaRoche
- Department of Neurology, Ochsner Medical Center, Jefferson, LA, USA
| | - Beth Arredondo
- Department of Neurology, Ochsner Medical Center, Jefferson, LA, USA
| | - Brian Mizuki
- Department of Neurology, Ochsner Medical Center, Jefferson, LA, USA
| | - Colleen Knoop
- Department of Neurology, Ochsner Medical Center, Jefferson, LA, USA
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Simonetti A, Pais C, Jones M, Cipriani MC, Janiri D, Monti L, Landi F, Bernabei R, Liperoti R, Sani G. Neuropsychiatric Symptoms in Elderly With Dementia During COVID-19 Pandemic: Definition, Treatment, and Future Directions. Front Psychiatry 2020; 11:579842. [PMID: 33132939 PMCID: PMC7550649 DOI: 10.3389/fpsyt.2020.579842] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/25/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) of dementia, such as anxiety, depression, agitation, and apathy, are complex, stressful, and costly aspects of care, and are associated to poor health outcomes and caregiver burden. A steep worsening of such symptoms has been reported during Coronavirus Disease 2019 (COVID-19) pandemic. However, their causes, their impact on everyday life, and treatment strategies have not been systematically assessed. Therefore, the aim of this review is to provide a detailed description of behavioral and psychopathological alterations in subjects with dementia during COVID-19 pandemic and the associated management challenges. METHODS A PubMed search was performed focusing on studies reporting alterations in behavior and mood and treatment strategies for elderly patients with dementia, in accordance with PRISMA guidelines. The following search strategy was utilized: (COVID* OR coronavirus OR "corona vir*" OR SARS-CoV-2) AND (dementia OR demented OR dement* OR alzheimer* OR "pick's disease" OR "lewy body" OR "mild cognitive" OR mild cognitive impairment OR MCI). RESULTS Apathy, anxiety and agitation are the most frequently NPS during the COVID-19 pandemic and are mainly triggered by protracted isolation. Most treatment strategies rely on pharmacotherapy; technology is increasingly utilized with mixed results. CONCLUSIONS NPS of dementia during COVID-19 appear to arise from social restrictions occurring as a consequence of the pandemic. Implementation of caregiver support and the presence of skilled nursing home staff are required to restore social interaction and adjust technological support to the patients' needs.
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Affiliation(s)
- Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States.,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.,Centro Lucio Bini, Rome, Italy
| | - Cristina Pais
- Department of Aging, Neurological, Orthopedic and Head and Neck Sciences, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Melissa Jones
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Maria Camilla Cipriani
- Department of Aging, Neurological, Orthopedic and Head and Neck Sciences, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Delfina Janiri
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.,Centro Lucio Bini, Rome, Italy.,Department of Aging, Neurological, Orthopedic and Head and Neck Sciences, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Laura Monti
- Service of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesco Landi
- Department of Aging, Neurological, Orthopedic and Head and Neck Sciences, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.,Department of Geriatric and Orthopedic Sciences, Catholic University of Sacred Heart, Rome, Italy
| | - Roberto Bernabei
- Department of Aging, Neurological, Orthopedic and Head and Neck Sciences, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.,Department of Geriatric and Orthopedic Sciences, Catholic University of Sacred Heart, Rome, Italy
| | - Rosa Liperoti
- Department of Aging, Neurological, Orthopedic and Head and Neck Sciences, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.,Department of Geriatric and Orthopedic Sciences, Catholic University of Sacred Heart, Rome, Italy
| | - Gabriele Sani
- Department of Aging, Neurological, Orthopedic and Head and Neck Sciences, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.,Department of Neuroscience, Section of Psychiatry, Catholic University of Sacred Heart, Rome, Italy
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Guisado-Fernández E, Giunti G, Mackey LM, Blake C, Caulfield BM. Factors Influencing the Adoption of Smart Health Technologies for People With Dementia and Their Informal Caregivers: Scoping Review and Design Framework. JMIR Aging 2019; 2:e12192. [PMID: 31518262 PMCID: PMC6716546 DOI: 10.2196/12192] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/13/2018] [Accepted: 03/11/2019] [Indexed: 01/22/2023] Open
Abstract
Background Smart Health technologies (s-Health technologies) are being developed to support people with dementia (PwD) and their informal caregivers at home, to improve care and reduce the levels of burden and stress they experience. However, although s-Health technologies have the potential to facilitate this, the factors influencing a successful implementation in this population are still unknown. Objective The aim of this study was to review existing literature to explore the factors influencing PwD and their informal caregivers’ adoption of s-Health technologies for home care. Methods Following the Arksey and O’Malley methodology, this study is a scoping review providing a narrative description of the scientific literature on factors influencing s-Health technology adoption for PwD and their informal caregivers. A search was conducted using PubMed, the Cochrane library, the IEEE library, and Scopus. Publications screening was conducted by 2 researchers based on inclusion criteria, and full-text analysis was then conducted by 1 researcher. The included articles were thematically analyzed by 2 researchers to gain an insight into factors influencing adoption that PwD and their informal caregivers have to encounter when using s-Health technologies. Relevant information was identified and coded. Codes were later discussed between the researchers for developing and modifying them and for achieving a consensus, and the researchers organized the codes into broader themes. Results Emerging themes were built in a way that said something specific and meaningful about the research question, creating a list of factors influencing the adoption of s-Health technologies for PwD and their informal caregivers, including attitudinal aspects, ethical issues, technology-related challenges, condition-related challenges, and identified gaps. A design framework was created as a guide for future research and innovation in the area of s-Health technologies for PwD and their informal caregivers: DemDesCon for s-Health Technologies. DemDesCon for s-Health Technologies addresses 4 domains to consider for the design and development of s-Health technologies for this population: cognitive decline domain, physical decline domain, social domain, and development domain. Conclusions Although s-Health technologies have been used in health care scenarios, more work is needed for them to fully achieve their potential for use in dementia care. Researchers, businesses, and public governments need to collaborate to design and implement effective technology solutions for PwD and their informal caregivers, but the lack of clear design guidelines seems to be slowing the process. We believe that the DemDesCon framework will provide them with the guidance and assistance needed for creating meaningful devices for PwD home care and informal caregivers, filling a much-needed space in the present knowledge gap.
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Affiliation(s)
- Estefanía Guisado-Fernández
- University College Dublin School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland.,Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | | | - Laura M Mackey
- University College Dublin School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
| | - Catherine Blake
- University College Dublin School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
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Acceptance and Use of Innovative Assistive Technologies among People with Cognitive Impairment and Their Caregivers: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9196729. [PMID: 30956989 PMCID: PMC6431399 DOI: 10.1155/2019/9196729] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 02/11/2019] [Indexed: 01/13/2023]
Abstract
Cognitive impairments (CI), associated with the consequences of Alzheimer's disease and other dementias, are increasingly prevalent among older adults, leading to deterioration in self-care, mobility, and interpersonal relationships among them. Innovative Assistive Technologies (IAT) such as electronic reminders and surveillance systems are considered as increasingly important tools to facilitate independence among this population and their caregivers. The aim of this study is to synthesise knowledge on facilitators and barriers related to acceptance of and use of IAT among people with CI and their caregivers. This systematic review includes original papers with quantitative, qualitative, or mixed methods design. Relevant peer-reviewed articles published in English between 2007 and 2017 were retrieved in the following databases: CINAHL; PubMed; Inspec; and PsycINFO. The Mixed Method Appraisal Tool (MMAT) was used for quality assessment. We retrieved thirty studies, including in total 1655 participants from Europe, USA/Canada, Australia, and Asia, enrolled in their homes, care-residences, day-care centres, or Living Labs. Two-thirds of the studies tested technologies integrating home sensors and wearable devices for care and monitoring CI symptoms. Main facilitators for acceptance and adherence to IAT were familiarity with and motivation to use technologies, immediate perception of effectiveness (e.g., increase in safety perceptions), and low technical demands. Barriers identified included older age, low maturity of the IAT, little experience with technologies in general, lack of personalization, and support. More than 2/3 of the studies met 80% of the quality criteria of the MMAT. Low acceptance and use of IAT both independently and with caregivers remains a significant concern. More knowledge on facilitators and barriers to use of IAT among clients of health care and social services is crucial for the successful implementation of innovative programmes aiming to leverage innovative technologies for the independence of older people with CI.
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Teipel S, König A, Hoey J, Kaye J, Krüger F, Robillard JM, Kirste T, Babiloni C. Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia. Alzheimers Dement 2018; 14:1216-1231. [PMID: 29936147 PMCID: PMC6179371 DOI: 10.1016/j.jalz.2018.05.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/20/2018] [Accepted: 05/03/2018] [Indexed: 12/11/2022]
Abstract
Cognitive function is an important end point of treatments in dementia clinical trials. Measuring cognitive function by standardized tests, however, is biased toward highly constrained environments (such as hospitals) in selected samples. Patient-powered real-world evidence using information and communication technology devices, including environmental and wearable sensors, may help to overcome these limitations. This position paper describes current and novel information and communication technology devices and algorithms to monitor behavior and function in people with prodromal and manifest stages of dementia continuously, and discusses clinical, technological, ethical, regulatory, and user-centered requirements for collecting real-world evidence in future randomized controlled trials. Challenges of data safety, quality, and privacy and regulatory requirements need to be addressed by future smart sensor technologies. When these requirements are satisfied, these technologies will provide access to truly user relevant outcomes and broader cohorts of participants than currently sampled in clinical trials.
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Affiliation(s)
- Stefan Teipel
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany; DZNE, German Center for Neurodegenerative Diseases, Rostock, Germany.
| | - Alexandra König
- Centre Mémoire de Ressources et de Recherche (CMRR), Centre Hospitalier Universitaire Nice, Cobtek (Cognition-Behaviour-Technology) Research Lab, Université de Nice Sophia Antipolis, Nice, France
| | - Jesse Hoey
- David R. Cheriton School of Computer Science, University of Waterloo, Waterloo, Canada
| | - Jeff Kaye
- NIA - Layton Aging & Alzheimer's Disease Center and ORCATECH, Oregon Center for Aging & Technology, Oregon Health & Science University, Portland, OR, USA
| | - Frank Krüger
- Institute of Communications Engineering, University of Rostock, Rostock, Germany
| | - Julie M Robillard
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Thomas Kirste
- Institute of Computer Science, University of Rostock, Rostock, Germany
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", University of Rome "La Sapienza", Rome, Italy; Institute for Research and Medical Care, IRCCS San Raffaele IRCCS San Raffaele and Cassino, Rome and Cassino, Italy
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Ienca M, Wangmo T, Jotterand F, Kressig RW, Elger B. Ethical Design of Intelligent Assistive Technologies for Dementia: A Descriptive Review. SCIENCE AND ENGINEERING ETHICS 2018; 24:1035-1055. [PMID: 28940133 DOI: 10.1007/s11948-017-9976-1] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/05/2017] [Indexed: 05/16/2023]
Abstract
The use of Intelligent Assistive Technology (IAT) in dementia care opens the prospects of reducing the global burden of dementia and enabling novel opportunities to improve the lives of dementia patients. However, with current adoption rates being reportedly low, the potential of IATs might remain under-expressed as long as the reasons for suboptimal adoption remain unaddressed. Among these, ethical and social considerations are critical. This article reviews the spectrum of IATs for dementia and investigates the prevalence of ethical considerations in the design of current IATs. Our screening shows that a significant portion of current IATs is designed in the absence of explicit ethical considerations. These results suggest that the lack of ethical consideration might be a codeterminant of current structural limitations in the translation of IATs from designing labs to bedside. Based on these data, we call for a coordinated effort to proactively incorporate ethical considerations early in the design and development of new products.
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Affiliation(s)
- Marcello Ienca
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, ETH, Zurich, Switzerland.
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| | - Fabrice Jotterand
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
- Center for Bioethics and Medical Humanities, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Reto W Kressig
- Felix Platter Hospital, University Center for Medicine of Aging, Basel, Switzerland
- Chair of Geriatrics, University of Basel, Basel, Switzerland
| | - Bernice Elger
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
- Center for Legal Medicine, University of Geneva, Geneva, Switzerland
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Holthe T, Halvorsrud L, Karterud D, Hoel KA, Lund A. Usability and acceptability of technology for community-dwelling older adults with mild cognitive impairment and dementia: a systematic literature review. Clin Interv Aging 2018; 13:863-886. [PMID: 29765211 PMCID: PMC5942395 DOI: 10.2147/cia.s154717] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The objective of this review was to obtain an overview of the technologies that have been explored with older adults with mild cognitive impairment and dementia (MCI/D), current knowledge on the usability and acceptability of such technologies, and how people with MCI/D and their family carers (FCs) were involved in these studies. Materials and methods Primary studies published between 2007 and 2017 that explored the use of technologies for community-dwelling people with MCI/D were identified through five databases: MEDLINE, PsycINFO, Embase, AMED, and CINAHL. Twenty-nine out of 359 papers met the criteria for eligibility. We used the Mixed Methods Appraisal Tool for quality assessment. Results A wide range of technologies was presented in the 29 studies, sorted into four domains: 1) safe walking indoors and outdoors; 2) safe living; 3) independent living; and 4) entertainment and social communication. The current state of knowledge regarding usability and acceptability reveals that even if researchers are aware of these concepts and intend to measure usability and acceptability, they seem difficult to assess. Terms such as “user friendliness” and “acceptance” were used frequently. User participation in the 29 studies was high. Persons with MCI/D, FCs, and staff/other older adults were involved in focus groups, workshops, and interviews as part of the preimplementation process. Conclusion Research regarding technologies to support people with MCI/D seems optimistic, and a wide range of technologies has been evaluated in homes with people with MCI/D and their FCs. A major finding was the importance of including people with MCI/D and their FCs in research, in order to learn about required design features to enhance usability and acceptability. Surprisingly, very few studies reported on the consequences of technology use with regard to quality of life, occupational performance, or human dignity.
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Affiliation(s)
- Torhild Holthe
- Faculty of Health, Oslo Metropolitan University, Oslo, Norway
| | - Liv Halvorsrud
- Faculty of Health, Oslo Metropolitan University, Oslo, Norway
| | - Dag Karterud
- Faculty of Health, Oslo Metropolitan University, Oslo, Norway
| | - Kari-Anne Hoel
- Faculty of Health, Oslo Metropolitan University, Oslo, Norway
| | - Anne Lund
- Faculty of Health, Oslo Metropolitan University, Oslo, Norway
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Maresova P, Tomsone S, Lameski P, Madureira J, Mendes A, Zdravevski E, Chorbev I, Trajkovik V, Ellen M, Rodil K. Technological Solutions for Older People with Alzheimer's Disease: Review. Curr Alzheimer Res 2018; 15:975-983. [PMID: 29701154 PMCID: PMC6128069 DOI: 10.2174/1567205015666180427124547] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 04/15/2018] [Accepted: 04/25/2018] [Indexed: 01/17/2023]
Abstract
In the nineties, numerous studies began to highlight the problem of the increasing number of people with Alzheimer's disease in developed countries, especially in the context of demographic progress. At the same time, the 21st century is typical of the development of advanced technologies that penetrate all areas of human life. Digital devices, sensors, and intelligent applications are tools that can help seniors and allow better communication and control of their caregivers. The aim of the paper is to provide an up-to-date summary of the use of technological solutions for improving health and safety for people with Alzheimer's disease. Firstly, the problems and needs of senior citizens with Alzheimer's disease (AD) and their caregivers are specified. Secondly, a scoping review is performed regarding the technological solutions suggested to assist this specific group of patients. Works obtained from the following libraries are used in this scoping review: Web of Science, PubMed, Springer, ACM and IEEE Xplore. Four independent reviewers screened the identified records and selected relevant articles which were published in the period from 2007 to 2018. A total of 6,705 publications were selected. In all, 128 full papers were screened. Results obtained from the relevant studies were furthermore divided into the following categories according to the type and use of technologies: devices, processing, and activity recognition. The leading technological solution in the category of devices are wearables and ambient noninvasive sensors. The introduction and utilization of these technologies, however, bring about challenges in acceptability, durability, ease of use, communication, and power requirements. Furthermore, it needs to be pointed out that these technological solutions should be based on open standards.
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Affiliation(s)
- Petra Maresova
- Address correspondence to this author at the Department of Economics, Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, 50003, Hradec Kralove, Czech Republic; Tel: + 420 737 928 745; E-mail:
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Klimova B, Valis M, Kuca K. Exploring assistive technology as a potential beneficial intervention tool for people with Alzheimer's disease - a systematic review. Neuropsychiatr Dis Treat 2018; 14:3151-3158. [PMID: 30532546 PMCID: PMC6247949 DOI: 10.2147/ndt.s181849] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Nowadays, due to the increase in the number of aging population groups, there is also a growth of aging diseases such as Alzheimer's disease (AD), which is a progressive brain disorder that eventually results in death. At the moment, it cannot be cured, only its symptoms can be alleviated both by using pharmacological and non-pharmacological approaches in order to maintain and in some cases even enhance quality of life of people living with AD, as well as their caregivers. One of such non-pharmacological approaches is the use of assistive technology (AT), which can contribute to the improvement and maintenance of the quality of life of both patients and their caregivers. The purpose of this study was to explore what types of AT are mostly used by patients with AD and how these devices can help their caregivers. This was done by conducting a literature review of available sources found in the Web of Science, Scopus, and PubMed. The findings, apart from one study, reveal that AT may have the potential to maintain the quality of life of people with AD, especially in the early stages of the disease, as well as to mitigate the mental and physical burden of their caregivers. The most common types of AT for patients with AD are devices of daily living and safety devices. The less frequent are still telecare devices and devices to support engagement, social participation, and leisure. Future research should focus on the effectiveness of AT on the improvement of patients' symptoms, as well as on the development and use of AT for social interactions, which can be used in patients with AD of different degree of severity and have a positive impact on their behavioral and psychological symptoms.
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Affiliation(s)
- Blanka Klimova
- Department of Applied Linguistics, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Martin Valis
- Department of Neurology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Centre for Basic and Applied Research, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic,
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Hudec M, Smutny Z. RUDO: A Home Ambient Intelligence System for Blind People. SENSORS (BASEL, SWITZERLAND) 2017; 17:E1926. [PMID: 28829372 PMCID: PMC5580207 DOI: 10.3390/s17081926] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/05/2017] [Accepted: 08/19/2017] [Indexed: 11/21/2022]
Abstract
The article introduces an ambient intelligence system for blind people which besides providing assistance in home environment also helps with various situations and roles in which blind people may find themselves involved. RUDO, the designed system, comprises several modules that mainly support or ensure recognition of approaching people, alerting to other household members' movement in the flat, work on a computer, supervision of (sighted) children, cooperation of a sighted and a blind person (e.g., when studying), control of heating and zonal regulation by a blind person. It has a unified user interface that gives the blind person access to individual functions. The interface for blind people offers assistance with work on a computer, including writing in Braille on a regular keyboard and specialized work in informatics and electronics (e.g., programming). RUDO can complement the standard aids used by blind people at home, it increases their independence and creates conditions that allow them to become fully involved. RUDO also supports blind people sharing a home with sighted people, which contributes to their feeling of security and greater inclusion in society. RUDO has been implemented in a household for two years, which allows an evaluation of its use in practice.
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Affiliation(s)
- Milan Hudec
- Department of Computer Science, Faculty of Natural Sciences, Matej Bel University, Tajovského 40, 974 01 Banská Bystrica, Slovakia.
| | - Zdenek Smutny
- Department of Systems Analysis, Faculty of Informatics and Statistics, University of Economics, Prague, W. Churchill Sq. 1938/4, 130 67 Prague, Czech Republic.
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Alberdi A, Aztiria A, Basarab A. On the early diagnosis of Alzheimer's Disease from multimodal signals: A survey. Artif Intell Med 2016; 71:1-29. [PMID: 27506128 DOI: 10.1016/j.artmed.2016.06.003] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/23/2016] [Accepted: 06/07/2016] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The number of Alzheimer's Disease (AD) patients is increasing with increased life expectancy and 115.4 million people are expected to be affected in 2050. Unfortunately, AD is commonly diagnosed too late, when irreversible damages have been caused in the patient. OBJECTIVE An automatic, continuous and unobtrusive early AD detection method would be required to improve patients' life quality and avoid big healthcare costs. Thus, the objective of this survey is to review the multimodal signals that could be used in the development of such a system, emphasizing on the accuracy that they have shown up to date for AD detection. Some useful tools and specific issues towards this goal will also have to be reviewed. METHODS An extensive literature review was performed following a specific search strategy, inclusion criteria, data extraction and quality assessment in the Inspec, Compendex and PubMed databases. RESULTS This work reviews the extensive list of psychological, physiological, behavioural and cognitive measurements that could be used for AD detection. The most promising measurements seem to be magnetic resonance imaging (MRI) for AD vs control (CTL) discrimination with an 98.95% accuracy, while electroencephalogram (EEG) shows the best results for mild cognitive impairment (MCI) vs CTL (97.88%) and MCI vs AD distinction (94.05%). Available physiological and behavioural AD datasets are listed, as well as medical imaging analysis steps and neuroimaging processing toolboxes. Some issues such as "label noise" and multi-site data are discussed. CONCLUSIONS The development of an unobtrusive and transparent AD detection system should be based on a multimodal system in order to take full advantage of all kinds of symptoms, detect even the smallest changes and combine them, so as to detect AD as early as possible. Such a multimodal system might probably be based on physiological monitoring of MRI or EEG, as well as behavioural measurements like the ones proposed along the article. The mentioned AD datasets and image processing toolboxes are available for their use towards this goal. Issues like "label noise" and multi-site neuroimaging incompatibilities may also have to be overcome, but methods for this purpose are already available.
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Affiliation(s)
- Ane Alberdi
- Mondragon University, Electronics and Computing Department, Goiru Kalea, 2, Arrasate 20500, Spain.
| | - Asier Aztiria
- Mondragon University, Electronics and Computing Department, Goiru Kalea, 2, Arrasate 20500, Spain.
| | - Adrian Basarab
- Université de Toulouse, Institut de Recherche en Informatique de Toulouse, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5505, Université Paul Sabatier, 118 Route de Narbonne, 31062 Toulouse, France.
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