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Dada S, van der Walt C, May AA, Murray J. Intelligent assistive technology devices for persons with dementia: A scoping review. Assist Technol 2024; 36:338-351. [PMID: 34644248 DOI: 10.1080/10400435.2021.1992540] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Assistive technology (AT) with context-aware computing and artificial intelligence capabilities can be applied to address cognitive and communication impairments experienced by persons with dementia (PwD). This paper aims to provide an overview of current literature regarding some characteristics of intelligent assistive technology devices (IATDs) for cognitive and communicative impairments of PwD. It also aims to identify the areas of impairment addressed by these IATDs.A multi-faceted systematic search strategy yielded records. Predefined criteria were applied for inclusion and data extraction. Thereafter data was thematically analysed and synthesised. This review demonstrates that almost all of the research involving IATDs has focused on cognitive impairments of PwD and has not yet evolved past the conceptual or prototype stages of development. Summaries of commercially available IATDs for PwD and relevant prototypes are provided at the end of this review.This research concluded that IATDs for PwD targeting cognition and communication problems primarily focus on social robots, and that they address cognitive impairments of attention, affect, and social-pragmatic communicative impairments. Future research endeavours concerning AT for PwD should explore collaboration between computer engineering and health practitioners to address the identified gaps. This may contribute to the available information for evidence-based decision making for PwD.
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Affiliation(s)
- Shakila Dada
- Centre for Augmentative and Alternative Communication, University of Pretoria
| | | | - Adele A May
- Centre for Augmentative and Alternative Communication, University of Pretoria
| | - Janice Murray
- Centre for Augmentative and Alternative Communication, University of Pretoria
- Manchester Metropolitan University
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Wiegel P, Fotteler ML, Kohn B, Mayer S, Verri FM, Dallmeier D, Denkinger M. Perceived Benefit and Satisfaction With a Tablet Computer and an Emergency Smartwatch by Older Adults and Their Relatives: Prospective Real-World Pilot Study. JMIR Hum Factors 2024; 11:e53811. [PMID: 39104048 PMCID: PMC11310738 DOI: 10.2196/53811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/08/2024] [Accepted: 06/07/2024] [Indexed: 08/07/2024] Open
Abstract
Background Assistive technologies (ATs) have the potential to promote the quality of life and independent living of older adults and, further, to relieve the burden of formal and informal caregivers and relatives. Technological developments over the last decades have led to a boost of available ATs. However, evidence on the benefits and satisfaction with ATs in real-world applications remains scarce. Objective This prospective, real-world, pilot study tested the perceived benefit and satisfaction with different ATs in the real-world environment. Methods Community-dwelling adults aged ≥65 and their relatives tested a tablet computer with a simplified interface or a smartwatch with programmable emergency contacts for 8 weeks in their everyday life. Perceived benefits and satisfaction with ATs were assessed by all older adults and their relatives using different assessment tools before and after the intervention. Outcome measures included the Technology Usage Inventory, Quebec User Evaluation of Satisfaction with Assistive Technology 2.0, and Canadian Occupational Performance Measure. Results A total of 17 older adults (tablet computer: n=8, 47% and smartwatch: n=9, 53%) and 16 relatives (tablet computer: n=7, 44% and smartwatch: n=9, 56%) were included in the study. The number of participants that were frail (according to the Clinical Frailty Scale) and received care was higher in the smartwatch group than in the tablet computer group. Older adults of the smartwatch group reported higher technology acceptance (Technology Usage Inventory) and satisfaction (Quebec User Evaluation of Satisfaction with Assistive Technology 2.0) scores than those of the tablet computer group, although the differences were not significant (all P>.05). In the tablet computer group, relatives had significantly higher ratings on the item intention to use than older adults (t12.3=3.3, P=.006). Identified everyday issues with the Canadian Occupational Performance Measure included contact/communication and entertainment/information for the tablet computer, safety and getting help in emergency situations for the smartwatch, and the usability of the AT for both devices. While the performance (t8=3.5, P=.008) and satisfaction (t8=3.2, P=.01) in these domains significantly improved in the smartwatch group, changes in the tablet computer group were inconsistent (all P>.05). Conclusions This study highlights the remaining obstacles for the widespread and effective application of ATs in the everyday life of older adults and their relatives. While the results do not provide evidence for a positive effect regarding communication deficits, perceived benefits could be shown for the area of safety. Future research and technical developments need to consider not only the preferences, problems, and goals of older adults but also their relatives and caregivers to improve the acceptability and effectiveness of ATs.
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Affiliation(s)
- Patrick Wiegel
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Zollernring 26, Ulm, 89073, Germany, 49 731187 ext 191
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
| | - Marina Liselotte Fotteler
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Brigitte Kohn
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Zollernring 26, Ulm, 89073, Germany, 49 731187 ext 191
- Geriatric Center Ulm, Ulm, Germany
| | - Sarah Mayer
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Zollernring 26, Ulm, 89073, Germany, 49 731187 ext 191
- Geriatric Center Ulm, Ulm, Germany
| | - Filippo Maria Verri
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Zollernring 26, Ulm, 89073, Germany, 49 731187 ext 191
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
| | - Dhayana Dallmeier
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Zollernring 26, Ulm, 89073, Germany, 49 731187 ext 191
- Geriatric Center Ulm, Ulm, Germany
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Michael Denkinger
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Zollernring 26, Ulm, 89073, Germany, 49 731187 ext 191
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
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MacNeil M, Hirslund E, Baiocco-Romano L, Kuspinar A, Stolee P. A scoping review of the use of intelligent assistive technologies in rehabilitation practice with older adults. Disabil Rehabil Assist Technol 2024; 19:1817-1848. [PMID: 37498115 DOI: 10.1080/17483107.2023.2239277] [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: 09/01/2022] [Revised: 05/30/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE There is growing interest in intelligent assistive technologies (IATs) in the rehabilitation and support of older adults, however, the factors contributing to or preventing their use in practice are not well understood. This study aimed to develop an overview of current knowledge on barriers and facilitators to the use of smart technologies in rehabilitative practice with older adults. MATERIALS AND METHODS We undertook a scoping review following guidelines proposed by Arksey and O'Malley (2005) and Levac et al. (2010). A computerised literature search was conducted using the Scopus and Ovid databases, yielding 7995 citations. Of these, 94 studies met inclusion criteria. Analysis of extracted data identified themes which were explored in semi-structured interviews with a purposefully selected sample of seven clinical rehabilitation practitioners (three physical therapists, two occupational therapists, and two speech-language pathologists). RESULTS Barriers and facilitators to using these technologies were associated with accessibility, reported effectiveness, usability, patient-centred considerations, and staff considerations. CONCLUSIONS Collaborative efforts of policy-makers, researchers, manufacturers, rehabilitation professionals, and older persons are needed to improve the design of technologies, develop appropriate funding and reimbursement strategies, and minimise barriers to their appropriate use to support independence and quality of life. Any strategies to improve upon barriers to prescribing smart technologies for older people should leverage the expertise of rehabilitation professionals operating at the interface between older people; their health/mobility; their families; and technology-based solutions.
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Affiliation(s)
- Maggie MacNeil
- School of Nursing, McMaster University, Hamilton, Canada
| | - Emily Hirslund
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | | | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Enríquez JG, Soria Morillo LM, García-García JA, Álvarez-García JA. Two decades of assistive technologies to empower people with disability: a systematic mapping study. Disabil Rehabil Assist Technol 2024; 19:2095-2112. [PMID: 37795612 DOI: 10.1080/17483107.2023.2263504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 09/19/2023] [Indexed: 10/06/2023]
Abstract
PURPOSE Information and Communication Technologies have transformed our lives in different social areas, facilitating interpersonal relationships thanks to technological tools. In the specific case of people with disabilities, Assistive Technologies (ATs) break down barriers and increase opportunities to become active members of society with equal opportunities. MATERIALS AND METHODS This paper presents a systematic mapping study that analyzes the current state-of-the-art of ATs proposed in the literature to support the empowering of people with disability. Specifically, this paper focuses on (1) describing a global vision of the scientific literature published in the last 20 years about ATs in the computer science field and (2) identifying research needs, gaps, and trends. RESULTS For this purpose, an in-depth analysis of 389 primary studies is presented. The information obtained from the mapping process is also constrained. Concretely, 35 ATs versus 22 disabilities are compared, obtaining striking peaks for some disabilities described in the discussion. CONCLUSIONS Finally, the findings show that several areas have been covered only lightly, revealing interesting future directions and challenges for junior researchers.
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Affiliation(s)
- J G Enríquez
- Computer Languages and Systems Department, University of Seville, Seville, Spain
| | - Luis M Soria Morillo
- Computer Languages and Systems Department, University of Seville, Seville, Spain
| | - J A García-García
- Computer Languages and Systems Department, University of Seville, Seville, Spain
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Jose A, Sasseville M, Gorus E, Giguère A, Bourbonnais A, Abbasgholizadeh Rahimi S, Balley C, Buyl R, Gagnon MP. Existing Digital Health Technology Index Summary Report for Older Adults Living with Neurocognitive Disorders (Mild and Major) and Their Informal Caregivers: An Environmental Scan. Geriatrics (Basel) 2024; 9:85. [PMID: 39051249 PMCID: PMC11270236 DOI: 10.3390/geriatrics9040085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 06/01/2024] [Accepted: 06/19/2024] [Indexed: 07/27/2024] Open
Abstract
Digital health has added numerous promising solutions to enhance the health and wellness of people with neurocognitive disorders (NCDs) and their informal caregivers. (1) Background: It is important to obtain a comprehensive view of currently available technologies, their outcomes, and conditions of success to inform recommendations regarding digital health solutions for people with NCDs and their caregivers. This environmental scan was performed to identify the features of existing digital health solutions relevant to the targeted population. This work reviews currently available digital health solutions and their related characteristics to develop a decision support tool for older adults living with mild or major neurocognitive disorders and their informal caregivers. This knowledge will aid the development of a decision support tool to assist older adults and their informal caregivers in their search for adequate digital health solutions according to their needs and preferences based on trustable information. (2) Methods: We conducted an environmental scan to identify digital health solutions from a systematic review and targeted searches in the grey literature covering the regions of Canada and Europe. Technological tools were scanned based on a preformatted extraction grid. We assessed their relevance based on selected attributes and summarized the findings. (3) Results: We identified 100 available digital health solutions. The majority (56%) were not specific to NCDs. Only 28% provided scientific evidence of their effectiveness. Remote patient care, movement tracking, and cognitive exercises were the most common purposes of digital health solutions. Most solutions were presented as decision aid tools, pill dispensers, apps, web, or a combination of these platforms. (4) Conclusions: This environmental scan allowed for identifying current digital health solutions for older adults with mild or major neurocognitive disorders and their informal caregivers. Findings from the environmental scan highlight the need for additional approaches to strengthen digital health interventions for the well-being of older adults with mild and major NCDs and their informal and formal healthcare providers.
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Affiliation(s)
- Ambily Jose
- VITAM Research Center in Sustainable Health, Quebec City, QC G1J 2G1, Canada; (A.J.); (M.S.); (A.G.); (C.B.)
| | - Maxime Sasseville
- VITAM Research Center in Sustainable Health, Quebec City, QC G1J 2G1, Canada; (A.J.); (M.S.); (A.G.); (C.B.)
- Faculty of Nursing Sciences, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Ellen Gorus
- Department of Gerontology, Frailty in Ageing Research Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Anik Giguère
- VITAM Research Center in Sustainable Health, Quebec City, QC G1J 2G1, Canada; (A.J.); (M.S.); (A.G.); (C.B.)
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montreal, QC H3T 1J4, Canada;
| | - Samira Abbasgholizadeh Rahimi
- Department of Family Medicine, McGill University, Montreal, QC H3A 0G4, Canada;
- Mila-Quebec AI Institute, Montreal, QC H2S 3H1, Canada
| | - Clémence Balley
- VITAM Research Center in Sustainable Health, Quebec City, QC G1J 2G1, Canada; (A.J.); (M.S.); (A.G.); (C.B.)
| | - Ronald Buyl
- Department of Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Marie-Pierre Gagnon
- VITAM Research Center in Sustainable Health, Quebec City, QC G1J 2G1, Canada; (A.J.); (M.S.); (A.G.); (C.B.)
- Faculty of Nursing Sciences, Université Laval, Quebec City, QC G1V 0A6, Canada
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Goerss D, Köhler S, Rong E, Temp AG, Kilimann I, Bieber G, Teipel S. Smartwatch-Based Interventions for People With Dementia: User-Centered Design Approach. JMIR Aging 2024; 7:e50107. [PMID: 38848116 PMCID: PMC11193079 DOI: 10.2196/50107] [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: 06/19/2023] [Revised: 01/30/2024] [Accepted: 02/27/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Assistive technologies can help people living with dementia maintain their everyday activities. Nevertheless, there is a gap between the potential and use of these materials. Involving future users may help close this gap, but the impact on people with dementia is unclear. OBJECTIVE We aimed to determine if user-centered development of smartwatch-based interventions together with people with dementia is feasible. In addition, we evaluated the extent to which user feedback is plausible and therefore helpful for technological improvements. METHODS We examined the interactions between smartwatches and people with dementia or people with mild cognitive impairment. All participants were prompted to complete 2 tasks (drinking water and a specific cognitive task). Prompts were triggered using a smartphone as a remote control and were repeated up to 3 times if participants failed to complete a task. Overall, 50% (20/40) of the participants received regular prompts, and 50% (20/40) received intensive audiovisual prompts to perform everyday tasks. Participants' reactions were observed remotely via cameras. User feedback was captured via questionnaires, which included topics like usability, design, usefulness, and concerns. The internal consistency of the subscales was calculated. Plausibility was also checked using qualitative approaches. RESULTS Participants noted their preferences for particular functions and improvements. Patients struggled with rating using the Likert scale; therefore, we assisted them with completing the questionnaire. Usability (mean 78 out of 100, SD 15.22) and usefulness (mean 9 out of 12) were rated high. The smartwatch design was appealing to most participants (31/40, 76%). Only a few participants (6/40, 15%) were concerned about using the watch. Better usability was associated with better cognition. The observed success and self-rated task comprehension were in agreement for most participants (32/40, 80%). In different qualitative analyses, participants' responses were, in most cases, plausible. Only 8% (3/40) of the participants were completely unaware of their irregular task performance. CONCLUSIONS People with dementia can have positive experiences with smartwatches. Most people with dementia provided valuable information. Developing assistive technologies together with people with dementia can help to prioritize the future development of functional and nonfunctional features.
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Affiliation(s)
- Doreen Goerss
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen Rostock/Greifswald, Rostock, Germany
| | - Stefanie Köhler
- Deutsches Zentrum für Neurodegenerative Erkrankungen Rostock/Greifswald, Rostock, Germany
| | - Eleonora Rong
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Anna Gesine Temp
- Neurozentrum, Berufsgenossenschaftliches Klinikum Hamburg, Hamburg, Germany
| | - Ingo Kilimann
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen Rostock/Greifswald, Rostock, Germany
| | - Gerald Bieber
- Fraunhofer Institut für Graphische Datenverarbeitung, Rostock, Germany
| | - Stefan Teipel
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen Rostock/Greifswald, Rostock, Germany
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Zheng J, Gresham M, Phillipson L, Hall D, Jeon YH, Brodaty H, Low LF. Exploring the usability, user experience and usefulness of a supportive website for people with dementia and carers. Disabil Rehabil Assist Technol 2024; 19:1369-1381. [PMID: 37086036 DOI: 10.1080/17483107.2023.2180546] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 02/08/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE This study explores the usability, usefulness and user experience of the Forward with Dementia website for people with dementia and family carers, and identifies strategies to improve web design for this population. METHODS The website was iteratively user-tested by 12 participants (five people with dementia, seven carers) using the Zoom platform. Data collection involved observations, semi-structured interviews and questionnaires. Integrative mixed-method data analysis was used, informed by inductive thematic qualitative analysis. RESULTS Users of Version 1 of the website experienced web functionality, navigation and legibility issues. Strategies for desirable web design were identified as simplifying functions, streamlining navigation and decluttering page layouts. Implementation of strategies produced improvements in usability, user experience and usefulness in Version 2, with mean System Usability Scale scores improving from 15 to 84, and mean task completion improving from 55% to 89%. The user journey for people with dementia and carers overlapped, but each group had their own unique needs in the context of web design. CONCLUSIONS The interplay between a website's content, functionality, navigation and legibility can profoundly influence user perceptions of a website. Dementia-related websites play an important role in informing audiences of management strategies, service availability and planning for the progression of dementia. Findings of this study may assist in guiding future web development targeting this population.
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Affiliation(s)
- Jacky Zheng
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Meredith Gresham
- Discipline of Psychiatry and Mental Health, Centre for Healthy Brain Ageing, UNSW Sydney, Sydney, Australia
| | - Lyn Phillipson
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Danika Hall
- Discipline of Psychiatry and Mental Health, Centre for Healthy Brain Ageing, UNSW Sydney, Sydney, Australia
| | - Yun-Hee Jeon
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Henry Brodaty
- Discipline of Psychiatry and Mental Health, Centre for Healthy Brain Ageing, UNSW Sydney, Sydney, Australia
| | - Lee-Fay Low
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Arthanat S, Wilcox J, LaRoche D. Smart home automation technology to support caring of individuals with Alzheimer's disease and related dementia: an early intervention framework. Disabil Rehabil Assist Technol 2024; 19:779-789. [PMID: 36136955 DOI: 10.1080/17483107.2022.2125088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/25/2022] [Accepted: 09/11/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Home automation technology comprising of Internet of Things and Smart gadgets is a rapidly growing industry that is projected to have a major scope for ageing-in-place and caregiving. This study examined the feasibility and cost-benefits of a personalized home automation intervention for care of individuals with Alzheimer's disease and related dementia (ADRD) with emphasis on their safety and independence, and reduction of care burden. METHODS A mixed method intervention study was conducted with five dyads each comprising of a caregiver and care recipient with ADRD. Each dyad received personalized home automation intervention with individualized goals centred on home safety, activity engagement, and caregiver-recipient connectivity. The goals were created and monitored using goal attainment scaling (GAS). The dyads were followed up after three months with a home visit and interview. Goal attainment scoring and thematic analysis of the interviews were conducted to examine the findings from the study. RESULTS All dyads indicated positive goal attainment between pre and post intervention. Goals that were met were complimented by the categories of peace of mind, self-efficacy, and care recipient engagement, while unmet goals as well as complexities with the technology were elucidated under challenges. Overarching and conceptually linked themes from the study were unfamiliarity, value, and timing. CONCLUSION Home automation technology has the potential to be adapted to promote independence and safety of individuals with ADRD while relieving care burden. Nonetheless, we propose an early intervention framework to overcome identified challenges and optimize the technology's usability and sustainability.IMPLICATIONS FOR REHABILITATIONHome automation involving Internet of Things and Smart gadgets has gained rapid popularity owing to the comfort and connectivity they provide to mainstream consumers.The technology has an emerging significance to ageing-in-place and care of individuals with Alzheimer's Disease and Related Dementia (ADRD) as it can be adapted and implemented to enhance home safety and activity engagement of the care recipients while also strengthening their connectivity with the caregivers.Unfamiliarity with the technology compounded by the progression of ADRD can, however, be detrimental to its adoption.Individualized focus and early integration of the technology for caregiver-care recipient dyads can mitigate these challenges and optimize its usability and long-term value in relation to ageing-in-place and caregiver wellbeing.
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Affiliation(s)
- Sajay Arthanat
- Department of Occupational Therapy, University of New Hampshire, Durham, NH, USA
| | - John Wilcox
- Department of Occupational Therapy, University of New Hampshire, Durham, NH, USA
| | - Dain LaRoche
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
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Kirby P, Lai H, Horrocks S, Harrison M, Wilson D, Daniels S, Calvo RA, Sharp DJ, Alexander CM. Patient and Public Involvement in Technology-Related Dementia Research: Scoping Review. JMIR Aging 2024; 7:e48292. [PMID: 38437014 PMCID: PMC10949132 DOI: 10.2196/48292] [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: 04/18/2023] [Revised: 09/12/2023] [Accepted: 01/17/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Technology-related research on people with dementia and their carers often aims to enable people to remain living at home for longer and prevent unnecessary hospital admissions. To develop person-centered, effective, and ethical research, patient and public involvement (PPI) is necessary, although it may be perceived as more difficult with this cohort. With recent and rapid expansions in health and care-related technology, this review explored how and with what impact collaborations between researchers and stakeholders such as people with dementia and their carers have taken place. OBJECTIVE This review aims to describe approaches to PPI used to date in technology-related dementia research, along with the barriers and facilitators and impact of PPI in this area. METHODS A scoping review of literature related to dementia, technology, and PPI was conducted using MEDLINE, PsycINFO, Embase, and CINAHL. Papers were screened for inclusion by 2 authors. Data were then extracted using a predesigned data extraction table by the same 2 authors. A third author supported the resolution of any conflicts at each stage. Barriers to and facilitators of undertaking PPI were then examined and themed. RESULTS The search yielded 1694 papers, with 31 (1.83%) being analyzed after screening. Most (21/31, 68%) did not make clear distinctions between activities undertaken as PPI and those undertaken by research participants, and as such, their involvement did not fit easily into the National Institute for Health and Care Research definition of PPI. Most of this mixed involvement focused on reviewing or evaluating technology prototypes. A range of approaches were described, most typically using focus groups or co-design workshops. In total, 29% (9/31) described involvement at multiple stages throughout the research cycle, sometimes with evidence of sharing decision-making power. Some (23/31, 74%) commented on barriers to or facilitators of effective PPI. The challenges identified often regarded issues of working with people with significant cognitive impairments and pressures on time and resources. Where reported, the impact of PPI was largely reported as positive, including the experiences for patient and public partners, the impact on research quality, and the learning experience it provided for researchers. Only 4 (13%) papers used formal methods for evaluating impact. CONCLUSIONS Researchers often involve people with dementia and other stakeholders in technology research. At present, involvement is often limited in scope despite aspirations for high levels of involvement and partnership working. Involving people with dementia, their carers, and other stakeholders can have a positive impact on research, patient and public partners, and researchers. Wider reporting of methods and facilitative strategies along with more formalized methods for recording and reporting on meaningful impact would be helpful so that all those involved-researchers, patients, and other stakeholders-can learn how we can best conduct research together.
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Affiliation(s)
- Pippa Kirby
- Department of Therapies, Imperial College Healthcare NHS Trust, London, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre (UK DRI CR&T), London, United Kingdom
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Helen Lai
- UK Dementia Research Institute, Care Research and Technology Centre (UK DRI CR&T), London, United Kingdom
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Sophie Horrocks
- UK Dementia Research Institute, Care Research and Technology Centre (UK DRI CR&T), London, United Kingdom
- Helix Centre, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Matthew Harrison
- UK Dementia Research Institute, Care Research and Technology Centre (UK DRI CR&T), London, United Kingdom
- Helix Centre, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Danielle Wilson
- UK Dementia Research Institute, Care Research and Technology Centre (UK DRI CR&T), London, United Kingdom
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Sarah Daniels
- UK Dementia Research Institute, Care Research and Technology Centre (UK DRI CR&T), London, United Kingdom
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Rafael A Calvo
- Dyson School of Design Engineering, Imperial College London, London, United Kingdom
| | - David J Sharp
- UK Dementia Research Institute, Care Research and Technology Centre (UK DRI CR&T), London, United Kingdom
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Caroline M Alexander
- Department of Therapies, Imperial College Healthcare NHS Trust, London, United Kingdom
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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AboJabel H, Welsch J, Schicktanz S. Cross-cultural perspectives on intelligent assistive technology in dementia care: comparing Israeli and German experts' attitudes. BMC Med Ethics 2024; 25:15. [PMID: 38326778 PMCID: PMC10848426 DOI: 10.1186/s12910-024-01010-6] [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: 03/29/2023] [Accepted: 02/01/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Despite the great benefits of intelligent assistive technology (IAT) for dementia care - for example, the enhanced safety and increased independence of people with dementia and their caregivers - its practical adoption is still limited. The social and ethical issues pertaining to IAT in dementia care, shaped by factors such as culture, may explain these limitations. However, most studies have focused on understanding these issues within one cultural setting only. Therefore, the aim of this study was to explore and compare the attitudes of Israeli and German dementia experts toward IAT in dementia care, to contribute to a more cultural-comparative perspective. METHODS Semi-structured interviews were conducted with 35 experts (15 Israelis and 20 Germans) in key roles in health and community services for people with dementia as well as in the fields of dementia and IAT (e.g., computer science, electrical/biomedical engineering, ethics, nursing, and gerontology). Thematic content analysis was used to analyze the data. FINDINGS Israeli and German experts identified the same social accelerators in the development and implementation of IAT in dementia care (i.e., changes in family structure and social digitization) and benefits of adopting IAT (e.g., enhancing the safety of people with dementia and increasing their independence). However, there were differences in inhibitor/risk assessments between the two groups. Namely, economic considerations and the cognitive capacity of people with dementia were identified by both groups as inhibitors, while Israeli experts additionally reported stigma and ageism. Whereas both groups agreed that IAT might reduce human connection, and that the technology is not yet reliable enough, German experts highlighted concerns regarding privacy; in contrast, Israeli experts prioritized safety over privacy. CONCLUSIONS Our research findings allow for the identification of relevant similarities but also important differences between German and Israeli experts' perspectives. As such, an important basis has been provided for a more in-depth discussion regarding where, why, and how culturally-sensitive technology development is needed.
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Affiliation(s)
- Hanan AboJabel
- Department of Medical Ethics and History of Medicine, University Medical Center Göttingen, Göttingen, Germany.
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Johannes Welsch
- Department of Medical Ethics and History of Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Silke Schicktanz
- Department of Medical Ethics and History of Medicine, University Medical Center Göttingen, Göttingen, Germany
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van Santen J, Dröes RM, Blanson Henkemans O, Schoone M, Valk R, Straten AV, Meiland F. Implementation of exergaming for people with dementia: facilitators, barriers, and recommendations. Aging Ment Health 2024; 28:244-253. [PMID: 37493266 DOI: 10.1080/13607863.2023.2238259] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/23/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVES To identify facilitators, barriers, and formulate recommendations for the implementation of exergames for people with dementia (PWD) in day-care centers (DCCs). METHODS Within a randomized controlled trial into the effectiveness of exergaming, 73 PWD with their informal caregivers (IC) from 11 DCCs in the Netherlands and two exergame providers participated in a process evaluation. This was a mixed-methods study using focus groups, semi-structured interviews, the Measurement Instrument for Determinants of Innovations, forms for DCC staff, and a short satisfaction questionnaire. We used descriptive statistics for the quantitative outcomes, and thematic analysis for qualitative data. The Medical Research Council guidance for process evaluation was used to identify facilitators and barriers to the implementation, mechanisms of impact, and context. RESULTS Implementation-related facilitators and barriers were the availability of budget, staff, equipment, instructions, location, and supervision. Mechanisms of impact-related facilitators were experienced positive effects on physical functioning and mobility, cognitive, emotional, and social functioning, and quality of life. Barriers were mainly linked to the need to customize the intervention for each participant. Contextual facilitators were support and enthusiasm from others; barriers were costs and planning. Recommendations by DCC staff involved technical support, instructions, responsibility, location, supervision, planning, and exergaming as a group or individually. CONCLUSION Users, IC, and staff positively valued exergaming. We found various facilitators and barriers leading to recommendations for successful implementation. We recommend further research into tailoring exergaming to specific users and contexts, and into usability and cost-effectiveness. This may contribute to further dissemination and implementation of exergaming for PWD.
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Affiliation(s)
- Joeke van Santen
- Department of Psychiatry, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | | | | | - Ronald Valk
- HilverZorg-Day-Care Center Zonnehoeve, Hilversum, Netherlands
| | - Annemieke van Straten
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Department of Clinical- Neuro- and Developmental Psychology, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, Netherlands
| | - Franka Meiland
- Department of Psychiatry, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Department of Medicine for Older People, Gerion, Amsterdam, Netherlands
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Hirt J, Beer T, Cavalli S, Cereghetti S, Pusterla ERG, Zeller A. Recruiting Persons With Dementia: A Systematic Review of Facilitators, Barriers, and Strategies. Am J Alzheimers Dis Other Demen 2024; 39:15333175241276443. [PMID: 39137907 PMCID: PMC11322929 DOI: 10.1177/15333175241276443] [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] [Indexed: 08/15/2024]
Abstract
Study recruitment of persons with dementia is challenging. We aimed to assess facilitators, barriers, and strategies to identify and approach persons with dementia for recruitment to dementia care studies. We systematically searched MEDLINE/PubMed, CINAHL, Web of Science, and other sources (ORRCA [Online Resource for Research in Clinical triAls]; pertinent evidence syntheses; citation searching) and narratively summarised the results (PROSPERO CRD42022342600). Facilitators and barriers consisted of "characteristics of participants, researchers, clinical contact persons", "study characteristics", and "communication with participants". The highest number of participants were recruited by study information in electronic and print formats, as well as by networking and collaboration. Advertisements proved to be the most expensive way of recruitment. There is limited evidence on the impact of recruitment strategies to identify persons with dementia for recruitment to dementia care studies. Our analysis of facilitators and barriers may inform research teams in designing strategies to identify persons with dementia for recruitment purposes.
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Affiliation(s)
- Julian Hirt
- Department of Health, Eastern Switzerland University of Applied Sciences, St.Gallen, Switzerland
- Pragmatic Evidence Lab, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Thomas Beer
- Department of Health, Eastern Switzerland University of Applied Sciences, St.Gallen, Switzerland
| | - Stefano Cavalli
- Centre of Competence on Ageing, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - Stefano Cereghetti
- Centre of Competence on Ageing, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - Elia R. G. Pusterla
- Centre of Competence on Ageing, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - Adelheid Zeller
- Department of Health, Eastern Switzerland University of Applied Sciences, St.Gallen, Switzerland
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Budak KB, Atefi G, Hoel V, Laporte Uribe F, Meiland F, Teupen S, Felding SA, Roes M. Can technology impact loneliness in dementia? A scoping review on the role of assistive technologies in delivering psychosocial interventions in long-term care. Disabil Rehabil Assist Technol 2023; 18:1107-1119. [PMID: 34752177 DOI: 10.1080/17483107.2021.1984594] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/17/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE We aimed to identify assistive technologies that are promising for addressing loneliness in people living with dementia in long-term care. MATERIALS AND METHODS A scoping review was conducted. EBSCO, PubMed, Cochrane Library, and ProQuest were searched from 2000 to 2020. The included studies were selected by three independent researchers and summarised, compared, and categorized according to technology type. Publications were eligible for inclusion when they reported on psychosocial interventions aiming to reduce loneliness and/or social isolation in people with dementia in long-term care settings. RESULTS Twenty-four papers were included (20 original research papers and four reviews). Most studies were conducted in Australia and Europe. The studies aimed to investigate two different types of assistive technology: social robots, and multimedia computer systems. Most studies focussed on behaviour, engagement, and mood as primary outcomes. Only one study directly aimed to alleviate loneliness. CONCLUSIONS Even though only one study addressed loneliness directly, it became clear that assistive technologies used to apply psychosocial interventions have the potential to impact loneliness in people with dementia in long-term care. However, it remains unclear why loneliness was not included as an outcome and how loneliness could become a key outcome in evaluating assistive technologies.IMPLICATIONS FOR REHABILITATIONLoneliness among older adults is associated with health risks, such as the development of dementia, depression, and increased mortality.Ambient Assisted Living (AAL) technologies have been studied to address loneliness for older adults; however people with dementia are often excluded from such studies.This diverse group of technologies is shown to have a promising impact on outcomes, such as social engagement, quality of life, and mood, but loneliness was studied less often.More research is needed to discover the potential of assistive technologies for people with dementia living in long-term care.
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Affiliation(s)
- Kübra Beliz Budak
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Golnaz Atefi
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Viktoria Hoel
- Institute for Public Health and Nursing Science, University of Bremen, Bremen, Germany
| | - Franziska Laporte Uribe
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Franka Meiland
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) site Witten, Witten, Germany
- Department of Medicine for Older People Amsterdam UMC, Amsterdam, The Netherlands
| | - Sonja Teupen
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Simone Anna Felding
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Martina Roes
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany
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Conway A, Ryan A, Harkin D, Mc Cauley C. "It's Another Feather in My Hat"-Exploring Factors Influencing the Adoption of Apps With People Living With Dementia. DEMENTIA 2023; 22:1487-1513. [PMID: 37365816 PMCID: PMC10521156 DOI: 10.1177/14713012231185283] [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] [Indexed: 06/28/2023]
Abstract
INTRODUCTION With the growing interest and availability of mobile applications (apps) for people living with dementia, it is desirable to have a broader insight into how technology adoption may be further improved. This paper aims to explore the factors influencing adoption of mobile applications for people living with dementia. METHODS The recruitment of participants was facilitated through a dementia advocacy group of people living with dementia. A focus group design was applied to elicit discussion and to explore divergent views on the topic. The data was analysed using thematic analysis. FINDINGS The 15 individuals who participated in this study comprised of seven women and eight men within the age range of 60-90 years. This study reports key findings pertaining to the views and experiences of using mobile apps. Data analysis revealed the following four distinct themes; (Theme 1: Living with dementia)-"That's the difficulty there even with apps or anything else." (Theme 2: Motivation)- "It makes me feel good. I feel a little with it [laughs], that its not all gone in there" (Theme 3: Fears and Concerns)- "Can somebody else get into your personal memories?" (Theme 4- Support)- "So it's important that we have that support". Together these themes encapsulate the most influential aspects, as highlighted by the participants influencing the acceptance and adoption of apps. CONCLUSION This paper explores the barriers and facilitators to app acceptance and adoption. This includes the importance of "feel good moments" and positive experiences, challenges associated with living with dementia, the importance of ongoing support, and security of the user's information. This study adds to what is already known by capturing the views and experiences of people living with dementia in relation to the factors influencing the adoption of apps.
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Affiliation(s)
- Aoife Conway
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
| | - Assumpta Ryan
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
| | - Deirdre Harkin
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
| | - Claire Mc Cauley
- School of Nursing and Paramedic Science, Ulster University, Co Londonderry, NI, UK
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Pilli K, Worne B, Simpson G. Clinician experiences with using assistive technology in brain injury rehabilitation: a survey of clinician capability, attitudes, and barriers. BRAIN IMPAIR 2023; 24:185-203. [PMID: 38167181 DOI: 10.1017/brimp.2023.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND The rise in assistive technology (AT) solutions to support people with an acquired brain injury (ABI) has warranted clinicians to build capability in assisting clients to select goal-centred AT. The study explored, amongst ABI clinicians, (a) capability, attitudes, and barriers with AT implementation, (b) age-related differences in technology self-efficacy and capability (c) strategies to support AT use in rehabilitation and (d) thematic analysis of AT-related experiences. METHOD Mixed methods design. Online survey circulated to ABI clinicians across New South Wales, Australia, comprising purpose-designed items as well as the Modified Computer Self-Efficacy Scale (MCSES; range 0-100). RESULTS Clinicians (n = 123) were evenly distributed across decadal age groups. The majority were female (90%, n = 111) and one-third were occupational therapists.Clinicians scored strongly on the MCSES (Mdn = 76, IQR = 19), with younger age groups significantly associated with higher scores (H[3] = 9.667, p = .022). Most clinicians (92%) were knowledgeable of mainstream technology for personal use, but over half (65%) reported insufficient knowledge of suitable AT for clients. Clinicians reported positive attitudes towards AT, however, time to research and develop proficiency with a range of AT was the primary barrier (81%).Thematic analysis suggested that whilst the ideal AT experience is client-motivated requiring multidisciplinary guidance, the clinician role and experience with AT is evolving, influenced by rapid technological advancement and extrinsic opportunities to access AT. CONCLUSIONS Whilst clinicians have positive attitudes towards AT, there is a gap in clinician implementation. There is need to support further resources to build clinician capability and access to AT.
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Affiliation(s)
- Kavya Pilli
- Liverpool Brain Injury Unit, Liverpool Hospital, Sydney, Australia
| | - Brendan Worne
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Grahame Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
- John Walsh Centre of Rehabilitation Research, Kolling Institute, Sydney, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Schicktanz S, Welsch J, Schweda M, Hein A, Rieger JW, Kirste T. AI-assisted ethics? considerations of AI simulation for the ethical assessment and design of assistive technologies. Front Genet 2023; 14:1039839. [PMID: 37434952 PMCID: PMC10331421 DOI: 10.3389/fgene.2023.1039839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 05/23/2023] [Indexed: 07/13/2023] Open
Abstract
Current ethical debates on the use of artificial intelligence (AI) in healthcare treat AI as a product of technology in three ways. First, by assessing risks and potential benefits of currently developed AI-enabled products with ethical checklists; second, by proposing ex ante lists of ethical values seen as relevant for the design and development of assistive technology, and third, by promoting AI technology to use moral reasoning as part of the automation process. The dominance of these three perspectives in the discourse is demonstrated by a brief summary of the literature. Subsequently, we propose a fourth approach to AI, namely, as a methodological tool to assist ethical reflection. We provide a concept of an AI-simulation informed by three separate elements: 1) stochastic human behavior models based on behavioral data for simulating realistic settings, 2) qualitative empirical data on value statements regarding internal policy, and 3) visualization components that aid in understanding the impact of changes in these variables. The potential of this approach is to inform an interdisciplinary field about anticipated ethical challenges or ethical trade-offs in concrete settings and, hence, to spark a re-evaluation of design and implementation plans. This may be particularly useful for applications that deal with extremely complex values and behavior or with limitations on the communication resources of affected persons (e.g., persons with dementia care or for care of persons with cognitive impairment). Simulation does not replace ethical reflection but does allow for detailed, context-sensitive analysis during the design process and prior to implementation. Finally, we discuss the inherently quantitative methods of analysis afforded by stochastic simulations as well as the potential for ethical discussions and how simulations with AI can improve traditional forms of thought experiments and future-oriented technology assessment.
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Affiliation(s)
- Silke Schicktanz
- University Medical Center Göttingen, Department for Medical Ethics and History of Medicine, Göttingen, Germany
- Hanse-Wissenschaftskolleg, Institute of Advance Studies, Delmenhorst, Germany
| | - Johannes Welsch
- University Medical Center Göttingen, Department for Medical Ethics and History of Medicine, Göttingen, Germany
| | - Mark Schweda
- University of Oldenburg, Department of Health Services Research, Division for Ethics in Medicine, Oldenburg, Germany
| | - Andreas Hein
- University of Oldenburg, Department of Health Services Research, Division Assistance Systems and Medical Device Technology, Oldenburg, Germany
| | - Jochem W. Rieger
- University of Oldenburg, Applied Neurocognitive Psychology Lab, Oldenburg, Germany
| | - Thomas Kirste
- University of Rostock, Institute for Visual and Analytic Computing, Rostock, Germany
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Ohneberg C, Stöbich N, Warmbein A, Rathgeber I, Mehler-Klamt AC, Fischer U, Eberl I. Assistive robotic systems in nursing care: a scoping review. BMC Nurs 2023; 22:72. [PMID: 36934280 PMCID: PMC10024291 DOI: 10.1186/s12912-023-01230-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/03/2023] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND The use of assistive robotic systems in care is intended to relieve nursing staff. Differentiated and literature-based findings on current application possibilities, technological developments and empirical findings are necessary to enable a goal-oriented and participatory development of assistive robotic systems of care. The aim of this review was to identify assistive robotic systems and their areas of application in nursing settings. Furthermore, an overview of existing social and nursing science findings from the research field of assistive robotic systems will be described. METHODS A systematic literature search was performed based on the JBI scoping review methodology. During the period from May to August 2020, the databases MEDLINE via PubMed, CINAHL, Cochrane Library, Web of Science, and IEEE Xplore Digital Library were searched. In order to reflect current developments and evidence in the present literature work, a supplementary search with these same requirements was conducted in January 2022. RESULTS The 47 included publications are divided into 15 studies, 23 technical articles and nine opinion-based articles (text-opinion). A total of 39 different assistive robotic systems were identified. There were 55% in the testing phase and 29% of the systems in the development phase. Assistive robotic systems can be divided into six fields of application: Information and patient data processing, assistance with activities of daily living, fetch and bring activities, telepresence and communication, monitoring, safety and navigation, and complex assistance systems. The description of the study findings is divided into "integration of technology and impact on practice" and "attitude and acceptance of elderly people towards assistive robotic systems". CONCLUSION The results of the research show that the use of assistive robotic systems in care mainly take place in the context of development and testing phases. In addition to usability and acceptance issues, implementation factors must be integrated into theory-driven research projects.
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Affiliation(s)
- Christoph Ohneberg
- Professorship of Nursing Science, Faculty of Social Work, Catholic University of Eichstätt-Ingolstadt, Kapuzinergasse 2, 85072, Eichstätt, Germany.
| | - Nicole Stöbich
- Professorship of Nursing Science, Faculty of Social Work, Catholic University of Eichstätt-Ingolstadt, Kapuzinergasse 2, 85072, Eichstätt, Germany
| | - Angelika Warmbein
- Clinical Nursing Research and Quality Management Unit, University Hospital LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Ivanka Rathgeber
- Clinical Nursing Research and Quality Management Unit, University Hospital LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Amrei Christin Mehler-Klamt
- Professorship of Nursing Science, Faculty of Social Work, Catholic University of Eichstätt-Ingolstadt, Kapuzinergasse 2, 85072, Eichstätt, Germany
| | - Uli Fischer
- Clinical Nursing Research and Quality Management Unit, University Hospital LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Inge Eberl
- Professorship of Nursing Science, Faculty of Social Work, Catholic University of Eichstätt-Ingolstadt, Kapuzinergasse 2, 85072, Eichstätt, Germany
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Berridge C, Turner NR, Liu L, Fredriksen-Goldsen KI, Lyons KS, Demiris G, Kaye J, Lober WB. Preliminary Efficacy of Let's Talk Tech: Technology Use Planning for Dementia Care Dyads. Innov Aging 2023; 7:igad018. [PMID: 37123031 PMCID: PMC10132307 DOI: 10.1093/geroni/igad018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Indexed: 03/06/2023] Open
Abstract
Background and Objective Care partners of people living with dementia require support to knowledgeably navigate decision making about how and when to use monitoring technologies for care purposes. We conducted a pilot study of a novel self-administered intervention, "Let's Talk Tech," for people living with mild dementia and their care partners. This paper presents preliminary efficacy findings of this intervention designed to educate and facilitate dyadic communication about a range of technologies used in dementia care and to document the preferences of the person living with dementia. It is the first-of-its-kind decision-making and planning tool with a specific focus on technology use. Research Design and Methods We used a 1-group pretest-post-test design and paired t tests to assess change over 2 time periods in measures of technology comprehension, care partner knowledge of the participant living with mild Alzheimer's disease's (AD) preferences, care partner preparedness to make decisions about technology use, and mutual understanding. Thematic analysis was conducted on postintervention interview transcripts to elucidate mechanisms and experiences with Let's Talk Tech. Results Twenty-nine mild AD dementia care dyads who live together completed the study. There was statistically significant improvement with medium and large effect sizes on outcome measures of care partners' understanding of each technology, care partners' perceptions of the person living with dementia's understanding of each technology, knowledge of the person living with dementia's preferences, decision-making preparedness, and care partners' feelings of mutual understanding. Participants reported that it helped them have important and meaningful conversations about using technology. Discussion and Implications Let's Talk Tech demonstrated promising preliminary efficacy on targeted measures that can lead to informed, shared decision making about technologies used in dementia care. Future studies should assess efficacy with larger samples and more diverse sample populations in terms of race, ethnicity, and dementia type.
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Affiliation(s)
- Clara Berridge
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Natalie R Turner
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Liu Liu
- College of Education, University of Washington, Seattle, Washington, USA
| | | | - Karen S Lyons
- William F. Connell School of Nursing, Boston College, Boston, Massachusetts, USA
| | - George Demiris
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jeffrey Kaye
- Layton Aging and Alzheimer’s Disease Center and Oregon Center for Aging and Technology, School of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - William B Lober
- Clinical Informatics Research Group, School of Nursing, University of Washington, Seattle, Washington, USA
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[Artificial intelligence and ethics in healthcare-balancing act or symbiosis?]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:176-183. [PMID: 36650296 PMCID: PMC9892090 DOI: 10.1007/s00103-022-03653-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/19/2022] [Indexed: 01/19/2023]
Abstract
Artificial intelligence (AI) is becoming increasingly important in healthcare. This development triggers serious concerns that can be summarized by six major "worst-case scenarios". From AI spreading disinformation and propaganda, to a potential new arms race between major powers, to a possible rule of algorithms ("algocracy") based on biased gatekeeper intelligence, the real dangers of an uncontrolled development of AI are by no means to be underestimated, especially in the health sector. However, fear of AI could cause humanity to miss the opportunity to positively shape the development of our society together with an AI that is friendly to us.Use cases in healthcare play a primary role in this discussion, as both the risks and the opportunities of new AI-based systems become particularly clear here. For example, would older people with dementia (PWD) be allowed to entrust aspects of their autonomy to AI-based assistance systems so that they may continue to independently manage other aspects of their daily lives? In this paper, we argue that the classic balancing act between the dangers and opportunities of AI in healthcare can be at least partially overcome by taking a long-term ethical approach toward a symbiotic relationship between humans and AI. We exemplify this approach by showcasing our I‑CARE system, an AI-based recommendation system for tertiary prevention of dementia. This system has been in development since 2015 as the I‑CARE Project at the University of Bremen, where it is still being researched today.
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Ma B, Yang J, Wong FKY, Wong AKC, Ma T, Meng J, Zhao Y, Wang Y, Lu Q. Artificial intelligence in elderly healthcare: A scoping review. Ageing Res Rev 2023; 83:101808. [PMID: 36427766 DOI: 10.1016/j.arr.2022.101808] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/26/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022]
Abstract
The ageing population has led to a surge in the adoption of artificial intelligence (AI) technologies in elderly healthcare worldwide. However, in the advancement of AI technologies, there is currently a lack of clarity about the types and roles of AI technologies in elderly healthcare. This scoping review aimed to provide a comprehensive overview of AI technologies in elderly healthcare by exploring the types of AI technologies employed, and identifying their roles in elderly healthcare based on existing studies. A total of 10 databases were searched for this review, from January 1 2000 to July 31 2022. Based on the inclusion criteria, 105 studies were included. The AI devices utilized in elderly healthcare were summarised as robots, exoskeleton devices, intelligent homes, AI-enabled health smart applications and wearables, voice-activated devices, and virtual reality. Five roles of AI technologies were identified: rehabilitation therapists, emotional supporters, social facilitators, supervisors, and cognitive promoters. Results showed that the impact of AI technologies on elderly healthcare is promising and that AI technologies are capable of satisfying the unmet care needs of older adults and demonstrating great potential in its further development in this area. More well-designed randomised controlled trials are needed in the future to validate the roles of AI technologies in elderly healthcare.
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Affiliation(s)
- Bingxin Ma
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Jin Yang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | | | | | - Tingting Ma
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Jianan Meng
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, China.
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China; School of Integrative Medicine, Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China; National Institute of Health Data Science at Peking University, Beijing, China.
| | - Qi Lu
- School of Nursing, Tianjin Medical University, Tianjin, China.
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Conway A, Ryan A, Harkin D, Mc Cauley C, Goode D. A review of the factors influencing adoption of digital health applications for people living with dementia. Digit Health 2023; 9:20552076231162985. [PMID: 36937696 PMCID: PMC10017937 DOI: 10.1177/20552076231162985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/23/2023] [Indexed: 03/17/2023] Open
Abstract
Objective Researchers have used various theories and models to understand technology adoption, however, with the growing interest and availability of mobile applications (apps) for people living with dementia, it is desirable to have a broader insight into how technology adoption may be further improved. This paper aims to explore the factors influencing the adoption of digital health applications for people living with dementia and add to the current literature on this topic. Methods Searches were conducted in CINHAL, Web of Science, Psych Info, ProQuest Health and Medical, IEEE Xplore and Scopus. Citation searching and handsearching were used in the identification of other studies. Results Following an assessment of relevancy, nine studies remained and are included within this review. Methodological quality was assessed using The Mixed Methods Appraisal Tool (MMAT). A thematic analysis was used for the data synthesis of included studies. Each study reported on different types of apps. Conclusion From the synthesis of included studies, four analytic themes were identified; Theme 1: Personal and contextual factors; Theme 2: Perceived value and benefit; Theme 3: Design and content of app; and Theme 4: Digital Literacy and Confidence. People are diverse and so are their reasons for the adoption of apps. These findings provide an insight into the range of factors that impact the adoption of apps for people living with dementia. Understanding the factors that impact the adoption of mobile applications is critical to their success. These findings can be beneficial for app developers and for people living with dementia and their carers.
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Affiliation(s)
- Aoife Conway
- School of Nursing and Paramedic Science, Faculty of Life & Health Sciences, Ulster University, Co. Derry, Northern Ireland
- Aoife Conway, School of Nursing and Paramedic Science, Faculty of Life & Health Sciences, Magee Campus, Ulster University, Co. Derry, Northern Ireland.
| | - Assumpta Ryan
- School of Nursing and Paramedic Science, Faculty of Life & Health Sciences, Ulster University, Co. Derry, Northern Ireland
| | - Deirdre Harkin
- School of Nursing and Paramedic Science, Faculty of Life & Health Sciences, Ulster University, Co. Derry, Northern Ireland
| | - Claire Mc Cauley
- School of Nursing and Paramedic Science, Faculty of Life & Health Sciences, Ulster University, Co. Derry, Northern Ireland
| | - Deborah Goode
- School of Nursing and Paramedic Science, Faculty of Life & Health Sciences, Ulster University, Co. Derry, Northern Ireland
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Prieto-Avalos G, Sánchez-Morales LN, Alor-Hernández G, Sánchez-Cervantes JL. A Review of Commercial and Non-Commercial Wearables Devices for Monitoring Motor Impairments Caused by Neurodegenerative Diseases. BIOSENSORS 2022; 13:72. [PMID: 36671907 PMCID: PMC9856141 DOI: 10.3390/bios13010072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
Neurodegenerative diseases (NDDs) are among the 10 causes of death worldwide. The effects of NDDs, including irreversible motor impairments, have an impact not only on patients themselves but also on their families and social environments. One strategy to mitigate the pain of NDDs is to early identify and remotely monitor related motor impairments using wearable devices. Technological progress has contributed to reducing the hardware complexity of mobile devices while simultaneously improving their efficiency in terms of data collection and processing and energy consumption. However, perhaps the greatest challenges of current mobile devices are to successfully manage the security and privacy of patient medical data and maintain reasonable costs with respect to the traditional patient consultation scheme. In this work, we conclude: (1) Falls are most monitored for Parkinson's disease, while tremors predominate in epilepsy and Alzheimer's disease. These findings will provide guidance for wearable device manufacturers to strengthen areas of opportunity that need to be addressed, and (2) Of the total universe of commercial wearables devices that are available on the market, only a few have FDA approval, which means that there is a large number of devices that do not safeguard the integrity of the users who use them.
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Affiliation(s)
- Guillermo Prieto-Avalos
- Tecnológico Nacional de México/I.T. Orizaba, Av. Oriente 9 No. 852 Col. Emiliano Zapata, Orizaba 94320, Veracruz, Mexico
| | - Laura Nely Sánchez-Morales
- CONACYT-Tecnológico Nacional de México/I.T. Orizaba, Av. Oriente 9 No. 852 Col. Emiliano Zapata, Orizaba 94320, Veracruz, Mexico
| | - Giner Alor-Hernández
- Tecnológico Nacional de México/I.T. Orizaba, Av. Oriente 9 No. 852 Col. Emiliano Zapata, Orizaba 94320, Veracruz, Mexico
| | - José Luis Sánchez-Cervantes
- CONACYT-Tecnológico Nacional de México/I.T. Orizaba, Av. Oriente 9 No. 852 Col. Emiliano Zapata, Orizaba 94320, Veracruz, Mexico
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23
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Ohneberg C, Warmbein A, Stöbich N, Rathgeber I, Kruppa A, Nast-Kolb J, Träger MF, Bahou A, Stahl O, Eberl I, Fischer U. Study protocol for the implementation and evaluation of a digital-robotic-based intervention for nurses and patients in a hospital: a quantitative and qualitative triangulation based on the Medical Research Council (MRC) framework for developing and evaluating complex interventions. BMC Nurs 2022; 21:349. [PMID: 36494679 PMCID: PMC9733387 DOI: 10.1186/s12912-022-01088-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/27/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Nurses spend part of their working time on non-nursing tasks. Unnecessary walking distances and the assumption of service activities and other non-care-related tasks take up a lot of space, which reduces the time for direct patient care and demonstrably increases the dissatisfaction of the persons involved. The REsPonSe project aims to relieve nursing staff by using a smartphone app for communication in combination with an autonomous service robot to reduce walking distances and service activities. The technical systems are tested on a nuclear medicine ward and are intended to reduce the radiation exposure of the staff. The aim of this study is to test and evaluate the use and intervention of the technical systems, the acceptance of the users and the change in the utilisation of the nursing service. In addition to findings on usability and manageability, effects on nursing practice, as well as facilitating and inhibiting contextual factors for implementation, will be identified. METHODS The Medical Research Council (MRC) Framework for Developing and Evaluating for Complex Interventions was chosen as the theoretical basis. The data collection in the Feasibility and Evaluation phase is a triangulation of quantitative and qualitative methods. Standardised observations are planned to collect data on non-care activities and walking distances, and a survey of utilisation by use of a questionnaire based on the NASA TLX. Qualitative individual interviews with patients and group discussions with nursing staff will be conducted. Statements on the subjective experiences, as well as the evaluation of the use of the digital-robotic system in the clinical setting, will be collected. The descriptive evaluation of the usage and retrieval data will provide information on duration, time, requests, and reduced contact times, as well as error and fault messages. DISCUSSION The evaluation study will make it possible to represent a variety of perspectives from different interest groups. The results should contribute to the definition of implementation and evaluation criteria and facilitate the integration of digital-robotic assistance systems in nursing acute inpatient settings. TRIAL REGISTRATION The trial was registered with the German Clinical Trials Register (DRKS) on 16.02.2022: DRKS00028127.
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Affiliation(s)
- Christoph Ohneberg
- grid.440923.80000 0001 1245 5350Professorship of Nursing Science, Faculty of Social Work, Catholic University of Eichstätt-Ingolstadt, Kapuzinergasse 2, 85072 Eichstätt, Germany
| | - Angelika Warmbein
- grid.411095.80000 0004 0477 2585Clinical Nursing Research and Quality Management Unit, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Nicole Stöbich
- grid.440923.80000 0001 1245 5350Professorship of Nursing Science, Faculty of Social Work, Catholic University of Eichstätt-Ingolstadt, Kapuzinergasse 2, 85072 Eichstätt, Germany
| | - Ivanka Rathgeber
- grid.411095.80000 0004 0477 2585Clinical Nursing Research and Quality Management Unit, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Astrid Kruppa
- Cliniserve GmbH, Balanstr. 73/10, 81541 Munich, Germany
| | | | | | - Aissam Bahou
- Robotise AG, Otto-Hahn-Ring 6, Building 60, 81739 Munich, Germany
| | - Oliver Stahl
- Robotise AG, Otto-Hahn-Ring 6, Building 60, 81739 Munich, Germany
| | - Inge Eberl
- grid.440923.80000 0001 1245 5350Professorship of Nursing Science, Faculty of Social Work, Catholic University of Eichstätt-Ingolstadt, Kapuzinergasse 2, 85072 Eichstätt, Germany
| | - Uli Fischer
- grid.411095.80000 0004 0477 2585Clinical Nursing Research and Quality Management Unit, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
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Zhu J, Shi K, Yang C, Niu Y, Zeng Y, Zhang N, Liu T, Chu CH. Ethical issues of smart home-based elderly care: A scoping review. J Nurs Manag 2022; 30:3686-3699. [PMID: 34806243 DOI: 10.1111/jonm.13521] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 11/10/2021] [Accepted: 11/16/2021] [Indexed: 12/30/2022]
Abstract
AIM To explore current research on the ethics of smart home technologies including artificial intelligence and information technologies for elderly care by conducting a scoping review. BACKGROUND The development of smart home technologies for care of the older adults provides potential solutions to reduce the caregiver burden within families where they are urgently needed. Building an ethical system to support the application of these technical products should be explored. METHODS The literature search was performed in seven electronic databases. Relevant studies from January 2015 to February 2021 were selected; screening and analysis were completed independently by two researchers. RESULTS There were a total of 15 included studies on the ethics of smart home technologies for elderly care, which focused on the following issues: privacy (information privacy and physical privacy), autonomy (independence, informed consent and user-centred control), safety guarantee, fairness and concerns about reduced human contact. CONCLUSIONS There exist a number of ethical conflicts in the application of smart home technologies for elderly care. Therefore, it is necessary to further investigate the ethical issues with regards to the decision-making process of weighing the advantages and disadvantages of these technologies. IMPLICATIONS FOR NURSING MANAGEMENT Efforts should be made to establish a corresponding ethical framework to ensure the sustainable development of smart, home-based elderly care. Nurses may play an important role in the design and implementation of these technologies to promote ethical awareness and practice.
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Affiliation(s)
- Junhong Zhu
- Nursing Studies, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kaiyuan Shi
- Nursing Studies, School of Medicine, Zhejiang University and Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Chengyue Yang
- Department of Sociology, Zhejiang University, Hangzhou, China
| | - Yanping Niu
- Department of Nursing, Changzhi Medical College, Changzhi, China
| | - Yingchun Zeng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Ning Zhang
- School of Public Health and the Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China
| | - Tao Liu
- State Key Laboratory of Fluid Power and Mechatronic Systems, School of Mechanical Engineering, Zhejiang University, Yuquan Campus, Hangzhou, China
| | - Charlene H Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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25
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Liddle J, Worthy P, Frost D, Taylor E, Taylor D. Partnering with people living with dementia and care partners in technology research and design: Reflections and recommendations. Aust Occup Ther J 2022; 69:723-741. [PMID: 36203322 PMCID: PMC10092369 DOI: 10.1111/1440-1630.12843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/15/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Occupational therapists may recommend and support technology use for facilitating independence, safety, wellbeing, and participation. There are high expectations for technology for people living with dementia. However, there is recognition that technologies will need to improve to deliver these expected benefits. People living with dementia have historically been excluded from direct involvement in research and design. A program of participatory research was undertaken to codesign technologies and technology research with people living with dementia and care partners. This work aims to capture the requirements, actions, and barriers experienced in forming these partnerships in technology research and design. METHODS A shared metareflection of experiences was conducted by members (5) of the research teams involved in three participatory research and technology design studies. The team comprising living experience experts, an occupational therapist, and interaction designer reflected on their experiences and derived recommendations. Key considerations for effective partnerships were drawn inductively by the authors from study experiences, materials, and reflexive discussion. FINDINGS Six core areas were identified. These were four action areas-(1) Agree on the value; (2) The time to start partnering is now; (3) Ask not assume; and (4) Push back on 'we always have'-(5) barriers and tensions, and (6) unexpected benefits. The reflections indicated that genuine partnerships and engagements were possible with living experience experts in research and design teams. These required resourcing and focussed actions to promote partnership. Despite some structural changes that encourage partnering, there are considerable barriers to this engagement; however, benefits beyond the expected ones can be realised. CONCLUSION Genuine partnerships in technology research and design with living experience experts are possible and lead to benefits for the team, research outcomes, and technologies. Recommended actions could support expansion of effective partnerships with people living with dementia and care partners as well as other partnerships in research.
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Affiliation(s)
- Jacki Liddle
- The Florence Project, School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland, Australia
| | - Peter Worthy
- The Florence Project, School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland, Australia
| | - Dennis Frost
- The Florence Project, School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland, Australia
| | - Eileen Taylor
- The Florence Project, School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland, Australia
| | - Dubhglas Taylor
- The Florence Project, School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland, Australia
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Tea, Technology and Me: a World Café approach to engage people with dementia and their carers about research priorities and policy development in digital technology and artificial intelligence. RESEARCH FOR ALL 2022. [DOI: 10.14324/rfa.06.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Digital technology and artificial intelligence (AI) use in health care is increasing, and it potentially offers significant patient benefit, such as independence, improved care and health care at home. Workforce benefits are apparent, for example, releasing time to see patients. However, are ethical and moral dilemmas of such technologies sufficiently unpacked by patients and understood by clinicians? A person living with dementia, and carers of people with dementia, alongside academics and clinicians, designed a public engagement World Café event for 20 people living with dementia and their carers. This process is described, as are reflections on a World Café approach to generate knowledge on a lesser explored topic. Working with a graphic recorder at the event proved a dynamic and engaging way of visually displaying feedback, served as an aide memoire and generated further discussion. Three feedback themes are highlighted: (1) trust; (2) continuity of care; and (3) support and independence. The event’s subsequent evaluation and impact, including a presentation to the House of Lords All-Party Parliamentary Group on Artificial Intelligence, are described. In conclusion, a suitable World Café approach enables people with dementia and their carers to voice exceptionally useful insights into a topic that already affects, or is very likely to, affect them.
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Chan DKY, Chan LKM, Kuang YM, Le MNV, Celler B. Digital care technologies in people with dementia living in long-term care facilities to prevent falls and manage behavioural and psychological symptoms of dementia: a systematic review. Eur J Ageing 2022; 19:309-323. [PMID: 36052197 PMCID: PMC9424434 DOI: 10.1007/s10433-021-00627-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2021] [Indexed: 11/26/2022] Open
Abstract
Fall prevention and management of behavioural and psychological symptoms of dementia (BPSD) in long-term care (LTC) facility is a major challenge. The objective of this systematic review is to assess the evidence of digital technology in their management. All studies of English-language excluding case-reports were eligible for review. Databases chosen were MEDLINE, EMBASE, Scopus, Web of Science and PSYCINFO from January 2000 to June 2020. Downs and Black checklist was used to check for risk of bias. Papers with a focus in LTC setting, using digital technology as intervention for older adults with dementia, and with measurable outcomes (outcomes that are quantified, not descriptive) were included in the final review. Seventeen original papers (8 RCTs, 8 quasi-experimental and 1 mixed method) were included. Three articles examining position-sensor technology for fall prevention showed mixed results. Two showed no difference and 1 showed small reduction in fall after alarm removal but the positive effect might be due to bias. Overall, the sample sizes were too small to draw meaningful conclusion. Fourteen studies (9 pet robots of which 8 were robotic seal/PARO) were identified for BPSD and results were mixed. Overall, PARO might have modest benefit in BPSD compared to usual care but might be no better than plush toy with more hallucinations or delusions seen in advanced dementia. However, the significant heterogeneity in methodology (intervention intensity, lack of record in psychoactive drug use), clinical tools used (different BPSD scales, different digital technologies) and variability in outcomes made it difficult to draw clear-cut conclusion. Studies involving other digital technologies are scarce and in pilot phases; hence, conclusion is premature. One limitation of the review was that only 9 out of 17 studies were of good quality. The limited research work in position-sensors meant insufficient evidence to prove efficacy for their use in LTC setting. The possible modest benefit of PARO in BPSD (e.g. in agitation, apathy or reduction in psychoactive drugs) was off-set by possible adverse events such as delusions or hallucinations in advanced dementia. Supplementary Information The online version contains supplementary material available at 10.1007/s10433-021-00627-5.
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Affiliation(s)
- Daniel Kam Yin Chan
- University of New South Wales, Sydney, NSW 2052 Australia
- Department of Aged Care and rehabilitation, Bankstown-Lidcombe Hospital, Bankstown, NSW 2200 Australia
| | | | - Ye Min Kuang
- Department of Aged Care and rehabilitation, Bankstown-Lidcombe Hospital, Bankstown, NSW 2200 Australia
| | - Mai Nhat Vi Le
- University of New South Wales, Sydney, NSW 2052 Australia
| | - Branko Celler
- University of New South Wales, Sydney, NSW 2052 Australia
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28
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New horizons in digital innovation and technology in dementia: potential and possible pitfalls. Eur Geriatr Med 2022; 13:1025-1027. [PMID: 35879561 PMCID: PMC9314243 DOI: 10.1007/s41999-022-00677-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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29
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Löbe C, AboJabel H. Empowering people with dementia via using intelligent assistive technology: A scoping review. Arch Gerontol Geriatr 2022; 101:104699. [DOI: 10.1016/j.archger.2022.104699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/28/2022] [Accepted: 03/24/2022] [Indexed: 11/16/2022]
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Dequanter S, Fobelets M, Steenhout I, Gagnon MP, Bourbonnais A, Rahimi S, Buyl R, Gorus E. Determinants of technology adoption and continued use among cognitively impaired older adults: a qualitative study. BMC Geriatr 2022; 22:376. [PMID: 35484488 PMCID: PMC9047390 DOI: 10.1186/s12877-022-03048-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Technology offers opportunities to support older adults with mild cognitive impairments to remain independent and socially connected, but is often not used. Although determinants of technology use among older adults in general are well studied, much less is known about how these factors impact technology use behaviour in cognitively impaired older adults. This study aimed to bridge this gap in research by examining the factors underlying technology use in community-dwelling older adults with mild cognitive impairments. Methods We applied a generic qualitative design and used 16 semi-structured interviews to collect data from Belgian (Flemish) community-dwelling older adults diagnosed with Mild Cognitive Impairment or dementia and informal caregivers. To get data from different perspectives, a focus group with professional caregivers was added. We used thematic analysis with an inductive approach to identify and select themes from the data. Results We identified two themes: introduction of technology and determinants of technology adoption and continued use. Successful technology adoption in cognitively impaired older adults is need-driven and subject to individual, technological and contextual characteristics. Specific for older adults with cognitive impairments are the importance of disease awareness and cognitive ability for adoption and continued use, respectively. Although social support can be a valuable alternative to technology, it is an important facilitator of continued technology use in these older adults. Similarly, integration of technologies in daily routines can buffer discontinuation of technologies. Conclusions Future research is encouraged to validate our findings in a postpandemic era and to further develop a novel theoretical framework for technology acceptance among older adults with cognitive impairments. Moreover, identification of crucial determinants as well as strategies to remove use barriers are also important future research tasks. Clinical practice should focus on improving disease awareness to facilitate technology adoption and policies should invest in training and support of professional caregivers and in reimbursement strategies to facilitate implementation of technology in practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03048-w.
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Affiliation(s)
- Samantha Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maaike Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Iris Steenhout
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | | | | | - Samira Rahimi
- Department of Family Medicine, McGill University, Montreal, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,MILA - Quebec Artificial Intelligence Institute, Montreal, Quebec, Canada
| | - Ronald Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ellen Gorus
- Department of Gerontology, Faculty of Medicine and Pharmacy, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium. .,Department of Geriatrics, UZ Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
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31
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Liddle J, Worthy P, Frost D, Taylor E, Taylor D, Beleno R, Angus D, Wiles J, Angwin A. Personal and complex: The needs and experiences related to technology use for people living with dementia. DEMENTIA 2022; 21:1511-1531. [PMID: 35420505 DOI: 10.1177/14713012221084521] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND With increasing focus on living well with dementia, technology has been identified as having potential benefits for safety, independence and wellbeing. Despite a large growth in specialised technology development, there has been limited uptake. There is a need to understand the current use and needs related to technology for people living with dementia and their care partners (informal carers). METHODS As part of a participatory design study, a qualitative inquiry into technology experiences and needs was undertaken within an interpretive description approach. A cross-disciplinary team including living experience experts (people living with dementia, unpaid care partners) was involved. Semi-structured interviews, including sharing technology locations and supports, were conducted, audio-recorded and transcribed. Key aspects of the technology use experience were constructed. FINDINGS Thirteen people living with dementia and 21 care partners participated in the study. Two core aspects of technology use were identified: Lots of moving parts: the complex context, and A technology cycle: the use and non-use. The findings indicated that the context involved an individual configuration of multiple factors including the user, their technology identity, their supporters, the technology and the environment. The experience is underpinned by shifting foundations created by constantly changing technologies and user characteristics. The cycle of use and non-use identified the processes required to maintain technology engagement. CONCLUSION The use of technology for people living with dementia is complex and personal. Future technology development, policies and practices need to consider this complexity and the effort required to keep using technology to realise the benefits.
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Affiliation(s)
- Jacki Liddle
- Human Centred Computing Group, School of Information Technology and Electrical Engineering, 1974The University of Queensland, Brisbane, QLD, Australia
| | - Peter Worthy
- Human Centred Computing Group, School of Information Technology and Electrical Engineering, 1974The University of Queensland, Brisbane, QLD, Australia
| | - Dennis Frost
- Human Centred Computing Group, School of Information Technology and Electrical Engineering, 1974The University of Queensland, Brisbane, QLD, Australia
| | - Eileen Taylor
- Human Centred Computing Group, School of Information Technology and Electrical Engineering, 1974The University of Queensland, Brisbane, QLD, Australia
| | - Dubhglas Taylor
- Human Centred Computing Group, School of Information Technology and Electrical Engineering, 1974The University of Queensland, Brisbane, QLD, Australia
| | - Ron Beleno
- Human Centred Computing Group, School of Information Technology and Electrical Engineering, 1974The University of Queensland, Brisbane, QLD, Australia
| | - Daniel Angus
- School of Communication, 1969Queensland University of Technology, Brisbane, QLD, Australia
| | - Janet Wiles
- Human Centred Computing Group, School of Information Technology and Electrical Engineering, 1974The University of Queensland, Brisbane, QLD, Australia
| | - Anthony Angwin
- School of Health and Rehabilitation Sciences, 1974The University of Queensland, Brisbane, QLD, Australia
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- Human Centred Computing Group, School of Information Technology and Electrical Engineering, 1974The University of Queensland, Brisbane, QLD, Australia
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Fan J, Mion LC, Beuscher L, Ullal A, Newhouse PA, Sarkar N. SAR-Connect: A Socially Assistive Robotic System to Support Activity and Social Engagement of Older Adults. IEEE T ROBOT 2022; 38:1250-1269. [PMID: 36204285 PMCID: PMC9531900 DOI: 10.1109/tro.2021.3092162] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Multi-domain activities that incorporate physical, cognitive, and social stimuli can enhance older adults' overall health and quality of life. Several robotic platforms have been developed to provide these therapies in a quantifiable manner to complement healthcare personnel in resource-strapped long-term care settings. However, these platforms are primarily limited to one-to-one human robot interaction (HRI) and thus do not enhance social interaction. In this paper, we present a novel HRI framework and a realized platform called SAR-Connect to foster robot-mediated social interaction among older adults through carefully designed tasks that also incorporate physical and cognitive stimuli. SAR-Connect seamlessly integrates a humanoid robot with a virtual reality-based activity platform and a multimodal data acquisition module including game interaction, audio, visual and electroencephalography responses of the participants. Results from a laboratory-based user study with older adults indicates the potential of SAR-Connect that showed this system could 1) involve one or multiple older adults to perform multi-domain activities and provide dynamic guidance, 2) engage them in the robot-mediated task and foster human-human interaction, and 3) quantify their social and activity engagement from multiple sensory modalities.
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Affiliation(s)
- Jing Fan
- Electrical Engineering and Computer Science Department, Vanderbilt University, Nashville, TN 37212 USA
| | - Lorraine C. Mion
- Center of Excellence in Critical and Complex Care, College of Nursing, The Ohio State University, OH 43210 USA
| | - Linda Beuscher
- Vanderbilt University School of Nursing, Nashville, TN 37204 USA
| | - Akshith Ullal
- Electrical Engineering and Computer Science Department, Vanderbilt University, Nashville, TN 37212 USA
| | - Paul A. Newhouse
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University, Geriatric Research Education and Clinical Center (GRECC), Tennessee Valley Veterans Affairs Medical Center, Nashville, TN 37212 USA
| | - Nilanjan Sarkar
- Mechanical Engineering Department, Electrical Engineering and Computer Science Department, Vanderbilt University, Nashville, TN 37212 USA
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König T, Pigliautile M, Águila O, Arambarri J, Christophorou C, Colombo M, Constantinides A, Curia R, Dankl K, Hanke S, Mayer CC, Moritsch S, Müllner-Rieder M, Pernkopf F, Schüler C, Stillo M, Mecocci P, Stögmann E. User experience and acceptance of a device assisting persons with dementia in daily life: a multicenter field study. Aging Clin Exp Res 2022; 34:869-879. [PMID: 34762252 PMCID: PMC8581127 DOI: 10.1007/s40520-021-02013-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/18/2021] [Indexed: 12/03/2022]
Abstract
Background Assistive technologies have the potential to facilitate everyday life of people with dementia and their families. Close collaboration with affected people and interdisciplinary research are essential to understand and address the needs of prospective users. In this study, we present the results of the evaluation of such an assistive system prototype. Aims Challenges from the patient and caregiver side, technical and design problems and acceptance and usability with regard to our special target group were evaluated. Methods MEMENTO, a system of two e-ink tablets and a smartwatch, was tested in the domestic environment of dementia patients. Thirty participants from Italy, Spain and Austria took part in a 3-month field trial and compared the MEMENTO system to traditional strategies in everyday life. Quantitative and qualitative data were collected and frequency of use of the system was monitored. Results There were no significant changes in quantitative measurements, such as activities of daily living and caregiver burden over the duration of the 3-month field trial. More frequent usage was significantly correlated with positive attitude towards technology (r = 0.723, p < 0.05), but not with age. The design of the system was positively emphasized, reducing fear of the technology on the one hand and stigmatization on the other. Conclusion We show that a positive attitude towards technology is the essential variable for successful implementation of such systems, regardless of age. Participants showed great interest in digital solutions and agreed that technological systems will help in maintaining independency of persons with cognitive dysfunction in the future. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-02013-8.
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Phan H, Mikkelsen K. Automatic sleep staging of EEG signals: recent development, challenges, and future directions. Physiol Meas 2022; 43. [PMID: 35320788 DOI: 10.1088/1361-6579/ac6049] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/23/2022] [Indexed: 11/11/2022]
Abstract
Modern deep learning holds a great potential to transform clinical practice on human sleep. Teaching a machine to carry out routine tasks would be a tremendous reduction in workload for clinicians. Sleep staging, a fundamental step in sleep practice, is a suitable task for this and will be the focus in this article. Recently, automatic sleep staging systems have been trained to mimic manual scoring, leading to similar performance to human sleep experts, at least on scoring of healthy subjects. Despite tremendous progress, we have not seen automatic sleep scoring adopted widely in clinical environments. This review aims to give a shared view of the authors on the most recent state-of-the-art development in automatic sleep staging, the challenges that still need to be addressed, and the future directions for automatic sleep scoring to achieve clinical value.
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Affiliation(s)
- Huy Phan
- School of Electronic Engineering and Computer Science, Queen Mary University of London, Mile End Rd, London, E1 4NS, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Kaare Mikkelsen
- Department of Electrical and Computer Engineering, Aarhus Universitet, Finlandsgade 22, Aarhus, 8000, DENMARK
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Dequanter S, Steenhout I, Fobelets M, Gagnon MP, Sasseville M, Bourbonnais A, Giguère A, Ndiaye MA, Lambert A, Gorus E, Buyl R. Technology implementation in care practices for community-dwelling older adults with mild cognitive decline: Perspectives of professional caregivers in Quebec and Brussels. Digit Health 2022; 8:20552076221139693. [PMID: 36420317 PMCID: PMC9677160 DOI: 10.1177/20552076221139693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/01/2022] [Indexed: 10/24/2023] Open
Abstract
OBJECTIVE As worldwide population aging is accelerating, innovative technologies are being developed to support independent living among community-dwelling older adults with mild cognitive decline. However, the successful implementation of these interventions is often challenging. Until now, literature on implementation issues related to the specific context of older adults with mild cognitive decline is lacking and the few studies available do not focus specifically on the perspective of professional caregivers. Yet the perspective of these caregivers is important as they can be considered a key facilitator for technology implementation among this population. Therefore, this study was the first to examine technology implementation among community-dwelling older adults with mild cognitive decline from the broader perspective of professional caregivers. METHODS In this qualitative study, two focus groups consisting of a heterogeneous pool of professional caregivers were conducted: one in Quebec (Canada, n = 6) and one in Brussels (Belgium, n = 8). Braun and Clarke' method for thematic analysis, guided by a qualitative descriptive approach was applied to inductively identify themes from the data. RESULTS We identified factors influencing technology implementation in older adults with mild cognitive decline on three levels: an individual level (e.g., characteristics of older adults with mild cognitive decline and professional caregivers' attitude), an organizational level (e.g., lack of training among professional caregivers) and a level referring to the broader context (e.g., ethical considerations). CONCLUSIONS This study contributes to the research gap in knowledge on the needs of professional caregivers to facilitate technology implementation among the population of older adults with cognitive decline. Future directions for research, practice, and policy are given, more specifically to improve knowledge among caregivers and on the development of decision support to retrieve safe and effective technologies that suit patient-centered care.
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Affiliation(s)
- S Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - I Steenhout
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Square, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Teacher Education, Vrije Universiteit Brussel, Brussels, Belgium
| | - MP Gagnon
- Department of Nursing Sciences, Université Laval, Quebec, Canada
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Quebec, Canada
| | - M Sasseville
- Department of Nursing Sciences, Université Laval, Quebec, Canada
- VITAM Centre de recherche en santé durable, Centre Intégré de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec, Canada
| | - A Bourbonnais
- Faculty of Nursing, Université de Montreal, Montreal, Canada
- Research Centre of the Institut Universitaire de gériatrie de Montréal, Canada
| | - A Giguère
- Department of Nursing Sciences, Université Laval, Quebec, Canada
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Quebec, Canada
| | - MA Ndiaye
- Arthritis Research Canada, Richmond, Canada
| | - A Lambert
- Department of Nursing Sciences, Université Laval, Quebec, Canada
| | - E Gorus
- Department of Gerontology, Faculty of Medicine and Pharmacy, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Geriatrics, UZ Brussel, Brussels, Belgium
| | - R Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
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Hackett K, Lehman S, Divers R, Ambrogi M, Gomes L, Tan CC, Giovannetti T. Remind Me To Remember: A pilot study of a novel smartphone reminder application for older adults with dementia and mild cognitive impairment. Neuropsychol Rehabil 2022; 32:22-50. [PMID: 32684106 PMCID: PMC7854961 DOI: 10.1080/09602011.2020.1794909] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The SmartPrompt is a smartphone-based reminder application informed by a neuropsychological model of functional disability. This laboratory-based pilot study examined the SmartPrompt feasibility, efficacy, and subjective usability using a within-participant, counterbalanced, cross-over design. Ten participants (M age = 80.3 + 8.2; M education = 15.7 + 2.5; 60% female) with mild cognitive impairment or mild dementia completed the Remember to Drink Test, which required preparing a glass of water at four predetermined times, in a SmartPrompt (SP) and Unprompted condition (UP). Written cues and a clock were available in both conditions; however, in the SP, the smartphone presented auditory alarms and visual reminders to obtain the water at specified times and required photo logging. In a separate session, caregivers were trained and tested on configuring the SmartPrompt. Overall, caregivers and participants learned to effectively use the SmartPrompt. Caregivers achieved near-perfect scores on the configuration quiz and responded well to training. Participants completed significantly more Remember to Drink tasks in the SP (93%) than UP (56%); checking the cues/clock decreased by 87% in the SP. Usability ratings were excellent among caregivers and fair among participants. Results indicate that the SmartPrompt holds promise for reducing functional disability in older adults with cognitive difficulties in at-home contexts.
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Affiliation(s)
| | - Sarah Lehman
- Department of Computer and Information Sciences, Temple University, Philadelphia, PA
| | - Ross Divers
- Department of Psychology, Louisiana State University, Baton Rouge, LA
| | - Matthew Ambrogi
- Department of Psychology, Temple University, Philadelphia, PA
| | - Likhon Gomes
- Department of Computer and Information Sciences, Temple University, Philadelphia, PA
| | - Chiu C. Tan
- Department of Computer and Information Sciences, Temple University, Philadelphia, PA
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Roberts E, Fan G, Chen X. In-Lab Development of a Mobile Interface for Cognitive Assistive Technology to Support Instrumental Activities of Daily Living in Dementia Homecare. JOURNAL OF AGING AND ENVIRONMENT 2021. [DOI: 10.1080/26892618.2021.2001710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kowe A, Köhler S, Görß D, Teipel S. The patients' and caregivers' perspective: In-hospital navigation aids for people with dementia- a qualitative study with a value sensitive design approach. Assist Technol 2021:1-10. [PMID: 34919023 DOI: 10.1080/10400435.2021.2020378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
People with dementia (PwD) have serious difficulties orienting themselves in a hospital environment. In this qualitative study, we asked PwD and their informal caregivers about requirements for assistive technology when navigating in inpatient care settings. We aimed to provide user-centred recommendations for the development of an in-hospital navigation aid following a value sensitive design approach. We conducted semi-structured interviews with two stakeholder groups as potential future users of in-hospital navigation aids: PwD (n = 10, agemean = 83.9 years, MMSEmean = 21.2) and informal caregivers (n = 10, agemean = 75.9 years). The interviews were evaluated using qualitative content analysis in a multistage process involving six members of a self-help group for relatives of PwD as co-researchers. Independence and relief/respite were the most important values regarding assistive technology for PwD. Informal caregivers attributed greatest importance to safety and relief/respite. The underlying values of these stakeholder groups contribute to recommendations for designing new assistive technologies for patient-centred in-patient care: Assistive technology needs to overcome age- and disease-related limitations, and the resulting individual risks, while providing subsidiary assistance to maintain the desired independence of PwD for as long as possible.
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Affiliation(s)
- Antonia Kowe
- Department "Ageing of Individuals and Society" (AGIS), Interdisciplinary Faculty, University of Rostock, Rostock, Germany
| | - Stefanie Köhler
- Rostock University Medical Center, Rostock, Germany.,German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Rostock, Germany
| | - Doreen Görß
- Rostock University Medical Center, Rostock, Germany.,German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Rostock, Germany
| | - Stefan Teipel
- Department "Ageing of Individuals and Society" (AGIS), Interdisciplinary Faculty, University of Rostock, Rostock, Germany.,Rostock University Medical Center, Rostock, Germany.,German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Rostock, Germany
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Qiu S, An P, Kang K, Hu J, Han T, Rauterberg M. Investigating socially assistive systems from system design and evaluation: a systematic review. UNIVERSAL ACCESS IN THE INFORMATION SOCIETY 2021; 22:609-633. [PMID: 34803565 PMCID: PMC8591319 DOI: 10.1007/s10209-021-00852-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 05/24/2023]
Abstract
Purpose The development of assistive technologies that support people in social interactions has attracted increased attention in HCI. This paper presents a systematic review of studies of Socially Assistive Systems targeted at older adults and people with disabilities. The purpose is threefold: (1) Characterizing related assistive systems with a special focus on the system design, primarily including HCI technologies used and user-involvement approach taken; (2) Examining their ways of system evaluation; (3) Reflecting on insights for future design research. Methods A systematic literature search was conducted using the keywords "social interactions" and "assistive technologies" within the following databases: Scopus, Web of Science, ACM, Science Direct, PubMed, and IEEE Xplore. Results Sixty-five papers met the inclusion criteria and were further analyzed. Our results showed that there were 11 types of HCI technologies that supported social interactions for target users. The most common was cognitive and meaning understanding technologies, often applied with wearable devices for compensating users' sensory loss; 33.85% of studies involved end-users and stakeholders in the design phase; Four types of evaluation methods were identified. The majority of studies adopted laboratory experiments to measure user-system interaction and system validation. Proxy users were used in system evaluation, especially in initial experiments; 42.46% of evaluations were conducted in field settings, primarily including the participants' own homes and institutions. Conclusion We contribute an overview of Socially Assistive Systems that support social interactions for older adults and people with disabilities, as well as illustrate emerging technologies and research opportunities for future work.
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Affiliation(s)
- Shi Qiu
- Department of Design, Shanghai Jiao Tong University, Shanghai, 800 Dongchuan RD. Minhang District China
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Pengcheng An
- School of Design, Southern University of Science and Technology, Shenzhen, China
- School of Computer Science, University of Waterloo, Waterloo, ON Canada
| | - Kai Kang
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
- Department of Industrial Design, Nantong University, Nantong, China
| | - Jun Hu
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Ting Han
- Department of Design, Shanghai Jiao Tong University, Shanghai, 800 Dongchuan RD. Minhang District China
| | - Matthias Rauterberg
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
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Yaddaden A, Spalla G, Gouin-Vallerand C, Briskie-Semeniuk P, Bier N. A mixed reality cognitive orthosis to support older adults in achieving their daily living activities: A qualitative study (Preprint). JMIR Rehabil Assist Technol 2021; 9:e34983. [PMID: 35857354 PMCID: PMC9350820 DOI: 10.2196/34983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/14/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Amel Yaddaden
- École de réadaptation, Université de Montréal, Montreal, QC, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Guillaume Spalla
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
- Laboratoire Domus, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Charles Gouin-Vallerand
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
- Laboratoire Domus, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Patricia Briskie-Semeniuk
- École de réadaptation, Université de Montréal, Montreal, QC, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Nathalie Bier
- École de réadaptation, Université de Montréal, Montreal, QC, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
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Wies B, Landers C, Ienca M. Digital Mental Health for Young People: A Scoping Review of Ethical Promises and Challenges. Front Digit Health 2021; 3:697072. [PMID: 34713173 PMCID: PMC8521997 DOI: 10.3389/fdgth.2021.697072] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/06/2021] [Indexed: 11/13/2022] Open
Abstract
Mental health disorders are complex disorders of the nervous system characterized by a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Mental illness is of particular concern for younger people. The WHO estimates that around 20% of the world's children and adolescents have a mental health condition, a rate that is almost double compared to the general population. One approach toward mitigating the medical and socio-economic effects of mental health disorders is leveraging the power of digital health technology to deploy assistive, preventative, and therapeutic solutions for people in need. We define “digital mental health” as any application of digital health technology for mental health assessment, support, prevention, and treatment. However, there is only limited evidence that digital mental health tools can be successfully implemented in clinical settings. Authors have pointed to a lack of technical and medical standards for digital mental health apps, personalized neurotechnology, and assistive cognitive technology as a possible cause of suboptimal adoption and implementation in the clinical setting. Further, ethical concerns have been raised related to insufficient effectiveness, lack of adequate clinical validation, and user-centered design as well as data privacy vulnerabilities of current digital mental health products. The aim of this paper is to report on a scoping review we conducted to capture and synthesize the growing literature on the promises and ethical challenges of digital mental health for young people aged 0–25. This review seeks to survey the scope and focus of the relevant literature, identify major benefits and opportunities of ethical significance (e.g., reducing suffering and improving well-being), and provide a comprehensive mapping of the emerging ethical challenges. Our findings provide a comprehensive synthesis of the current literature and offer a detailed informative basis for any stakeholder involved in the development, deployment, and management of ethically-aligned digital mental health solutions for young people.
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Affiliation(s)
- Blanche Wies
- Department of Health Sciences and Technology, ETH Zurich (Swiss Federal Institut of Technology), Zurich, Switzerland
| | - Constantin Landers
- Department of Health Sciences and Technology, ETH Zurich (Swiss Federal Institut of Technology), Zurich, Switzerland
| | - Marcello Ienca
- Department of Health Sciences and Technology, ETH Zurich (Swiss Federal Institut of Technology), Zurich, Switzerland
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42
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Hirt J, Meyer G, Beer T. [Options for using assistive technologies for people with dementia in Switzerland: a qualitative interview study with experts]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2021; 166:69-78. [PMID: 34697005 DOI: 10.1016/j.zefq.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/10/2021] [Accepted: 09/19/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND To overcome challenges in dementia care, technological concepts are considered to have a potential. It is unclear, however, how utilization of assistive technologies in Switzerland could look like and which specific potentials it may offer. Therefore, the aim of the present study is to elaborate options for using assistive technologies in dementia care on the basis of the opinion, experience and knowledge of experts. METHODS We chose a qualitative study design. Thematic analysis served to evaluate the expert interviews. To report this study, we followed the Standards for Reporting Qualitative Research (SRQR). RESULTS Between November 2018 and May 2019, we interviewed 15 experts. The analysis resulted in three themes, each with three sub-themes: (i) use and potentials of technologies (support in the home care network, promoting a sense of security, facilitating and preserving interaction), (ii) requirements for using technology (structural framework conditions, enhancing quality of life and care, considering individual needs and health situation), and (ii) ethical considerations and technical assets (security and freedom, side effects of telepresence care, caveats and technological optimism). CONCLUSIONS To exploit the identified potentials of assistive technologies for people with dementia, it is necessary to fulfil the requirements on a structural level in nursing policy, education and clinical practice. Furthermore, assistive technologies should be applied that have demonstrated effectiveness without unwanted effects. The decision to use assistive technologies should be made on an individual basis. Accordingly, the use of assistive technologies should take into account the needs of the persons involved and be adapted to the state of health of people with dementia.
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Affiliation(s)
- Julian Hirt
- Kompetenzzentrum Demenz, Institut für Angewandte Pflegewissenschaft, Departement Gesundheit, OST (ehemals FHS St. Gallen), St. Gallen, Schweiz; Internationale Graduiertenakademie, Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland.
| | - Gabriele Meyer
- Internationale Graduiertenakademie, Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Thomas Beer
- Kompetenzzentrum Demenz, Institut für Angewandte Pflegewissenschaft, Departement Gesundheit, OST (ehemals FHS St. Gallen), St. Gallen, Schweiz
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Bastoni S, Wrede C, da Silva MC, Sanderman R, Gaggioli A, Braakman-Jansen A, van Gemert-Pijnen L. Factors Influencing Implementation of eHealth Technologies to Support Informal Dementia Care: Umbrella Review. JMIR Aging 2021; 4:e30841. [PMID: 34623314 PMCID: PMC8538023 DOI: 10.2196/30841] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 01/26/2023] Open
Abstract
Background The worldwide increase in community-dwelling people with dementia underscores the need for innovative eHealth technologies that aim to provide support to both patients and their informal caregivers in the home setting. However, sustainable implementation of eHealth technologies within this target group can be difficult. Objective The goal of this study was to gain a thorough understanding of why it is often difficult to implement eHealth technologies in practice, even though numerous technologies are designed to support people with dementia and their informal caregivers at home. In particular, our study aimed to (1) provide an overview of technologies that have been used and studied in the context of informal dementia care and (2) explore factors influencing the implementation of these technologies. Methods Following an umbrella review design, five different databases were searched (PubMed, PsycINFO, Medline, Scopus, and Cochrane) for (systematic) reviews. Among 2205 reviews retrieved, 21 were included in our analysis based on our screening and selection procedure. A combination of deductive and inductive thematic analyses was performed, using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework for organizing the findings. Results We identified technologies designed to be used “by informal caregivers,” “by people with dementia,” and “with people with dementia.” Within those groups, most of the represented technologies included, respectively: (i) devices for in-home monitoring of lifestyle, health, and safety; (ii) technologies for supporting memory, orientation, and day structure; and (iii) technologies to facilitate communication between the informal caregiver and person with dementia. Most of the identified factors influencing implementation related to the condition of dementia, characteristics of the technology, expected/perceived value of users, and characteristics of the informal caregiver. Considerably less information has been reported on factors related to the implementing organization and technology supplier, wider institutional and sociocultural context of policy and regulations, and continued adaptation of technology over time. Conclusions Our study offers a comprehensive overview of eHealth technologies in the context of informal dementia care and contributes to gaining a better understanding of a broad range of factors influencing their implementation. Our results uncovered a knowledge gap regarding success factors for implementation related to the organizational and broader context and continuous adaptation over the long term. Although future research is needed, the current findings can help researchers and stakeholders in improving the development and implementation of eHealth technologies to support informal dementia care.
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Affiliation(s)
- Sofia Bastoni
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Christian Wrede
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Marcia Cristina da Silva
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Robbert Sanderman
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands.,Department of Health Psychology, University Medical Center Groningen, Groningen, Netherlands
| | - Andrea Gaggioli
- Department of Psychology, Universitá Cattolica del Sacro Cuore, Milan, Italy.,Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Annemarie Braakman-Jansen
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Lisette van Gemert-Pijnen
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
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Dequanter S, Gagnon MP, Ndiaye MA, Gorus E, Fobelets M, Giguère A, Bourbonnais A, Buyl R. The Effectiveness of e-Health Solutions for Aging With Cognitive Impairment: A Systematic Review. THE GERONTOLOGIST 2021; 61:e373-e394. [PMID: 32525977 PMCID: PMC8437510 DOI: 10.1093/geront/gnaa065] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives e-Health solutions are an innovative approach to support aging with cognitive impairment. Because technology is developing at a fast pace, the aim of this review was to present an overview of the research regarding the effectiveness of these solutions. Moreover, the availability of these solutions was examined. Research Design and Methods Systematic searches were conducted in 7 databases. Full texts of potentially relevant references were assessed by 2 reviewers, and discrepancies were solved through discussion. Data on study characteristics, technology type, application domain, availability, outcomes, and effects were extracted. A categorization exercise and narrative synthesis were conducted. Results In total, 72 studies describing 70 e-Health solutions were identified. The majority of solutions comprised cognitive training for older adults, followed by educational and supportive web platforms for caregivers. Outcomes included mainly measures of cognition, psychosocial functioning, caregiving processes, caregiver–care receiver relationship, and activities of daily living. Positive effects of cognitive training technologies were observed on cognitive functioning of older adults, as well as those of supportive web platforms on behavioral and psychological symptoms of dementia and caregiver self-efficacy. The effects of these solutions on depression in both target groups were inconclusive. The methodological quality of the studies was moderate to good. However, some important limitations were observed. Discussion and Implications The review identified cognitive training solutions and supportive web platforms as the most effective on a limited number of outcomes. Although other solutions seem promising, further research has to overcome methodological issues. Furthermore, solutions for leisure and reminiscence and outcomes specifically related to independent living deserve more attention.
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Affiliation(s)
- Samantha Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Belgium
| | - Marie-Pierre Gagnon
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada.,Faculty of Nursing Sciences, Université Laval, Québec, Canada
| | - Mame-Awa Ndiaye
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada
| | - Ellen Gorus
- Department of Gerontology, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Belgium
| | - Maaike Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Belgium
| | - Anik Giguère
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada.,Faculty of Nursing Sciences, Université Laval, Québec, Canada
| | | | - Ronald Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Belgium
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45
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Gu X, Cao Z, Jolfaei A, Xu P, Wu D, Jung TP, Lin CT. EEG-Based Brain-Computer Interfaces (BCIs): A Survey of Recent Studies on Signal Sensing Technologies and Computational Intelligence Approaches and Their Applications. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2021; 18:1645-1666. [PMID: 33465029 DOI: 10.1109/tcbb.2021.3052811] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Brain-Computer interfaces (BCIs) enhance the capability of human brain activities to interact with the environment. Recent advancements in technology and machine learning algorithms have increased interest in electroencephalographic (EEG)-based BCI applications. EEG-based intelligent BCI systems can facilitate continuous monitoring of fluctuations in human cognitive states under monotonous tasks, which is both beneficial for people in need of healthcare support and general researchers in different domain areas. In this review, we survey the recent literature on EEG signal sensing technologies and computational intelligence approaches in BCI applications, compensating for the gaps in the systematic summary of the past five years. Specifically, we first review the current status of BCI and signal sensing technologies for collecting reliable EEG signals. Then, we demonstrate state-of-the-art computational intelligence techniques, including fuzzy models and transfer learning in machine learning and deep learning algorithms, to detect, monitor, and maintain human cognitive states and task performance in prevalent applications. Finally, we present a couple of innovative BCI-inspired healthcare applications and discuss future research directions in EEG-based BCI research.
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46
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Abstract
Dementia is an eurodegenerative disorder, which causes significant disability, especially among the elderly population worldwide. The affected person shows a progressive cognitive decline, which interferes with the independence in performing the activities of daily living. Other than the cognitive domain, the patient tends to have neuropsychiatric, behavioral, sensorimotor, speech, and language-related issues. It is expected that the global burden of the disease will rise with more people entering the geriatric age group. By 2050 close, to 140 million people will be living with one or the other type of dementia. Alzheimer's disease contributes to more than 60% of cases worldwide, followed by vascular dementia. Pharmacotherapy has a limited role to play in the treatment, and at present, no drug is available, which can halt or reverse the progress of the disease. World Health Organization has mandated rehabilitation as a core recommendation in the global action plan on the public health response to dementia. Rehabilitation services are widely recognized as a practical framework to maximize independence and community participation in dementia care. The rehabilitation program is customized to achieve the desired goals, as each person has different experiences, preferences, motivations, strengths, and requirements based on type, course, and severity of the illness. It is an interdisciplinary-team approach with the involvement of several health care professionals. This article reviews the existing literature and outlines the effective rehabilitation strategies concisely in dementia care.
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Affiliation(s)
- Anupam Gupta
- Dept. of Neurological Rehabilitation, NIMHANS, Bangalore, Karnataka, India
| | - Naveen B. Prakash
- Dept. of Neurological Rehabilitation, NIMHANS, Bangalore, Karnataka, India
| | - Gourav Sannyasi
- Dept. of Neurological Rehabilitation, NIMHANS, Bangalore, Karnataka, India
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47
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Boumans R, van de Sande Y, Thill S, Bosse T. Voice-enabled Intelligent Virtual Agents for People with Amnesia: Systematic Review (Preprint). JMIR Aging 2021; 5:e32473. [PMID: 35468084 PMCID: PMC9086881 DOI: 10.2196/32473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/14/2021] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Roel Boumans
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Yana van de Sande
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Serge Thill
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Tibor Bosse
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
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48
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Behera CK, Condell J, Dora S, Gibson DS, Leavey G. State-of-the-Art Sensors for Remote Care of People with Dementia during a Pandemic: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2021; 21:4688. [PMID: 34300428 PMCID: PMC8309480 DOI: 10.3390/s21144688] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/31/2021] [Accepted: 07/02/2021] [Indexed: 01/10/2023]
Abstract
In the last decade, there has been a significant increase in the number of people diagnosed with dementia. With diminishing public health and social care resources, there is substantial need for assistive technology-based devices that support independent living. However, existing devices may not fully meet these needs due to fears and uncertainties about their use, educational support, and finances. Further challenges have been created by COVID-19 and the need for improved safety and security. We have performed a systematic review by exploring several databases describing assistive technologies for dementia and identifying relevant publications for this review. We found there is significant need for appropriate user testing of such devices and have highlighted certifying bodies for this purpose. Given the safety measures imposed by the COVID-19 pandemic, this review identifies the benefits and challenges of existing assistive technologies for people living with dementia and their caregivers. It also provides suggestions for future research in these areas.
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Affiliation(s)
- Chandan Kumar Behera
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| | - Joan Condell
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| | - Shirin Dora
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
| | - David S. Gibson
- Northern Ireland Centre for Stratified Medicine (NICSM), Biomedical Sciences Research Institute, University of Ulster, Altnagelvin Area Hospital, C-TRIC Building, Glenshane Road, Londonderry BT47 6SB, UK;
| | - Gerard Leavey
- Intelligent Systems Research Centre, Faculty of Computing, Engineering and Built Environment, University of Ulster, Northland Road, Londonderry BT48 7JL, UK; (C.K.B.); (S.D.); (G.L.)
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49
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Ienca M, Schneble C, Kressig RW, Wangmo T. Digital health interventions for healthy ageing: a qualitative user evaluation and ethical assessment. BMC Geriatr 2021; 21:412. [PMID: 34215209 PMCID: PMC8252216 DOI: 10.1186/s12877-021-02338-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 04/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Digital health technologies are being increasingly developed with the aim of allowing older adults to maintain functional independence throughout the old age, a process known as healthy ageing. Such digital health technologies for healthy ageing are expected to mitigate the socio-economic effects of population ageing and improve the quality of life of older people. However, little is known regarding the views and needs of older people regarding these technologies. Aim The aim of this study was to explore the views, needs and perceptions of community-dwelling older adults regarding the use of digital health technologies for healthy ageing. Method Face-to-face, in-depth qualitative interviews were conducted with community-dwelling older adults (median age 79.6 years). The interview process involved both abstract reflections and practical demonstrations. The interviews were transcribed verbatim and analyzed according to inductive content analysis. Results Three main themes and twelve sub-themes addressing our study aim resulted from the data obtained. The main themes revolved around favorable views and perceptions on technology-assisted living, usability evaluations and ethical considerations. Conclusions Our study reveals a generally positive attitude towards digital health technologies as participants believed digital tools could positively contribute to improving their overall wellbeing, especially if designed in a patient-centered manner. Safety concerns and ethical issues related to privacy, empowerment and lack of human contact were also addressed by participants as key considerations. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02338-z.
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Affiliation(s)
- Marcello Ienca
- Department of Health Sciences and Technology, ETH Zurich, Hottingerstrasse 10, HOA H17, Zürich, Switzerland. .,Competence Centre for Rehabilitation Engineering and Science, ETH Zurich, Zürich, Switzerland.
| | | | - Reto W Kressig
- Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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50
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Richardson S, Sinha A, Vahia I, Dawson W, Kaye J, Reynolds CF, Smith E, Cummings J, Berk M, Lavretsky H, Eyre HA. Brain Health Living Labs. Am J Geriatr Psychiatry 2021; 29:698-703. [PMID: 33342676 PMCID: PMC9011364 DOI: 10.1016/j.jagp.2020.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/21/2020] [Accepted: 11/23/2020] [Indexed: 11/20/2022]
Abstract
We call on geriatric brain health care providers, executives and entrepreneurs to embrace our Brain Health Living Lab model-a user-centered, iterative ecosystem, integrating concurrent clinical care, research and innovation processes.
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Affiliation(s)
| | - Anika Sinha
- School of Medicine (SR, AS, ES), Stanford University, Palo Alto, CA
| | - Ipsit Vahia
- McLean Hospital, Harvard Medical School (IV), Boston, MA
| | - Walter Dawson
- Global Brain Health Institute, University of California (WD, HAE), San Francisco (UCSF), CA; Department of Neurology, School of Medicine (WD), Oregon Health & Science University, Portland, OR; Institute on Aging, College of Urban and Public Affairs (WD, JK), Portland State University, Portland, OR
| | - Jeffrey Kaye
- Department of Neurology, School of Medicine (WD), Oregon Health & Science University, Portland, OR
| | - Charles F Reynolds
- Department of Psychiatry (CFR), University of Pittsburgh, Pittsburgh, PA
| | - Erin Smith
- School of Medicine (SR, AS, ES), Stanford University, Palo Alto, CA
| | - Jeffrey Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences (JC), University of Nevada Las Vegas, Las Vegas, NV; Cleveland Clinic Lou Ruvo Center for Brain Health (JC), Las Vegas, NV
| | - Michael Berk
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation (MB, HAE), School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry (MB, HAE), University of Melbourne, Melbourne, Victoria, Australia; Orygen Youth Health (MB), University of Melbourne, Melbourne, Victoria, Australia; The Florey Institute for Neuroscience and Mental Health, University of Melbourne (MB), Melbourne, Victoria, Australia
| | - Helen Lavretsky
- Semel Institute for Neuroscience and Human Behavior, University of California (HL), Los Angeles (UCLA), CA
| | - Harris A Eyre
- Global Brain Health Institute, University of California (WD, HAE), San Francisco (UCSF), CA; Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation (MB, HAE), School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry (MB, HAE), University of Melbourne, Melbourne, Victoria, Australia; Discipline of Psychiatry, School of Medicine (HAE), The University of Adelaide, Adelaide, South Australia, Australia; Brainstorm Lab for Mental Health Innovation (HAE), Stanford University, Palo Alto, CA.
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