Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia

Cognitive function is an important end point of treatments in dementia clinical trials. Measuring cognitive function by standardized tests, however, is biased toward highly constrained environments (such as hospitals) in selected samples. Patient-powered real-world evidence using information and communication technology devices, including environmental and wearable sensors, may help to overcome these limitations. This position paper describes current and novel information and communication technology devices and algorithms to monitor behavior and function in people with prodromal and manifest stages of dementia continuously, and discusses clinical, technological, ethical, regulatory, and user-centered requirements for collecting real-world evidence in future randomized controlled trials. Challenges of data safety, quality, and privacy and regulatory requirements need to be addressed by future smart sensor technologies. When these requirements are satisfied, these technologies will provide access to truly user relevant outcomes and broader cohorts of participants than currently sampled in clinical trials

Categorizing Health Outcomes and Efficacy of mHealth Apps for Persons With Cognitive Impairment: A Systematic Review

Background Use of mobile health (mHealth) apps is growing at an exponential rate in the United States and around the world. Mild cognitive impairment (MCI), Alzheimer disease, and related dementias are a global health problem. Numerous mHealth interventions exist for this population, yet the effect of these interventions on health has not been systematically described. Objective The aim of this study is to catalog the types of health outcomes used to measure effectiveness of mHealth interventions and assess which mHealth interventions have been shown to improve the health of persons with MCI, Alzheimer disease, and dementia. Methods We searched 13 databases, including Ovid MEDLINE, PubMed, EMBASE, the full Cochrane Library, CINAHL, PsycINFO, Ei Compendex, IEEE Xplore, Applied Science & Technology Source, Scopus, Web of Science, ClinicalTrials.gov, and Google Scholar from inception through May 2017 for mHealth studies involving persons with cognitive impairment that were evaluated using at least one quantitative health outcome. Proceedings of the Annual ACM Conferences on Human Factors in Computing Systems, the ACM User Interface Software and Technology Symposium, and the IEEE International Symposium on Wearable Computers were searched in the ACM Digital Library from 2012 to 2016. A hand search of JMIR Publications journals was also completed in July 2017. Results After removal of duplicates, our initial search returned 3955 records. Of these articles, 24 met final inclusion criteria as studies involving mHealth interventions that measured at least one quantitative health outcome for persons with MCI, Alzheimer disease, and dementia. Common quantitative health outcomes included cognition, function, mood, and quality of life. We found that 21.2% (101/476) of the fully reviewed articles were excluded because of a lack of health outcomes. The health outcomes selected were observed to be inconsistent between studies. For those studies with quantitative health outcomes, more than half (58%) reported postintervention improvements in outcomes. Conclusions Results showed that many mHealth app interventions targeting those with cognitive impairment lack quantitative health outcomes as a part of their evaluation process and that there is a lack of consensus as to which outcomes to use. The majority of mHealth app interventions that incorporated health outcomes into their evaluation noted improvements in the health of persons with MCI, Alzheimer disease, and dementia. However, these studies were of low quality, leading to a grade C level of evidence. Clarification of the benefits of mHealth interventions for people with cognitive impairment requires more randomized controlled trials, larger numbers of participants, and trial designs that minimize bias. Trial Registration PROSPERO Registration: PROSPERO 2016:CRD42016033846; http://www.crd.york.ac.uk/PROSPERO/ display_record.asp?ID=CRD42016033846 (Archived by WebCite at http://www.webcitation.org/6sjjwnv1M

Development of an ontology for the inclusion of app users with visual impairments

Approximately 15% of the world’s population have some form of disability and the majority use apps on their mobile devices to help them in their daily lives with communication, healthcare, or for entertainment purposes. It is not, however, easy for users with impairments to choose the most suitable apps since this will depend on their particular personal characteristics or circumstances in a specific context, and because such users require apps with certain accessibility features which are not always specified in the app description. In order to overcome such difficulties, it is necessary to obtain a user profile that gathers the user’s personal details, abilities, disabilities, skills, and interests to facilitate selection. The basis for our research work is to develop an app that recommends a set of apps to users with disabilities. In this respect, the focus of this paper is to obtain a semantic user profile model on which more precise search requests can be performed. The disability we have chosen to concentrate on is that of visual impairment. We propose an ontology-based user profile that matches users’ characteristics, disabilities, and interests, and which not only simplifies the classification process but also provides a mechanism for linking them with existing disability ontologies, assistive devices, accessibility concepts, etc. Moreover, thanks to the inclusion of semantic relations and rules, it is possible to reason and infer new information that can be used to make more personalized recommendations than a simple app store search.Spanish Ministry of Economy and Competitiveness (Agencia Estatal de Investigacion) PID2019-109644RB-I00/AEI/10.13039/50110001103

Studies involving people with dementia and touchscreen technology: a literature review

Background: Devices using touchscreen interfaces such as tablets and smartphones have been highlighted as potentially suitable for people with dementia due to their intuitive and simple control method. This population experience a lack of meaningful, engaging activities, yet the potential use of the touchscreen format to address this issue has not been fully realized. Objective: To identify and synthesize the existing body of literature involving the use of touchscreen technology and people with dementia in order to guide future research in this area. Methods: A systematized review of studies in the English language was conducted, where a touchscreen interface was used with human participants with dementia. Results: A total of 45 articles met the inclusion criteria. Four questions were addressed concerning (1) the context of use, (2) reasons behind the selection of the technology, (3) details of the hardware and software, and (4) whether independent use by people with dementia was evidenced. Conclusions: This review presents an emerging body of evidence demonstrating that people with dementia are able to independently use touchscreen technology. The intuitive control method and adaptability of modern devices has driven the selection of this technology in studies. However, its primary use to date has been as a method to deliver assessments and screening tests or to provide an assistive function or cognitive rehabilitation. Building on the finding that people with dementia are able to use touchscreen technology and which design features facilitate this, more use could be made to deliver independent activities for meaningful occupation, entertainment, and fun

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Aprendizagem Digital: Modelos diferenciados de ensino utilizando TICs para alunos com problemas de visão – Boas práticas: Jogando entre 1 a 10

The idea of inclusion encourages an inclusive, open-door school. By adapting formal instruction to standard instruction that is acceptable for everyone while taking into account the requirements, quirks, skills, interests, and experiences of each student, the use of ICTs aids in this direction. One such group is the visually challenged, whose inclusion in general education classes is made possible with the use of ICTs. In the current study, a method of individualized education in the field of mathematics is developed and put into practice, allowing all students-visually impaired or not-to master the mathematical operation of adding to the first ten at their own speed and time. Results show that differentiated instruction improves students' ability to understand mathematical operations: ADDITION from 1 to 10.La idea de inclusión fomenta una escuela inclusiva y de puertas abiertas. Al adaptar la instrucción formal a la instrucción estándar aceptable para todos, teniendo en cuenta los requisitos, peculiaridades, habilidades, intereses y experiencias de cada estudiante, el uso de las TIC ayuda en esta dirección. Uno de estos grupos es el de los discapacitados visuales, cuya inclusión en las clases de educación general es posible con el uso de las TIC. En el presente estudio se desarrolla y pone en práctica un método de enseñanza individualizado en el área de matemáticas, que permite a todos los alumnos -con discapacidad visual o no- dominar la operación matemática de sumar al top ten a su propio ritmo y tiempo. Los resultados muestran que la enseñanza diferenciada mejora la capacidad de los estudiantes para comprender las operaciones matemáticas: SUMA del 1 al 10.A ideia de inclusão incentiva uma escola inclusiva e de portas abertas. Ao adaptar a instrução formal à instrução padrão aceitável para todos, levando em conta os requisitos, peculiaridades, habilidades, interesses e experiências de cada aluno, o uso das TICs auxilia nessa direção. Um desses grupos é o dos deficientes visuais, cuja inclusão nas classes de educação geral é possível com o uso das TICs. No presente estudo, é desenvolvido e colocado em prática um método de ensino individualizado na área da matemática, permitindo que todos os alunos-deficientes visuais ou não-dominem a operação matemática de somar aos dez primeiros no seu próprio ritmo e tempo. Os resultados mostram que o ensino diferenciado melhora a capacidade dos alunos de entender as operações matemáticas: ADIÇÃO de 1 a 10

Enhancing Cognitive Performance and Monitoring through a Mobile App: Insights from the Rodi Study

The prevalence of neurocognitive disorders has led to increased interest in mobile health applications (mHealth apps) for detection and training. However, there’s a need for apps that integrate comprehensive cognitive training, assessment, and monitoring in personalized contexts. The RODI app was meticulously developed with the objective of catering to individuals with deficits as well as healthy adults. In this study, 11 participants without diagnosed impairments used the app twice weekly for eight weeks. Results show a consistent enhancement in cognitive performance within the app over time. Notably, a discernible divergence is observed, with the rate of improvement appearing to be comparatively slower in the younger age group in contrast to their older counterparts. Furthermore, the study assesses the reliability of the application using the intraclass correlation coefficient (ICC), confirming its consistent performance across repeated administrations. Finally, the app’s capacity to monitor participants’ cognitive status across various domains is investigated, unveiling controlled variations that indicate foreseeable outcomes within defined parameters. These findings underscore RODI’s potential for cognitive enhancement and monitoring, offering insights into user needs and the broader significance of mobile app interventions for cognitive well-being and future research in this field

Brain training using cognitive apps can improve cognitive performance and processing speed in older adults.

Managing age-related decrease of cognitive function is an important public health challenge, especially in the context of the global aging of the population. Over the last years several Cognitive Mobile Games (CMG) have been developed to train and challenge the brain. However, currently the level of evidence supporting the benefits of using CMG in real-life use is limited in older adults, especially at a late age. In this study we analyzed game scores and the processing speed obtained over the course of 100 sessions in 12,000 subjects aged 60 to over 80 years. Users who trained with the games improved regardless of age in terms of scores and processing speed throughout the 100 sessions, suggesting that old and very old adults can improve their cognitive performance using CMG in real-life use

Software Usability

This volume delivers a collection of high-quality contributions to help broaden developers’ and non-developers’ minds alike when it comes to considering software usability. It presents novel research and experiences and disseminates new ideas accessible to people who might not be software makers but who are undoubtedly software users