Wayfinding in People with Alzheimer’s Disease: Perspective Taking and Architectural Cognition—A Vision Paper on Future Dementia Care Research Opportunities

Based on a targeted literature review, this vision paper emphasizes the importance of dementia-sensitive built space. The article specifically focuses on supporting spatial orientation and wayfinding for people living with dementia. First, we discuss types of wayfinding challenges, underlying processes, and consequences of spatial disorientation in the context of dementia of the Alzheimer’s type. Second, we focus on current efforts aimed at planning and evaluating dementia-sensitive built space, i.e., environmental design principles, interventions, evaluation tools, strategies, and planning processes. Third, we use our findings as a starting point for developing an interdisciplinary research vision aimed at encouraging further debates and research about: (1) the perspective of a person with dementia, specifically in the context of wayfinding and spatial orientation, and (2) how this perspective supplements planning and design processes of dementia-sensitive built space. We conclude that more closely considering the perspective of people with dementia supports the development of demographically sustainable future cities and care institutions

Route learning by blind and partially sighted people

The paper aims to fill an important gap in the literature by reporting on blind and partially sighted people's route-learning experiences and strategies from their perspective. The existing literature has largely reported the results of experiments in indoor and outdoor, often artificially created, environments rather than real experiences of travel and route learning. The results presented here were obtained from semi-structured interviews with 100 blind and partially sighted people in five different countries. They show that they prefer to keep to known routes where possible, in line with the literature, but do not wish to be restricted to them. The paper discusses the conditions in which they consider it worth learning new routes and the strategies they use to do this. The paper is interpreted in a theoretical framework of independence, autonomy, and self-determination, understood, in line with the disability literature, as making choices and decisions and having control rather than necessarily doing everything oneself. A further contribution is a confirmation of the role of the (greater) memory of blind people in travel and a suggestion that the ability to develop memory may affect differences in travel skills. The paper concludes with several recommendations, including for further research

Mental health and wayfinding

Wayfinding uses a range of skills including recalling information from memory, interpreting information from the environment, and taking decisions based on this information. Mental health conditions such as anxiety or depression can adversely affect these skills. A significant proportion of the population has one or more mental health conditions. This paper discusses the issues that these people face when wayfinding. It is based on a descriptive study which uses the results from an on-line survey of domestic travel by people with mental health conditions. The anxieties associated with wayfinding such as feeling disorientated and becoming lost are examined. The roles that mobile phone apps and information play in wayfinding are discussed. Many of the respondents indicated that initiatives such as clearer information about bus and train services, the provision of information on board buses and trains and travel training would encourage them to travel more

Spatial navigation in autism spectrum disorders: a critical review

On the basis of relative strengths that have been attributed to the Autistic cognitive profile, it has been suggested by a number of theorists that people with Autism Spectrum Disorders (ASD) excel at spatial navigational tasks. However, many of these claims have been made in the absence of a close inspection of extant data in the scientific literature, let alone anecdotal reports of daily navigational experiences. The present review gathers together published studies that have attempted to explicitly address functional components of navigation in ASD populations, including assays of wayfinding, large-scale search, and path integration. This inspection reveals a pattern of apparent strengths and weaknesses in navigational abilities, thus illustrating the necessity for a more measured and comprehensive approach to the understanding of spatial behaviour in ASD

The Effects of a Tactile Display on First Responder Performance

Firefighting is a dangerous and difficult task. Simulation affords researchers and practitioners the ability to examine performance and training in adverse conditions while preserving life, offering repeatable scenarios, and reducing costs. Multiple Resource Theory is used in this study as a model for assessing alternate sensory channels for information delivery when the optimal channel is not available. Specifically, this study tests the influence of a waist-worn vibrotactile display to assist navigation when visibility is reduced in a firefighter simulation. The present study measures participants\u27 objective performance and self-reported workload while navigating a simulated fireground. Results from 70 research participants revealed statistically significant differences between the experimental and control conditions for completion time and overall workload scores. Workload and performance emerged as significantly correlated in both the experimental and control conditions; however, no statistically significant correlations were found for the spatial anxiety hypotheses. The results of this study indicate that participants engaged in a simulated search and rescue task in a low visibility environment benefit from the assistance of a vibrotactile display as a tool. Participants\u27 performance scores and self-reports show that they had more mental resources to engage in the search and rescue task more quickly when assisted by a vibrotactile tool. Evidence was found to demonstrate a statistically significant association between workload and performance. The implications of this study have real world consequences for training for dangerous tasks to maximize performance and save lives while minimizing risks to personnel

Impact of Positioning Technology on Human Navigation

In navigation from one place to another, spatial knowledge helps us establish a destination and route while travelling. Therefore, sufficient spatial knowledge is a vital element in successful navigation. To build adequate spatial knowledge, various forms of spatial tools have been introduced to deliver spatial information without direct experience (maps, descriptions, pictures, etc.). An innovation developed in the 1970s and available on many handheld platforms from the early 2000s is the Global Position System (GPS) and related map and text-based navigation support systems. Contemporary technical achievements, such as GPS, have made navigation more effective, efficient, and comfortable in most outdoor environments. Because GPS delivers such accurate information, human navigation can be supported without specific spatial knowledge. Unfortunately, there is no universal and accurate navigation system for indoor environments. Since smartphones have become increasingly popular, we can more frequently and easily access various positioning services that appear to work both indoors and outdoors. The expansion of positioning services and related navigation technology have changed the nature of navigation. For example, routes to destination are progressively determined by a “system,” not the individual. Unfortunately we only have a partial and nascent notion of how such an intervention affects spatial behaviour. The practical purpose of this research is to develop a trustworthy positioning system that functions in indoor environments and identify those aspects those should be considered before deploying Indoor Positioning System (IPS), all towards the goal of maintaining affordable positioning accuracy, quality, and consistency. In the same way that GPS provides worry free directions and navigation support, an IPS would extend such opportunities to many of our built environments. Unfortunately, just as we know little about how GPS, or any real time navigation system, affects human navigation, there is little evidence suggesting how such a system (indoors or outdoors) changes how we find our way. For this reason, in addition to specifying an indoor position system, this research examines the difference in human’s spatial behaviour based on the availability of a navigation system and evaluates the impact of varying the levels of availability of such tools (not available, partially available, or full availability). This research relies on outdoor GPS, but when such systems are available indoors and meet the accuracy and reliability or GPS, the results will be generalizable to such situations

Increasing Stimulation | Decreasing Progression: The Built Environment’s Impact on Alzheimer’s and Dementia

With people living longer lives, the population of elderly is increasing at significant rates. Currently 5.3 million suffer from Alzheimer’s in America and 35 million people worldwide. The disease is one that deteriorates brain cells which in turn affects everyday thinking, behavioral problems, and results in a reduced mastery of one’s environment. The current typology is one that has been designed along the same premises of medical institutions and hospitals. The configuration results in narrow corridors and confined, unlit spaces that lead to disorientation and fear—exacerbating both physical and mental symptoms of the disease. In addition to memory, sensory losses have a major impact on those with the disease. Along with decreased smell and taste, hearing decreases significantly; this is an issue that has the ability to be facilitated by the physical environment. In addition, sixty percent of people with Alzheimer’s have a decline in one or more visual capacities such as motion, depth, color or contrast. Seeing that everyday spaces are primarily understood through visual cues, buildings often become illegible and under-stimulating to those affected by the disease, further intensifying the detrimental progression. Contrary to the other four senses, touch is the one sense that stays intact as one ages and is least impacted as the disease develops. The sense of touch is the most important means of communicating for older individuals and is therapeutic since older adults are often touch deprived. Further regarding sensory deprivation, sunlight is a necessity that keeps circadian rhythms normalized. Accordingly, I selected a site in Allentown, located in Pennsylvania—the state with the third highest population of elderly. The city of Allentown receives the most number of days of sunlight per year for the state of Pennsylvania. In addition, the site is located in close proximity to numerous cultural institutions in which residents can easily engage. Numerous studies manifest that musical and art therapy have very positive effects on the disease and engage parts of the brain that remain undamaged long after the onset of dementia. Alzheimer’s is categorized into eight stages, with stage one being the point of diagnosis and stage eight being most severe. At each of these stages, various architectural issues have the ability to tend to the medical necessities of a person’s health. At stages three and four—the mild to moderate period—people become socially withdrawn and depressed. A deficit in one’s personal history becomes apparent. At this stage, personalization and transformation of one’s environment helps them to achieve confidence and decrease agitation. The presence of social nodes to set up chance encounters is a crucial element to design. As one advances in later stages adequate amounts of sunlight are vital, one’s memory begins to fail, and the issue of wandering becomes a major issue. Materiality and tactility have the ability to act as a guide and stimulate the sensory impaired. This Alzheimer’s facility that I have designed is one that uses the aforementioned architectural issues to design a space that can support healing or help to slow down mental and physical decline. By stimulating the senses within the built environment, architecture has the ability to support a patient’s needs and influence the physical and mental well-being of the resident

Engineering and Clinical Evaluation of the VA-PAMAID Robotic Walker

The Veterans Affairs Personal Adaptive Mobility Aid (VA-PAMAID) is a robotic walker that is designed to provide physical support and obstacle avoidance and navigational assistance to frail visually impaired individuals. The goal of this study was to develop and implement testing protocols to determine the performance and safety capabilities of the device and use the results to redesign the walker to make it more reliable and effective.Engineering tests were performed to determine factors such as stability, range, speed, and fatigue strength. Additional tests to characterize the reliability and accuracy of the sensors and avoidance/navigation algorithms were also conducted. The walker traveled 10.9 kilometers on a full charge, and was able to avoid obstacles while traveling at a speed of up to 1.2 m/s. There were no failures during static stability, climatic, or static, impact, and fatigue testing. Some problems were encountered during obstacle climbing and sensor and control testing. Several significant differences were found with respect to the detection distance of the device when varying the obstacle height, material, approach angle, and lighting source. The walker also failed to detect 40-50% of the doorways during the hallway test.Clinical trials were conducted to compare the VA-PAMAID to a low-tech mobility aid (AMD). Subjects were recruited and trained to use both devices efficiently. Each participant was then asked to traverse an obstacle course several times. The time to complete the course, number of wall and obstacle collisions, and number of reorientations were all recorded and averaged. There were no significant differences between the VA-PAMAID and the AMD with respect to collisions or reorientations. The AMD had a significantly lower completion time (p=0.017) than the VA-PAMAID on the obstacle course. The results of the engineering and clinical tests were then used in a house of quality model to determine what factors of the walker needed to be revised. Specific modifications were recommended that would make the device safer, more reliable, and more marketable. Changing the wheel size, mass, component positions, detection algorithm, and other variables would make the VA-PAMAID easier to use and more effective for elderly visually impaired individuals