The use of motion-based technology for people living with dementia or mild cognitive impairment: a literature review

Background: The number of people living with dementia and mild cognitive impairment (MCI) is increasing substantially. Although there are many research efforts directed toward the prevention and treatment of dementia and MCI, it is also important to learn more about supporting people to live well with dementia or MCI through cognitive, physical, and leisure means. While past research suggests that technology can be used to support positive aging for people with dementia or MCI, the use of motion-based technology has not been thoroughly explored with this population. Objective: The aim of this study was to identify and synthesize the current literature involving the use of motion-based technology for people living with dementia or MCI by identifying themes while noting areas requiring further research. Methods: A systematic review of studies involving the use of motion-based technology for human participants living with dementia or MCI was conducted. Results: A total of 31 articles met the inclusion criteria. Five questions are addressed concerning (1) context of use; (2) population included (ie, dementia, MCI, or both); (3) hardware and software selection; (4) use of motion-based technology in a group or individual setting; and (5) details about the introduction, teaching, and support methods applied when using the motion-based technology with people living with dementia or MCI. Conclusions: The findings of this review confirm the potential of motion-based technology to improve the lives of people living with dementia or MCI. The use of this technology also spans across several contexts including cognitive, physical, and leisure; all of which support multidimensional well-being. The literature provides evidence that people living with dementia or MCI can learn how to use this technology and that they enjoy doing so. However, there is a lack of information provided in the literature regarding the introduction, training, and support methods applied when using this form of technology with this population. Future research should address the appropriate introduction, teaching, and support required for people living with dementia or MCI to use the motion-based technology. In addition, it is recommended that the diverse needs of these specific end-users be considered in the design and development of this technology

Computer Interactive Reminiscence and Conversation Aid groups – delivering cognitive stimulation with technology

INTRODUCTION: Group-based cognitive stimulation is the only nonpharmacological intervention recommended by the UK National Institute for Clinical and Health Excellence (NICE) for people with dementia. The potential of technology to extend the availability of group-based cognitive stimulation has not been tested. METHOD: One hundred and sixty-one people with dementia participated in an 8-session group activity using Computer Interactive Reminiscence and Conversation Aid (CIRCA). Cognition, quality of life and general health were assessed pre-, post- and three-months later. RESULTS: There was a significant improvement in cognition and quality of life at the end of the CIRCA group intervention, which was further improved at three-month follow-up. CONCLUSION: CIRCA group sessions improved cognition and quality of life similar to group-base cognitive stimulation approved by NICE. These benefits were maintained at three-month follow-up. The data confirm the potential of CIRCA, which can be populated with different cultural and language contents for different user groups

Kinect Project: people with dementia or mild cognitive impairment learning to play group motion-based games

Introduction: Motion-based technologies (MBT) could provide nonpharmacological interventions for people with dementia or mild cognitive impairment (PCI). This study examined the use of errorless learning techniques to empower PCI to use MBT. Methods: Thirty-eight PCI were recruited to a 10-week (20 x 1-hour sessions) Xbox Kinect bowling group. Video recorded data from first, middle, and final sessions were coded to track: (1) number of prompts per turn, (2) independent turn completion, and (3) duration of turns. were compared using repeated measures ANOVA. Results: Learning and improvement over time was demonstrated in 23 participants who were available for final analysis by significant decreases in number of prompts per turn and turn duration and significant increases in turns completed independently. Discussion: Errorless learning supported PCI to learn MBT and improve over time as evidenced by their need for fewer prompts, shorter turns, and more turns completed independently, confirming the potential of MBT to provide leisure activities for PCI

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

“That’s for old so and so’s!”: does identity influence older adults’ technology adoption decisions?

The role of identity in older adults’ decision-making about assistive technology adoption has been suggested but not fully explored. This scoping review was conducted to better understand how older adults’ self-image and their desire to maintain this, influences their decision-making processes regarding assistive technology adoption. Using the five-stage scoping review framework by Arksey and O’Malley, a total of 416 search combinations were run across 9 databases, resulting in a final yield of 49 articles. From these 49 articles, five themes emerged: (1) Resisting the negative reality of an ageing and/or disabled identity; (2) Independence and control are key; (3) The aesthetic dimension of usability; (4) Assistive technology as a last resort; and (5) Privacy versus pragmatics. The findings highlight the importance of older adults’ desire to portray an identity consistent with independence, self-reliance and competence, and how this desire directly impacts their assistive technology decision-making adoption patterns. These findings aim to support the adoption of assistive technologies by older adults to facilitate engagement in meaningful activities, enable social participation within the community, and promote health and well-being in later life

“Like another human being in the room”: a community case study of smart speakers to reduce loneliness in the oldest-old

This community case study examined the potential benefits of smart speakers to tackle loneliness in the oldest old adults living in supported accommodation. The program was established as a collaboration between the supported accommodation provider and a technology company to explore the feasibility of smart speakers to alleviate resident loneliness. Loneliness in later life often accompanies a shrinking social circle, loss of a spouse or increased disability. People aged 85 years of age and over are increasingly likely to experience these life events, leading to an increased risk of social isolation and loneliness. Five older people, mean age 90 years of age, who resided in supported accommodation, were given a smart speaker for 8 weeks to examine their experience with the voice assistant. The experiences of the five older adults are explored as case studies, with each person interviewed both before and after receiving the smart speaker. All five valued their smart speaker, recognised its potential for tackling loneliness, and wanted to keep it. The three most lonely individuals reported that their smart speaker made them feel less lonely and isolated through two mechanisms: (i) creating a presence and (ii) having some control over their situation. Although only a small study, these experiences suggest providing smart speakers for lonely and isolated oldest-old people, could be one way to help combat loneliness in community settings

Comparing recent reviews about touchscreens for dementia with lessons from the field

Conclusions were synthesised from recent reviews on (touchscreen)technologies and people with dementia and lessons learnt using these devices in projects in the UK, the Netherlands and Canada. The combined findings provide a strong basis for defining new strategies for exploiting touchscreen technology for people with dementia

Older adults’ perspectives on using digital technology to maintain good mental health: interactive group study

Background: A growing number of apps to support good mental health and wellbeing are available on digital platforms. However, very few studies have examined older adults’ attitudes towards the use of these, despite increasing uptake of digital technologies by this demographic. Objective: The present study sought to explore older adults’ perspectives on technology to support good mental health. Methods: Fifteen older adults (>50 years old), in two groups, participated in sessions to explore the use of digital technologies to support mental health. Interactive activities were designed to capture participants’ immediate reactions to apps and websites designed to support mental health, and explore their experiences of using technology for these purposes in their own lives. Template analysis was used to analyse transcripts of the group discussions. Results: Older adults were motivated to turn to technology to improve mood through mechanisms of distraction, normalisation and facilitated expression of mental states, while aiming to reduce burden on others. Perceived barriers to use included fear of consequences, and the impact of low mood on readiness to engage with technology, as well as a lack of prior knowledge applicable to digital technologies. Participants were aware of websites available to support mental health, but awareness alone did not motivate use. Conclusions: Older adults are motivated to use digital technologies to improve their mental health, but barriers remain that developers need to address for this population to access them

Disordered speech in dementia

What is the effect on language of the progressive degenerative disorder, Alzheimer's disease (AD)? What are the functional consequences of this illness, particularly for speech? The majority of accounts interpret speech disorder in AD as reflecting underlying semantic disruption. In contrast I apply current theories of lexicalization in speech production to the speech disorder. Four competing hypotheses are derived from a two-stage model of lexicalization in speech production. This model contains separate semantic, lexical and phonological representations. Data are collected from patients with probable AD and age-matched controls using standard psycholinguistic techniques. The data support an explanation of progressively impaired higher level cognitive processing which interacts with impaired semantic to lexical processing in speech production