Using a screening tool to evaluate potential use of e-health services for older people with and without cognitive impairment

Objectives: E-health services are increasingly offered to provide clients with information and a link to healthcare services. The aim of this study is to investigate the perceived access to and the potential to use technologies important for e-health services among older adults with MCI or mild AD and controls. Method: The perceived access to and perception of difficulty in the use of everyday technology (such as cell phones, coffee machines, computers) was investigated in a sample of older adults (n=118) comprising three subsamples: adults with mild cognitive impairment (MCI) (n=37), with mild Alzheimer’s disease (AD) (n=37) and controls (n=44) using the Everyday Technology Use Questionnaire (ETUQ). The use of seven technologies important for e-health services was specifically examined for each subsample and compared between the subsamples. Results: The findings demonstrated that the older adults in all subsamples both perceive access to e-health technologies and potentially would use them competently in several e-health services. However, among persons with AD a lower proportion of perceived access to the technology was described, as well as for persons with MCI. Conclusion: To make the benefits of e-health services available and used by all clients, it is important to consider access to the technology required in e-health services and also to support the clients’ capabilities to understand and use the technologies. Also, the potential use of the ETUQ to explore the perceived access to and competence in using e-health technologies is a vital issue in the use of e-health services.Swedish Brain PowerThe regional agreement on medical training and clinical research between the Stockholm County Council and the Karolinska InstitutetStrategic Research Programme in Care SciencesAccepte

An approach to facilitate healthcare professionals' readiness to support technology use in everyday life for persons with dementia

Everyday technologies (ETs) like microwave ovens and automatic telephone services as well as assistive technologies (ATs) are often used in the performance of everyday activities. As a consequence, the ability to manage technology is important. This pilot study aimed to clarify the applicability of a model for knowledge translation to support healthcare professionals, to support technology use among older adults with dementia and their significant others. An additional aim was to explore the process of translating the model into practice. The applicability of the model (comprising a one-day course, including introduction and provision of tools, followed by interviews during and after a period of practice) was clarified for 11 healthcare professionals using a constant comparative approach. The content of the model gave the participants an eye-opening experience of technology use among persons with dementia. They also described how they had incorporated the model as a new way of thinking which supported and inspired new investigations and collaborations with colleagues and significant others. This study provided an applicable model of how research knowledge about technology use can be translated into clinical practice and be used by healthcare professionals to support the use of technology for persons with dementia.Health Care Sciences Postgraduate SchoolSwedish Institute of Assistive TechnologySwedish BrainpowerThe Swedish Council for Working Life and Social Research (FAS)The regional agreement on medical training and clinical research (ALF) between the Stockholm County Council and Karolinska InstitutetAccepte

Psychometric evaluation of a new assessment of the ability to manage technology in everyday life

Technology increasingly influences the everyday lives of most people, and the ability to manage technology can be seen as a prerequisite for participation in everyday occupations. However, knowledge about ability and skills required for management of technology is sparse. This study aimed to validate a new observation-based assessment, the Management of Everyday Technology Assessment (META). The META is developed to assess the ability to manage technology in everyday life. A sample of 116 older adults with and without cognitive impairment were observed and interviewed by the use of the META when managing their everyday technology at home. The results indicate that the META demonstrates acceptable person response validity and technology goodness-of-fit. Additionally, the META can separate individuals with higher ability from individuals with lower ability to manage everyday technology. The META can be seen as a complement to existing ADL assessment techniques and is planned to be used both in research and practice.NoneAccepte

Everyday technologies' levels of difficulty when used by older adults with and without cognitive impairment : comparison of self-perceived versus observed difficulty estimates

BACKGROUND: Older adults may have difficulties in using everyday technologies, ET, e.g. micros, computers, particularly those with cognitive impairment. To guide supportive interventions, more knowledge of how to best assess ET use is needed. OBJECTIVE: To provide new knowledge of perceived and observed levels of difficulty of ETs in older adults with and without cognitive impairment. METHODS: Two samples of older adults (n=118 and 116) with and without cognitive impairment were assessed. One was interviewed with the Everyday Technology Use Questionnaire (ETUQ) about perceived difficulties in ET use. The other sample’s observed ability to manage ET was assessed with the Management of Everyday Technology (META). Data was analyzed using a Rasch measurement model and rank-ordered hierarchies of perceived and observed levels of ET difficulty were identified, correlated and examined. RESULTS: Findings demonstrated a correlation of 0.63 (p ˂.001). The upper range of both hierarchies contained more complex ETs like cell phones and computers while the lower comprised more home maintenance ETs. CONCLUSIONS: Perceived and observed levels of ET difficulty appear as similar, yet not identical constructs. In self-reports, though, ETUQ to a great extent seems to capture levels of ET difficulty. However, in clinical practice observations of actions may guide interventions, as they can identify why an ET is difficultSwedish Research CouncilSwedish Brain PowerBotkyrka CommunityThe regional agreement on medical training and clinical research (ALF) between the Stockholm County Council and Karolinska InstitutetAccepte

Individual variability and environmental characteristics influence older adults’ abilities to manage everyday technology

Background: The ability to manage everyday technology (ET) such as computers and microwave ovens is increasingly required in the performance of everyday activities and participation in society. This study aimed to identify aspects that influence the ability to manage ET among older adults with and without cognitive impairment. Methods: Older adults with mild Alzheimer’s disease and mild cognitive impairment and without known cognitive impairment were assessed as they managed their ET at home. Data was collected with the Management of Everyday Technology Assessment (META). Rasch-based measures of the person’s ability to manage ET were analyzed. These measures were used as dependent variables in backward procedure ANOVA analyses. Different pre-defined aspects that could influence the ability to manage ET were used as independent variables. Results: Three aspects had a significant effect upon the ability to manage ET. These were: (1) variability in intrapersonal capacities (such as “the capacity to pay attention and focus”, (2) environmental characteristics (such as “the impact of the design”) and (3) diagnostic group. Conclusions: Variability in intrapersonal capacities seems to be of more importance than the actual level of intrapersonal capacity in relation to the ability to manage ET for this sample. This implies that investigations of ability to manage ET should also include intra-person variability. Additionally, adaptations in environmental characteristics could simplify the management of ET to support older adults as technology users.Health Care Sciences Postgraduate SchoolSwedish BrainpowerBotkyrka municipalityThe Swedish Council for Working Life and Social Research (FAS)The regional agreement on medical training and clinical research (ALF) between the Stockholm County Council and Karolinska InstitutetAccepte

Ability to manage everyday technology : a comparison of persons with dementia or mild cognitive impairment and older adults without cognitive impairment

Purpose: The ability to manage technology is important for performance and participation in everyday activities. This study compares the management of technology in everyday activities among people with mild-stage dementia or MCI with older adults without known cognitive impairment (OA). Method: Persons with mild-stage dementia (n=38), MCI (n=34) and OA (n=45) were observed and interviewed when managing their everyday technology at home by using the Management of Everyday Technology Assessment (META). A computer application of a Rasch measurement model was used to generate measures of participants’ ability to manage technology. These measures were compared group-wise with ANCOVA. Results: The management of everyday technology was significantly more challenging for the samples with mild-stage AD or MCI compared to the OA sample (AD – OA, p<0.001; d=1.87, MCI – OA, p<0.001; d=0.66 ). The sample with MCI demonstrated a significantly higher ability to manage technology than the sample with mild-stage AD (AD – MCI, p<0.001; d=1.23). However, there were overlaps between the groups and decreased ability appeared in all groups. Conclusions: Persons with cognitive impairment are likely to have decreased ability to manage everyday technology. Since their decreased ability can have disabling consequences, ability to manage technology is important to consider when assessing ability to perform everyday activities.Health Care Sciences Postgraduate SchoolBotkyrka communitySwedish BrainpowerThe regional agreement on medical training and clinical research (ALF) between the Stockholm County Council and the Karolinska Institutet.Accepte

Factors that impact the level of difficulty of everyday technology in a sample of older adults with and without cognitive impairment

Everyday technologies (ET) are an important part of the environment in which we live and interact, and older adults with cognitive impairments have to be able to manage ETs in order to participate in society. The aim of the present study was to bring new insight into what makes an ET easy or difficult to use for older adults with and without cognitive impairment. Older adults with or without cognitive impairments (n=116) were observed managing 27 ETs. In order to analyze and detect variables that influenced the level of difficulty of the ETs managed, a regression analysis was used and predefined assumptions were investigated. The results revealed that ETs that were used less than once a week were more difficult to handle, as were those with a complex design. The results suggests that ETs, more specifically Information and Communication Technology, need to be designed to be more user-friendly and less complex, and older adults that wish to continue using an ET need to be frequent users. The age and gender of the user, and how long the ET had been in use did not relate to how difficult an ET was to manage.Swedish Research Council, Swedish Brain Power, Botkyrka Community, The regional agreement on medical training and clinical research (ALF) between the Stockholm County Council and Karolinska Institutet, The American Alzheimer’s Association (Everyday Technologies for Alzheimer’s Care)Accepte

Changes in the technological landscape over time : everyday technologies relevance and difficulty levels as perceived by older adults with and without cognitive impairment.

BACKGROUND: Everyday technology, ET (e.g. computers, TV's and vending machines) perceived as relevant and used in everyday activities change continuously. Not being able to keep up with these changes may hinder participation in activities. OBJECTIVE: To investigate stability and change in perceived relevance of ET, and in levels of perceived ET difficulty across two different occasions in time and between two similar samples of older adults with and without cognitive impairment. METHODS: Data of perceived relevance and difficulty in ET use in the samples (n= 157/118), collected with the Everyday Technology Use Questionnaire (ETUQ) was investigated. RESULTS: Thirty-three (70%) of the ETs in the ETUQ significantly increased in relevance, while the perceived levels of difficulty were statistically similar in 40/47 ETs (85%) across the two time occasions. CONCLUSIONS: The perceived relevance of ET among older adults with and without cognitive impairment was indicated to increase over time, but the levels of perceived levels of difficulty of ETs did not change as much. This knowledge could be used to support and facilitate ET use in the aging population, and in general to influence society's view of older people as active users of ET in activities at home and in public spaces.Swedish Brain PowerThe Swedish Council for Working Life and Social Research (FAS)The Health Care Sciences Postgraduate School,The regional agreement on medical training and clinical research between the Stockholm County Council and the Karolinska InstitutetManuscrip

Associations between community participation and types of places visited among persons living with and without dementia: risks perception and socio-demographic aspects

INTRODUCTION: Increasingly, literature has focused on community participation in places visited by persons living with and without dementia. Earlier research indicates that multiple factors, including socio-demographic aspects and risk perception may influence community participation. AIM AND METHODS: This cross-sectional, explorative study aims to inquire into how places visited, socio-demographic aspects and risks perception are associated with self-rated community participation for persons living with and without dementia (n = 70) in Switzerland. Data was collected through face-to-face interviews with questionnaires (ACT-OUT, MoCA, sociodemographic). First, we investigated whether the number of places visited was correlated with self-rated participation; then we added socio-demographic and risks perception factors with a bivariate analysis; and searched for a model using multinomial logistic regressions. RESULTS: For the group of participants living with dementia, risks of falling (p = .014) and of getting lost (p = .037) were significantly associated with self-rated participation. For the group of participants living without dementia, visiting places outside the home was significantly associated with self-rated participation, especially visiting places in domain D/places for recreational and physical activities (p = .005). DISCUSSION AND CONCLUSIONS: The results of exploring multiple factors and searching for a model highlights the complexity of community participation as a construct. Risks and visiting places for recreational and physical activities seem to play a role in self-rated participation. Mobile interviews might be better suited to gain in-depth understanding on community participation for persons living with dementia