scholarly journals Perceived Need and Acceptability of an App to Support Activities of Daily Living in People With Cognitive Impairment and Their Carers: Pilot Survey Study (Preprint)

2019 ◽  
Author(s):  
Rhoda Lai ◽  
Maria Tensil ◽  
Alexander Kurz ◽  
Nicola T Lautenschlager ◽  
Janine Diehl-Schmid

BACKGROUND Modern technologies, including smartphone apps, have the potential to assist people with cognitive impairment with activities of daily living, allowing them to maintain their independence and reduce carer burden. However, such tools have seen a slow rate of uptake in this population, and data on the acceptability of assistive technologies in this population are limited. OBJECTIVE This pilot study included older adults with cognitive impairment and their carers, and explored the perceived needs for and acceptability of an app that was designed to be a simple assistive tool for activities of daily living. In particular, this study aimed to assess the acceptability of common app functions such as communication, reminder, navigation, and emergency tools in this population, and to compare patients’ and carers’ responses to them. METHODS A total of 24 German participants with mild cognitive impairment or dementia and their family carers separately completed two short questionnaires. The first questionnaire asked the participants with cognitive impairment and their carers to self-rate the patients’ cognitive impairment levels and affinity to technology. Following a demonstration of the app, participants rated the usability and acceptability of the app and its functions in a second questionnaire. RESULTS Participants rated themselves as much less cognitively impaired than their carers did (<i>P</i>=.01), and insight into the level of support they received was low. The majority of the participants (19/24, 79%) and their carers (20/24, 83%) had low affinity to technology, and even after the demonstration, 63% (15/24) of the participants had low interest in using the app. A breakdown of acceptability responses by app function revealed that participants were more amenable to the reminder function, the emergency feature, and a wearable form of the app. Features that centered around carers monitoring participants’ movements were reported to be less acceptable to participants. CONCLUSIONS This study highlights the importance of focusing on acceptability and the consumer’s perceptions in the development of assistive technology for older adults with cognitive impairment. Participants showed an aversion to functions they perceived as eroding their independence, while functions that more closely aligned with independence and autonomy were perceived as more acceptable.

10.2196/16928 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e16928
Author(s):  
Rhoda Lai ◽  
Maria Tensil ◽  
Alexander Kurz ◽  
Nicola T Lautenschlager ◽  
Janine Diehl-Schmid

Background Modern technologies, including smartphone apps, have the potential to assist people with cognitive impairment with activities of daily living, allowing them to maintain their independence and reduce carer burden. However, such tools have seen a slow rate of uptake in this population, and data on the acceptability of assistive technologies in this population are limited. Objective This pilot study included older adults with cognitive impairment and their carers, and explored the perceived needs for and acceptability of an app that was designed to be a simple assistive tool for activities of daily living. In particular, this study aimed to assess the acceptability of common app functions such as communication, reminder, navigation, and emergency tools in this population, and to compare patients’ and carers’ responses to them. Methods A total of 24 German participants with mild cognitive impairment or dementia and their family carers separately completed two short questionnaires. The first questionnaire asked the participants with cognitive impairment and their carers to self-rate the patients’ cognitive impairment levels and affinity to technology. Following a demonstration of the app, participants rated the usability and acceptability of the app and its functions in a second questionnaire. Results Participants rated themselves as much less cognitively impaired than their carers did (P=.01), and insight into the level of support they received was low. The majority of the participants (19/24, 79%) and their carers (20/24, 83%) had low affinity to technology, and even after the demonstration, 63% (15/24) of the participants had low interest in using the app. A breakdown of acceptability responses by app function revealed that participants were more amenable to the reminder function, the emergency feature, and a wearable form of the app. Features that centered around carers monitoring participants’ movements were reported to be less acceptable to participants. Conclusions This study highlights the importance of focusing on acceptability and the consumer’s perceptions in the development of assistive technology for older adults with cognitive impairment. Participants showed an aversion to functions they perceived as eroding their independence, while functions that more closely aligned with independence and autonomy were perceived as more acceptable.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
T. Muhammad ◽  
Shobhit Srivastava ◽  
T. V. Sekher

Abstract Background Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. Methods Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. Results About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21–1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72–0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. Conclusion The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.


2020 ◽  
Vol 35 ◽  
pp. 153331752096087
Author(s):  
Kalpana P. Padala ◽  
Christopher M. Parkes ◽  
Prasad R. Padala

We present a case report to showcase that behavioral, cognitive, and functional decline may be associated with COVID-19 stay-home guidance among older adults with pre-existent cognitive impairment. In a functionally independent and physically active older adult with Mild Cognitive Impairment, there was worsening in depression and anxiety symptoms associated with the restrictions of COVID-19. Functional decline was also noted as assessed by Instrumental Activities of Daily Living. We discuss solutions to mitigate the effects of COVID-19 restrictions in this vulnerable population.


2012 ◽  
Vol 43 (4) ◽  
pp. 801-811 ◽  
Author(s):  
A. G. Gildengers ◽  
D. Chisholm ◽  
M. A. Butters ◽  
S. J. Anderson ◽  
A. Begley ◽  
...  

BackgroundWhile bipolar disorder (BD) is a leading cause of disability, and an important contributor to disability in BD is cognitive impairment, there is little systematic research on the longitudinal course of cognitive function and instrumental activities of daily living (IADLs) in late-life. In this report, we characterize the 2-year course of cognitive function and IADLs in older adults with BD.MethodWe recruited non-demented individuals 50 years and older with BD I or BD II (n = 47) from out-patient clinics or treatment studies at the University of Pittsburgh. Comparator subjects (‘controls’) were 22 individuals of comparable age and education with no psychiatric or neurologic history, but similar levels of cardiovascular disease. We assessed cognitive function and IADLs at baseline, 1- and 2-year time-points. The neuropsychological evaluation comprised 21 well-established and validated tests assessing multiple cognitive domains. We assessed IADLs using a criterion-referenced, performance-based instrument. We employed repeated-measures mixed-effects linear models to examine trajectory of cognitive function. We employed non-parametric tests for analysis of IADLs.ResultsThe BD group displayed worse cognitive function in all domains and worse IADL performance than the comparator group at baseline and over follow-up. Global cognitive function and IADLs were correlated at all time-points. The BD group did not exhibit accelerated cognitive decline over 2 years.ConclusionsOver 2 years, cognitive impairment and associated functional disability of older adults with BD appear to be due to long-standing neuroprogressive processes compounded by normal cognitive aging rather than accelerated cognitive loss in old age.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yun Zhang ◽  
Wen Hu ◽  
Zhixin Feng

Abstract Background Social isolation is a serious public health issue affecting a significant number of older adults worldwide. However, associations between different dimensions of social isolation and functional health are unclear. We assessed the varied effects of social isolation on health among a nationwide sample of older adults from China. Methods We assessed social isolation among 5,419 people aged 65 and older who took part in both the 2011 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Social isolation includes objective social isolation (kinlessness and lack of social contacts) and subjective social isolation. Four functional health outcomes were examined: self-rated health (SRH), activities of daily living (ADLs), instrumental activities of daily living (IADLs), and cognitive function measured by the Mini-Mental State Examination (MMSE). We used multivariable regression analyses to examine the associations between social isolation and health outcomes. Results Older people who never married or who had recently lost a spouse were more likely to report poor SRH (OR=2.44) and difficulty with IADLs (ORs=1.46) than those who were married and lived with a spouse. Older people who never gave birth were less likely to report cognitive impairment (OR=0.53) than those who had living children, while older people who had recently lost a child were more likely to report poor SRH than those who had living children (OR=1.32). Older people who had no children visiting were more likely to report difficulty with IADLs than those who had children visiting (OR=1.25). In terms of subjective social isolation, older people who felt lonely were more likely to report poor SRH, cognitive impairment, and difficulty with ADLs and IADLs (ORs=1.19, 1.27, 1.28 and 1.21, respectively), and older people who had no one to talk to were more likely to report poor SRH, cognitive decline, and difficulty with ADLs and IADLs (ORs=2.08, 5.32, 2.06 and 1.98, respectively). Conclusions Kinlessness, lack of social contacts and subjective social isolation may impact various dimensions of health in older people. Due to the varied health consequences of social isolation, targeted health interventions should be developed to address relevant situations of social isolation.


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