A Review of Interventions with Assistive Technologies for Patients with Cognitive Impairment

2015 ◽  
pp. 118-129 ◽  
Author(s):  
Panagiotis Georgakopoulos ◽  
Maria Chatzidimitriou ◽  
Magda Tsolaki
Keyword(s):  
Cognitive Impairment ◽  
Intelligent Systems ◽  
Holistic Approach ◽  
Assistive Technologies ◽  
Cognitively Impaired ◽  
Engineering Systems ◽  
Research Themes ◽  
Diverse Field ◽  
Computer Based ◽  
Cognitive Problems

Advances in technology in the last decade have created a diverse field of applications for the care of persons with cognitive impairment. This chapter is an attempt to review these advances in a systematic way, and focuses on observations of current software engineering systems (computer based assistive interventions) that contribute to the diagnosis and treatment of patients with cognitive problems. Nevertheless a holistic approach has been attempted, in order to view the research themes and applications that currently exist around the “intelligent systems” healthcare given to the cognitively impaired persons, thus looking at research directions, systems, technological frameworks and trends.

Investigating Assistive Technologies using Computers to Simulate Basic Curriculum for Individuals with Cognitive Impairments

2010 ◽  
pp. 61-75 ◽  
Author(s):  
Carolyn Kinsell
Keyword(s):  
Assistive Technology ◽  
Transfer Of Learning ◽  
Cognitive Impairments ◽  
Assistive Technologies ◽  
Cognitively Impaired ◽  
Traditional Classrooms ◽  
Active Participant ◽  
Knowledge And Skills ◽  
Computer Based ◽  
Theoretical Foundations

Providing assistive technologies to cognitively impaired students, in the form of computer-based simulations, may improve the transfer of learning at a greater rate than other training media. The underlying premise for using computer-based simulations is that the cognitively impaired student is no longer the passive learner normally found in traditional classrooms. Instead, the cognitively impaired student becomes an active participant with the simulation and learning. In addition, this type of assistive technology provides the student with an opportunity for repeated exposure and practice at a speed in which the student feels comfortable. This chapter discusses the benefits of using computer-based simulations, defines the theoretical foundations that support the transfer of learning, and presents the processes that facilitate individual acquisition and refinement of knowledge and skills. It concludes with a review of the cognitive elements in the creation of mental models and schema.

Families, Caregivers, and Assistance

2013 ◽  
Author(s):  
J. Eric Ahlskog
Keyword(s):  
Decision Making ◽  
Cognitive Impairment ◽  
Family Business ◽  
Psychometric Testing ◽  
Cognitive Testing ◽  
Cognitively Impaired ◽  
Leadership Positions ◽  
Hand Dexterity ◽  
The Family ◽  
Cognitive Problems

By definition, those with DLB or PDD are cognitively impaired. The degree of cognitive impairment is highly variable; some people remain relatively compensated and stable for years. For others, confusion impairs even the simplest of activities. Unlike Alzheimer’s disease, in which dementia occurs in isolation, DLB and PDD are often associated with other problems: gait and balance dysfunction; impairment of hand dexterity; the bowel, bladder, and blood pressure problems of dysautonomia. The challenges to not only the affected person, but also the spouse or partner and family can be substantial. Caregivers may have many responsibilities, and restructured lives become the rule. These issues are so variable that a one-size-fits-all approach is not realistic. Once DLB or PDD has been diagnosed, it is wise for the spouse, partner, or family to discuss with the affected patient whether revisions in decision-making should be addressed. Occasional people with DLB or PDD have relatively limited cognitive problems, and for these individuals perhaps no major changes in the family business or finances are necessary. However, this issue should still be discussed. Investments, taxes, and bill-paying may need to be switched to another family member or spouse. A family business may need new leadership. In some cases, leadership positions may be retained, but with an advisor who reviews all important decisions. When there is uncertainty, formal cognitive testing may provide important insight. Psychologists typically offer psychometric testing, assessing various aspects of cognition. The interpretation of these findings can be translated into implications for decision-making. One of the most disabling restrictions placed on someone in our society is the removal of driving privileges. Communities are no longer structured where one can simply walk to the store, church, or synagogue. In the setting of DLB or PDD, however, driving restrictions or limitations may be appropriate. At least the possibility should be discussed. Driving may be compromised by both cognitive impairment and parkinsonism. Usually it is the cognitive problems that are the greater threat to the driver and public safety.

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
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Assistive Technologies ◽  
Survey Study ◽  
Cognitively Impaired ◽  
Perceived Needs ◽  
Perceived Need ◽  
Modern Technologies

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.

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

10.2196/16928 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e16928
Author(s):  
Rhoda Lai ◽  
Maria Tensil ◽  
Alexander Kurz ◽  
Nicola T Lautenschlager ◽  
Janine Diehl-Schmid
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Assistive Technologies ◽  
Survey Study ◽  
Cognitively Impaired ◽  
Perceived Needs ◽  
Perceived Need ◽  
Modern Technologies

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.

scholarly journals Use radiography rarely, not routinely, for hip hemiarthroplasty

2021 ◽  
Author(s):  
Lucy Clare Maling ◽  
John Martin Lynch ◽  
Robert William Walker ◽  
Mark Ross Norton ◽  
Rory George Middleton
Keyword(s):  
Patient Safety ◽  
Cognitive Impairment ◽  
Limited Resources ◽  
Cognitively Impaired ◽  
Clinical Change ◽  
Index Procedure ◽  
Hip Hemiarthroplasty ◽  
Operative Care ◽  
Fluoroscopic Imaging ◽  
Retrospective Database

Abstract Purpose Hip hemiarthroplasty (HA) is a commonly performed operation. A post-operative radiograph forms part of the routine hip fracture pathway, although patients are often mobilised prior to this investigation. This study seeks to provide evidence for a pragmatic clinical change to optimise patient safety and allocate limited resources within the National Health Service (NHS). Methods We undertook a retrospective database review of 1563 HA procedures to assess whether the routine ordering of check radiographs played an important role in a patient’s post-operative care. Results 18 (1.2%) mechanical complications led to a return to theatre within 6 weeks of the index procedure. All were dislocations. Ten had a normal post-operative radiograph and five had documented suspicion of dislocation prior to radiography. The post-operative check radiograph was the sole identifier of dislocation in only three patients (0.2%). All three of these patients were pre-morbidly bed bound and non-communicative due to cognitive impairment (AMTS 0/10). Conclusion Unless a patient is pre-morbidly bed bound and cognitively impaired, routine post-operative radiography following HA surgery is of little clinical benefit, yet may carry considerable risk to the patient and cost to the NHS. A pragmatic compromise is to perform intra-operative fluoroscopic imaging.

Educational intervention to improve palliative care knowledge among informal caregivers of cognitively impaired older adults

2020 ◽  
pp. 1-9
Author(s):  
Hyunjin Noh ◽  
Lewis H. Lee ◽  
Chorong Won
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Cognitive Impairment ◽  
Educational Intervention ◽  
Test Scores ◽  
Informal Caregivers ◽  
Cognitively Impaired ◽  
Significant Difference ◽  
Post Test ◽  
Seriously Ill

Abstract Objective Lack of palliative care knowledge among caregivers may pose an access barrier for cognitively impaired older adults, who may benefit from the specialized care. Therefore, this study aims to examine the effectiveness of an educational intervention in improving palliative care knowledge among informal caregivers of cognitively impaired older adults. Method Using a one-group, pre- and post-test intervention design, this study implemented an individual, face-to-face educational intervention with an informational brochure for 43 informal caregivers of chronically or seriously ill older adults (50+) with cognitive impairment, recruited from communities in West Alabama. Their level of knowledge about palliative care was assessed by the Palliative Care Knowledge Scale (PaCKS). The pre- and post-test scores were compared by the Wilcoxon signed-ranks test, and the racial subgroup (Whites vs. Blacks) comparison was made by the Mann–Whitney U test. Results There was a statistically significant difference between the pre- and post-test scores (z = 5.38, p < 0.001), indicating a statistically significant effect of the educational intervention in improving palliative care knowledge among participants. There was a significant difference (U = 143, p < 0.05) between Whites and Blacks in the pre-test, which, however, disappeared in the post-test (U = 173.50, p > 0.05), suggesting that the amount of increased PaCKS scores were significantly greater for Blacks (Mdn = 9.50) than for Whites (Mdn = 4.00, U = 130.50, p < 0.05). Significance of results This study demonstrated that a one-time educational intervention can improve the level of palliative care knowledge among informal caregivers of chronically or seriously ill older adults with cognitive impairment, particularly among Black caregivers. Therefore, further educational efforts can be made to promote palliative care knowledge and reduce racial disparities in palliative care knowledge and its use.

scholarly journals Heterogeneity of Amyloid Binding in Cognitively Impaired Patients Consecutively Recruited from a Memory Clinic: Evaluating the Utility of Quantitative 18F-Flutemetamol PET-CT in Discrimination of Mild Cognitive Impairment from Alzheimer’s Disease and Other Dementias

2020 ◽  
pp. 1-14
Author(s):  
Yi-Wen Bao ◽  
Anson C.M. Chau ◽  
Patrick Ka-Chun Chiu ◽  
Yat Fung Shea ◽  
Joseph S.K. Kwan ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Amyloid Β ◽  
Standardized Uptake Value ◽  
Subjective Cognitive Decline ◽  
Cognitively Impaired ◽  
Memory Clinic ◽  
Pet Ct

Background: With the more widespread use of 18F-radioligand-based amyloid-β (Aβ) PET-CT imaging, we evaluated Aβ binding and the utility of neocortical 18F-Flutemetamol standardized uptake value ratio (SUVR) as a biomarker. Objective: 18F-Flutemetamol SUVR was used to differentiate 1) mild cognitive impairment (MCI) from Alzheimer’s disease (AD), and 2) MCI from other non-AD dementias (OD). Methods: 109 patients consecutively recruited from a University memory clinic underwent clinical evaluation, neuropsychological test, MRI and 18F-Flutemetamol PET-CT. The diagnosis was made by consensus of a panel consisting of 1 neuroradiologist and 2 geriatricians. The final cohort included 13 subjective cognitive decline (SCD), 22 AD, 39 MCI, and 35 OD. Quantitative analysis of 16 region-of-interests made by Cortex ID software (GE Healthcare). Results: The global mean 18F-Flutemetamol SUVR in SCD, MCI, AD, and OD were 0.50 (SD-0.08), 0.53 (SD-0.16), 0.76 (SD-0.10), and 0.56 (SD-0.16), respectively, with SUVR in SCD and MCI and OD being significantly lower than AD. Aβ binding in SCD, MCI, and OD was heterogeneous, being 23%, 38.5%, and 42.9% respectively, as compared to 100% amyloid positivity in AD. Using global SUVR, ROC analysis showed AUC of 0.868 and 0.588 in differentiating MCI from AD and MCI from OD respectively. Conclusion: 18F-Flutemetamol SUVR differentiated MCI from AD with high efficacy (high negative predictive value), but much lower efficacy from OD. The major benefit of the test was to differentiate cognitively impaired patients (either SCD, MCI, or OD) without AD-related-amyloid-pathology from AD in the clinical setting, which was under-emphasized in the current guidelines proposed by Amyloid Imaging Task Force.

scholarly journals The association between cognitive impairment and breast and colorectal cancer screening utilization

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuang Yang ◽  
Jiang Bian ◽  
Thomas J. George ◽  
Karen Daily ◽  
Dongyu Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cognitive Impairment ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Odds Ratio ◽  
National Health Interview Survey ◽  
Lower Percentage ◽  
Cognitively Impaired ◽  
Interview Survey ◽  
The Difference

Abstract Background Undergoing cancer screening is a debatable topic in patients with cognitive impairment. In this study, we aimed to examine the utilization and predictors of breast and colorectal cancer screening among screening eligible, cognitively impaired individuals. Methods We analyzed the 2018 and 2019 National Health Interview Survey data (n = 12,965 and 24,782, respectively) on individuals eligible for breast or colorectal cancer screening. We calculated the percentage of cancer screening eligible individuals who received mammogram or colonoscopy by cognitive impairment status. We used multivariable logistic regression to examine whether having a recent mammogram or colonoscopy differed by cognitive impairment status, adjusting for covariates. Results We observed a significantly lower percentage of mammogram use in the screening eligible, cognitively impaired (mild or severe) versus unimpaired women. Adjusting for the covariates, the cognitively impaired women, mild (odds ratio [OR] = 0.85; p = 0.015) or severe (OR = 0.54; p <  0.001), were less likely to have had a recent mammogram compared to the cognitively unimpaired women. Although statistically non-significant, the percentage of colonoscopy use in the screening eligible, cognitively impaired individuals were slightly higher than that in the cognitively unimpaired individuals. In the regression analysis, we found the cognitively impaired men, mild (OR = 0.79; p <  0.001) or severe (OR = 0.69; p = 0.038), were less likely to have had a recent colonoscopy compared to the cognitively unimpaired men. More studies are needed to examine the multilevel factors that underpin the difference in cancer screening utilization in this vulnerable population. Conclusion Our results highlight the need for additional research to address utilization and effectiveness of cancer screening in individuals with cognitive impairment.

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