Digital Assistive Technology to Support Everyday Living in Community-Dwelling Older Adults with Mild Cognitive Impairment and Dementia

Abstract

The objective of this review was to explore whether knowledge about and practice of technology for older adults with mild cognitive impairment (MCI) and dementia (D) had developed since our 2017 review. Furthermore, we wanted to explore the usability and acceptability of technology in the newer trials, and how these may impact quality of life, occupational performance and human dignity. Materials and Methods: We searched for primary studies published between 2017 and 2020 reusing medical subject heading (MeSH) terms in five databases -Medline, PsycINFO, Embase, Amed and Cinahl -and obtained 1452 titles. The titles were divided in six piles, two for each of the three authors. The titles were sorted utilizing the Rayyan web tool. Fourteen studies were included in this review. The Mixed Method Appraisal Tool (MMAT) was used to assess the quality of the studies examined. Results: This review included almost twice as many participants as in the 2007-2017 review. Since 2017, a shift seems to have occurred toward technologies that can be worn on the body to monitor body functions and report states, or imbalances. Moreover, research interest is now focused on mobile phone apps and wearables providing reminders and timely support, rather than on separate devices at home. Conclusion:The studies conducted since 2017 report on wearable and environmental digital assistive technologies and often with multiple purposes. Three strategies for support seem evident: prompting and reminding people with dementia, monitoring people with dementia at home using environmental sensors and biosensors and providing safety outdoors. Thus, there is still a need for further research on the impact of technologies promoting occupational performance, quality of life, and human dignity for independent living.

Impact of digital assistive technologies on the quality of life for people with dementia: A scoping review

“…From 50 of the included studies, the following were used to promote autonomy: patient monitoring [25], [38], [39], [46], [50], [51], [61], [93]–[95], [100], [101], [103], [105]–[108], [111], [120]–[123], [125], [132], [137], [141], care support [53], [95] and digital therapeutics [21], [22], [25], [30], [32], [33], [38], [39], [49]–[51], [53], [56], [60], [61], [64], [70], [80]–[82], [86], [91], [93]–[95], [100], [104], [105], [107], [109]–[111], [114], [123], [125], [131], [138], [141]. Resilience was also mentioned as a significant factor contributing to enhanced autonomy [41], [62], [129], [130].…”

“…In contrast to autonomy, dignity refers to the ability to preserve self-respect and personhood, while being recognized and valued in society, and discussed in 13 studies using diverse DAT categories: digital therapeutics [39], [50], [107], [125] and patient monitoring [25], [39], [50], [80], [82], [85], [91], [102], [107], [110], [118], [125], [129]. These categories are specifically designed to uphold and promote aging in place, as demonstrated in the review of Gettel et al [39], by the use of pet robots to maintain the resident’s dignity and self-worth [102].…”

“…There are 12 behavioral and psychological symptoms of dementia (BPSD), which include aberrant motor behavior, agitation, anxiety, apathy, appetite changes, delusions, depression, disinhibition, elation/euphoria, hallucinations, irritability, and sleep changes [142]. Different BPSD symptoms were shown to be managed by DATs in 64 studies through digital therapeutics [23], [24], [26]–[30], [34]–[36], [38], [40]–[45], [47], [48], [51], [52], [57], [61]–[63], [65], [67], [69]–[79], [84], [85], [88], [90], [91], [93], [95], [98], [99], [102], [104], [115], [116], [123], [125]–[129], [133]–[136], [139], [140] or by patient monitoring devices [30], [34], [36], [63], [76], [95], [115]. All the DATS were reported to have a positive effect on BPSD.…”

“…During the charting process, 33 studies revealed the utilization of different units of measurement in this context. In 18 studies, the Quality of Life in Alzheimer’s Disease Scale (QOL-AD) was utilized [25], [28], [30], [41], [43], [44], [52], [62], [65], [67], [70], [73], [85], [90], [91], [125], [130], [136], and in 11 studies the Quality of Life in Late-Stage Dementia scale (QUALID) [27], [35], [41], [43], [61], [73], [85], [91], [104], [126], [136]. Additionally, the self-reported Dementia Quality of Life measure (DEMQoL) was employed in 4 studies [73], [92], [104], [112], the Dementia Quality of Life Instrument (DQoL) in 3 studies [41], [61], [93], the EQ-5D-5L in 3 studies [99], [104], [110].…”

Characterization of Physical Movement Signatures from WiFibased Passive Forward Scattering Radar

“…Nowadays, researchers and developers are focused on improving affordable sensor technologies that can provide safety monitoring for a self-sufficient living [1]. Thus, cutting-edge functionality in the assistive living technology (ALT) is becoming increasingly important, especially for elderly [2] and the disabled [3]. In this context, robust systems should be capable of indicating the correct state of information and perform multiple detections.…”