“You Know, I Swipe My Card and Hope for the Best”: Technology and Cognition as Dual Landscapes of Change

Abstract

Mild cognitive impairment (MCI), or objective and subjective cognitive decline, affects an estimated 15%–20% of individuals over the age of 65 . People with MCI generally live in community settings but may be at risk for functional changes in out-of-home participation, particularly when their instrumental activities are cognitively demanding or complex. Technology is part of the interface in complex person-place relationships. The purpose of this study is to examine the nature of everyday technology use in the context of out-of-home participation for community-dwelling older adults with MCI. Community-dwelling older adults with MCI (MoCA <26, >17; ( n = 10)) were recruited for data collection using a Go-along method (naturalistic observation, semi-structured interviews, and photography) for multiple out-of-home activities. Findings from this project suggested that participants felt that technology, like their cognition, was out of their control and difficult to predict or change. Four ways the participants experienced the “technology landscape” in their daily lives included: enabling being present, facilitating participation, impeding goals, and constricting options. We present a model of the intersection of cognition, participation, and technology in daily life, and discuss ways that technology can most effectively be used to extend well-being for a population aging in place.

Digitalization of Activities of Daily Living and Its Influence on Social Participation for Community-Dwelling Older Adults: A Scoping Review

“…The numbers of the evaluated sample were considerably varied, and the range of variation ranged from the smallest sample with six participants [ 36 ] to the largest, reaching a total population of two hundred and seventy-four individuals [ 30 ]. Most studies were conducted in Sweden ( n = 6, 55%) [ 30 , 32 , 34 , 35 , 36 , 37 ], and other studies were conducted in the United States ( n = 4, 36%) [ 28 , 29 , 31 , 38 ] and Belgium ( n = 1, 9%) [ 33 ]. For most studies, the first author was from the field of occupational therapy or occupational therapy departments from several universities ( n = 8) [ 28 , 29 , 31 , 32 , 34 , 36 , 37 , 38 ], followed by neuropsychologists or departments of psychiatry and neuropsychology ( n = 2) [ 33 , 35 ] and departments of geriatrics ( n = 1) [ 30 ].…”

“…Six studies used quantitative research methodologies [ 28 , 29 , 31 , 33 , 34 , 35 ], whereas four adopted qualitative research methodologies [ 32 , 36 , 37 , 38 ]. Only one study used mixed methodologies [ 30 ].…”

“…Several studies have evaluated the relationship between the self-perceived ability to use relevant everyday technologies (as assessed by ETUQ or S-ETUQ) in cognitively healthy older people as compared to those with MCI or AD [ 28 , 30 , 31 , 34 , 35 , 37 ], whereby they investigated associations between activity engagement (AE), number of available and relevant everyday technologies, usability and cognitive status among older adults [ 28 ]. Six studies included older adults with MCI [ 33 , 34 , 35 , 36 , 37 , 38 ] ( Table 3 ); additionally, in four studies, cognitive status was evaluated by using specific tools [ 28 , 30 , 31 , 33 ]. The aim was to determine the relationships between ET and the measured cognitive status.…”

“…Participants reported a constant sense of change in their activities and expressed a feeling that some things that "make life easier" for others had an opposite effect on them. The decision to leave or move was also discussed [ 38 ]. On the other hand, other researchers explored the possibility of determining indicators of functional decline through the measurement of cognitive status and performance level.…”

“…To determine how technology influences patterns of participation, some articles focused on specific devices (television, Internet and telephones) [ 38 ]. Other authors considered aspects such as the importance of occupational purpose in influencing the incorporation of a new technology into occupational patterns [ 37 , 38 ]. Two studies explored the potential for achieving a satisfactory relationship between occupation and technology in older people [ 36 , 38 ]…”