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Assessing the ability to use everyday technology in people with MCI or Alzheimer's disease
S678
F4-01-02
Featured Research Sessions F4-01: TPIA: The Role of ICT in Cognitive Disorders
MOBILE PHONE VIDEO: STREAMING IN ALZHEIMER’S DISEASE – AN INTERNET: BASED SCHEDULING SYSTEM
Sarah Mason, Queens University, Belfast, United Kingdom. Background: Demographic changes highlight the need to address disabilities associated with the costly morbidities of old age such as dementia. Easy to use technological solutions offer a means of home support. This research project focuses on assisting persons with early Alzheimer’s disease (AD) in the area of memory support through the delivery of memory cues. Specifically, an entirely novel system to permit caregivers to record video reminders for scheduled transmission over-the-air has been developed and is currently being evaluated. Methods: Semistructured interviews were used to determine the efficacy of reminders as they are delivered in the form of a video message, displayed on a mobile phone to provide a ‘virtual carer’ for the person with AD. The system was initially trialed with two control groups consisting of three young and two older users who piloted the system. Results: Users provided favorable feedback although reported negatively on volume and weight. The system was then evaluated with five cohorts (n ¼ 22). Cohorts 1 and 2 consisted of AD/carer couples and feedback from these informed the recruitment for cohort 3, however, technical difficulties prevented a full analysis. Following stabilization of technical issues experienced by cohort 3 it was felt that it was important to establish a stable system and that this should be first tested on healthy individuals (cohort 4), cross-checked in those with Mild Cognitive Impairment (cohort 5) and tested again with people with AD. An ABA design evaluation (n ¼ 9) was then employed to trial the system under a more formal setting. Following this a longitudinal trial was undertaken (n ¼ 10) to assess potential impact on users and carers over a longer time period. Issues surrounding battery life, delivery of messages and resistance to the intervention where found. The system was found to be as effective as normal reminding systems. Conclusions: Further field testing is required to validate technical functionality and the effectiveness of the approach as a reminding tool on a large scale and in different memory-impaired cohorts. F4-01-03
TECHNOLOGY AND PARTICIPATORY RESEARCH ATTITUDES IN AN URBAN NATURALLY OCCURRING
prevention interventions which require technology use should tailor protocols to community characteristics and attitudes to maximize participation and implementation. F4-01-04
ASSESSING THE ABILITY TO USE EVERYDAY TECHNOLOGY IN PEOPLE WITH MCI OR ALZHEIMER’S DISEASE
Louise Nygard, Karolinska Institutet, Stockholm, Sweden. Background: The use of everyday technology, ET, (e.g. cell phones, electronic household equipment, cash machines) is important for participation in today’s society. ET has a potential to simplify our daily lives and compensate for disability, but it also may obscure certain groups’ participation in society if they cannot access or use ET. Methods: Two instruments have been developed by using a many-faceted Rasch measurement model; Everyday Technology Use Questionnaire, ETUQ, and Management of Everyday Technology Assessment, META. Data have been collected in three studies including samples with AD, MCI and controls (in total, n ¼ 391), and analyzed statistically. Results: Both ETUQ and META demonstrate good psychometric qualities in person response validity, task goodness-of-fit, and rating scale and internal scale validity. Our studies show that ability to use ET sensitively separates people with MCI from controls as well as from people with AD. We have also found a moderately positive relationship between perceived difficulty in ET use and engagement in ADL/IADL. Moreover, we have found that what influences a person’s ability to use technology - besides cognitive level/diagnosis - is within-person variability in intrapersonal characteristics and environmental influence (i.e. design of the technology and the context where it is used). From these data, we have also developed two hierarchies: The skill hierarchy identifies the relative level of difficulty of 9 skills (i.e. observable actions) that are required when ET is used. The technology hierarchy rank orders 90 common ETs’ level of challenge. Conclusions: The instruments provide a means to detect subtle changes in function in people with MCI or early AD. The findings show that ET use is an important dimension of everyday life activities, and call for attention to this issue, as disability occurs already in MCI. Both hierarchies might be clinically utilized, for example, in design and adaptation of health care interventions and technology. F4-01-05
ISISEMD HOME SUPPORT IN COGNITIVE IMPAIRMENT
Joshua Steinerman, Albert Einstein College of Medicine, Bronx, N.Y., United States.
Anelia Mitseva, North Denmark EU-office, Aalborg, Denmark.
Background: Technology-enabled research and care could empower efforts to promote healthy brain aging and prevent Alzheimer’s disease (AD), while expanding access and leveraging economies of scale. Our community-based strategy to build organizational capacity and infrastructure for AD preventative interventions included a survey of aging individuals in Co-op City (Bronx, New York). Survey items assessed participatory research attitudes; computer experience and technophilia; community social cohesion; AD attitudes; AD knowledge; personal, familial, and caregiving experience with AD; General health and demographics. Herein, we focus on technology and participatory research attitudes in this large, urban, age-in-place community. Methods: The Co-op Community Brain Health Survey was conducted from June through August 2010. Eligibility criteria included age > 50, Co-op City residence, English ability. Logistic regression was used to assess the relations between predictors and reported computer experience. Linear regression was used to assess the relations between predictors and participatory research attitudes. We created a “technophilia” score using the weighted sum of factor loadings and a cutoff of 0.30. Unidimensionality of this combined attitude and use construct is supported by the unrotated factor solution, which includes items on computer attitudes as well as email, digital camera, and mobile device use. We used linear regression to assess predictors of technophilia among the subgroup with computer experience. Results: 214 individuals were interviewed. Mean age was 70.9 years. 77% were female. Ethnicity was 58% African-American (AA), 27% White, 12% Hispanic. 60% had 12 or more years of education. 131 individuals (61%) reported “any experience with computers.” Significant predictors of computer experience were younger age. Conclusions: Aging and AD
Background: In Europe the number of people with dementia is conservatively anticipated to increase by 40% over the next 20 years mainly due to the increase in the ageing population. As a consequence, social care providers in Europe will face major challenges over the next couple of decades due to the increased care demand for people suffering from dementia and the burden for their informal caregivers. Current traditional care provides very limited services for these groups, leaving their needs unmet to a great extent. ISISEMD project aims to increase quality of life of elderly with mild dementia and their informal carers by offering a pilot platform of individualised ICT services for home support - home safety, support for daily activities, cognitive stimulation, outdoor support. The pilot services are being evaluated in four European regions, for a period of 12 months. The controlled study has the following characteristics. Methods: Validation of the services is being carried out in two stages - small-scale and large-scale validation. Number of participants: 80 elderly patients with MCI or MD across four regions - 20 per trial site (10 intervention and 10 control) with formal and informal caregivers. Results: Target variables and expected results: a) increased QoL and feeling of safety, reduced burden of care, maintained cognitive ability; b) user acceptance and satisfaction from the services; This presentation will discuss challenges experienced on the way from the pilot operation; lessons learnt and some preliminary results. Conclusions: ICT services for home support offers a number of promising opportunities to help patients and their relatives but address a subset of their unmet needs. The challenges have diverse nature - the need for multidisciplinary team work; pure practical issues to be overcome; real-life operation of the service platform in home environment is dependent also on external technology
F4-01-02
Featured Research Sessions F4-01: TPIA: The Role of ICT in Cognitive Disorders
MOBILE PHONE VIDEO: STREAMING IN ALZHEIMER’S DISEASE – AN INTERNET: BASED SCHEDULING SYSTEM
Sarah Mason, Queens University, Belfast, United Kingdom. Background: Demographic changes highlight the need to address disabilities associated with the costly morbidities of old age such as dementia. Easy to use technological solutions offer a means of home support. This research project focuses on assisting persons with early Alzheimer’s disease (AD) in the area of memory support through the delivery of memory cues. Specifically, an entirely novel system to permit caregivers to record video reminders for scheduled transmission over-the-air has been developed and is currently being evaluated. Methods: Semistructured interviews were used to determine the efficacy of reminders as they are delivered in the form of a video message, displayed on a mobile phone to provide a ‘virtual carer’ for the person with AD. The system was initially trialed with two control groups consisting of three young and two older users who piloted the system. Results: Users provided favorable feedback although reported negatively on volume and weight. The system was then evaluated with five cohorts (n ¼ 22). Cohorts 1 and 2 consisted of AD/carer couples and feedback from these informed the recruitment for cohort 3, however, technical difficulties prevented a full analysis. Following stabilization of technical issues experienced by cohort 3 it was felt that it was important to establish a stable system and that this should be first tested on healthy individuals (cohort 4), cross-checked in those with Mild Cognitive Impairment (cohort 5) and tested again with people with AD. An ABA design evaluation (n ¼ 9) was then employed to trial the system under a more formal setting. Following this a longitudinal trial was undertaken (n ¼ 10) to assess potential impact on users and carers over a longer time period. Issues surrounding battery life, delivery of messages and resistance to the intervention where found. The system was found to be as effective as normal reminding systems. Conclusions: Further field testing is required to validate technical functionality and the effectiveness of the approach as a reminding tool on a large scale and in different memory-impaired cohorts. F4-01-03
TECHNOLOGY AND PARTICIPATORY RESEARCH ATTITUDES IN AN URBAN NATURALLY OCCURRING
prevention interventions which require technology use should tailor protocols to community characteristics and attitudes to maximize participation and implementation. F4-01-04
ASSESSING THE ABILITY TO USE EVERYDAY TECHNOLOGY IN PEOPLE WITH MCI OR ALZHEIMER’S DISEASE
Louise Nygard, Karolinska Institutet, Stockholm, Sweden. Background: The use of everyday technology, ET, (e.g. cell phones, electronic household equipment, cash machines) is important for participation in today’s society. ET has a potential to simplify our daily lives and compensate for disability, but it also may obscure certain groups’ participation in society if they cannot access or use ET. Methods: Two instruments have been developed by using a many-faceted Rasch measurement model; Everyday Technology Use Questionnaire, ETUQ, and Management of Everyday Technology Assessment, META. Data have been collected in three studies including samples with AD, MCI and controls (in total, n ¼ 391), and analyzed statistically. Results: Both ETUQ and META demonstrate good psychometric qualities in person response validity, task goodness-of-fit, and rating scale and internal scale validity. Our studies show that ability to use ET sensitively separates people with MCI from controls as well as from people with AD. We have also found a moderately positive relationship between perceived difficulty in ET use and engagement in ADL/IADL. Moreover, we have found that what influences a person’s ability to use technology - besides cognitive level/diagnosis - is within-person variability in intrapersonal characteristics and environmental influence (i.e. design of the technology and the context where it is used). From these data, we have also developed two hierarchies: The skill hierarchy identifies the relative level of difficulty of 9 skills (i.e. observable actions) that are required when ET is used. The technology hierarchy rank orders 90 common ETs’ level of challenge. Conclusions: The instruments provide a means to detect subtle changes in function in people with MCI or early AD. The findings show that ET use is an important dimension of everyday life activities, and call for attention to this issue, as disability occurs already in MCI. Both hierarchies might be clinically utilized, for example, in design and adaptation of health care interventions and technology. F4-01-05
ISISEMD HOME SUPPORT IN COGNITIVE IMPAIRMENT
Joshua Steinerman, Albert Einstein College of Medicine, Bronx, N.Y., United States.
Anelia Mitseva, North Denmark EU-office, Aalborg, Denmark.
Background: Technology-enabled research and care could empower efforts to promote healthy brain aging and prevent Alzheimer’s disease (AD), while expanding access and leveraging economies of scale. Our community-based strategy to build organizational capacity and infrastructure for AD preventative interventions included a survey of aging individuals in Co-op City (Bronx, New York). Survey items assessed participatory research attitudes; computer experience and technophilia; community social cohesion; AD attitudes; AD knowledge; personal, familial, and caregiving experience with AD; General health and demographics. Herein, we focus on technology and participatory research attitudes in this large, urban, age-in-place community. Methods: The Co-op Community Brain Health Survey was conducted from June through August 2010. Eligibility criteria included age > 50, Co-op City residence, English ability. Logistic regression was used to assess the relations between predictors and reported computer experience. Linear regression was used to assess the relations between predictors and participatory research attitudes. We created a “technophilia” score using the weighted sum of factor loadings and a cutoff of 0.30. Unidimensionality of this combined attitude and use construct is supported by the unrotated factor solution, which includes items on computer attitudes as well as email, digital camera, and mobile device use. We used linear regression to assess predictors of technophilia among the subgroup with computer experience. Results: 214 individuals were interviewed. Mean age was 70.9 years. 77% were female. Ethnicity was 58% African-American (AA), 27% White, 12% Hispanic. 60% had 12 or more years of education. 131 individuals (61%) reported “any experience with computers.” Significant predictors of computer experience were younger age. Conclusions: Aging and AD
Background: In Europe the number of people with dementia is conservatively anticipated to increase by 40% over the next 20 years mainly due to the increase in the ageing population. As a consequence, social care providers in Europe will face major challenges over the next couple of decades due to the increased care demand for people suffering from dementia and the burden for their informal caregivers. Current traditional care provides very limited services for these groups, leaving their needs unmet to a great extent. ISISEMD project aims to increase quality of life of elderly with mild dementia and their informal carers by offering a pilot platform of individualised ICT services for home support - home safety, support for daily activities, cognitive stimulation, outdoor support. The pilot services are being evaluated in four European regions, for a period of 12 months. The controlled study has the following characteristics. Methods: Validation of the services is being carried out in two stages - small-scale and large-scale validation. Number of participants: 80 elderly patients with MCI or MD across four regions - 20 per trial site (10 intervention and 10 control) with formal and informal caregivers. Results: Target variables and expected results: a) increased QoL and feeling of safety, reduced burden of care, maintained cognitive ability; b) user acceptance and satisfaction from the services; This presentation will discuss challenges experienced on the way from the pilot operation; lessons learnt and some preliminary results. Conclusions: ICT services for home support offers a number of promising opportunities to help patients and their relatives but address a subset of their unmet needs. The challenges have diverse nature - the need for multidisciplinary team work; pure practical issues to be overcome; real-life operation of the service platform in home environment is dependent also on external technology