Due to the growing number of older adults with cognitive impairment, it is essential to delay the onset and progression of cognitive decline and promote a healthy lifestyle. The rapid growth of technology has considerably advanced the field of computerized cognitive interventions. Consequently, traditional cognitive interventions are being adapted and new multimedia systems are being developed to encourage health and independent living in old age. The primary objective of this review was to identify cognitive stimulation, training and rehabilitation programs aimed at older people with mild cognitive impairment (MCI) and dementia. PsycINFO, Medline, CINAHL, Web of Science, PubMed, and CORDIS databases were searched from January 2008 to August 2018. Two researchers reviewed the potential studies individually for eligibility. Studies of computerized cognitive interventions for people with dementia and cognitive impairment were included if they clearly described objectives, users and functioning. A systematic review of the studies was carried out, providing a qualitative synthesis of the features and study characteristics of each software. Nineteen studies met the inclusion criteria, and 11 different cognitive stimulation, training, and rehabilitation programs were identified. The studies found on cognitive intervention software indicate the existence of various technological programs for people with MCI and dementia. On the overall, the programs were aimed at people with different clinical conditions, able to create specific treatments and personalized training, optimized for portable devices, and user-friendly. However, the selected programs differ from each other in terms of objectives, usage mode and characteristics, even if they were used for the same purposes. Therefore, the information obtained in the review may be relevant to distinguish between programs and select the one that best suits each user. Thus, more information about the features and context of use is needed as well as more clinical studies to be able to compare among computerized cognitive programs.
IntroductionIncorporating technology in cognitive interventions represents an innovation, making them more accessible, flexible, and cost-effective. This will not be feasible without adequate user-technology fit. Bearing in mind the importance of developing cognitive interventions whose technology is appropriate for elderly people with cognitive impairment, the objective of this systematic review was to find evidence about usability and user experience (UX) measurements and features of stimulation, training, and cognitive rehabilitation technologies for older adults with mild cognitive impairment (MCI) or dementia.MethodThe Medline, PubMed, Scopus, ScienceDirect, and PsycINFO databases were searched for literature published in the last 10 years (2009–2019), and three researchers independently reviewed potentially eligible studies, following specific inclusion criteria. A systematic review of the studies was conducted, presenting a qualitative synthesis of usability and UX measures with their outcomes, study characteristics and features of the cognitive intervention technologies.ResultsTen studies were selected: five were cognitive stimulation and five were cognitive training. Most of them (60%) were computer-based programs with a serious game format. Efficiency and effectiveness were the most frequent measurements used for collecting objective usability data, showing that elderly people with cognitive impairment require more time (45%) and help (40%) but can complete tasks (60%). Regarding UX or subjective usability data, questionnaires and scales were the most used methods, reporting positive experience despite certain difficulties with the interface in five studies.ConclusionMeasuring usability and UX in cognitive intervention technologies for older adults with MCI or dementia provides an integrated view that can contribute to their development according to the needs and characteristics of the target population. More research is required to include this population group in usability and UX studies, as well as standardized tools and consensus on the relationship of these terms to guarantee the future effectiveness of cognitive intervention technologies.Review registrationThis review was registered in the PROSPERO (CRD42020158147) International Register of Systematic Review Protocols.
Resumen: En el proceso de envejecimiento, se produce un declive cognitivo debido a la edad. El deterioro cognitivo es uno de los síntomas más comunes de enfermedades neurodegenerativas como la demencia. A lo largo de décadas se han desarrollado rehabilitación cognitiva por ordenador en personas mayores:
In recent years, there has been a great development of software technology in the field of psychogeriatric research, helping to improve the quality of life of the elderly and preventing cognitive deterioration associated with aging, and thus decrease the possible dependence. The main objective of the present study is to evaluate the usability of the Long Lasting Memories program in elderly people with or without cognitive impairment in a region of Spain. For the study, users were classified into three groups: subjects with no cognitive impairment, with mild cognitive impairment and mild dementia, and they were given a usability questionnaire covering different variables. Of the 157 Spanish participants in the study, 84.1 percent answered the usability questionnaire, obtaining wide acceptance in all study groups regarding the usability of the Long Lasting Memories program. Current research begins to mark a new perspective that recognizes the need to establish a preventive strategy for degenerative diseases.
Objectives: The reduction in cognitive decline depends on timely diagnosis. The aim of this systematic review was to analyze the current available Information and Communication Technologies´ (ICT) based instruments for cognitive decline early screening and detection in terms of usability, validity and reliability.Methods: Electronic searches identified 1785 articles of which 34 met the inclusion criteria and were grouped according to their main purpose into test batteries, measures of isolated tasks, behavioral measures and diagnostic tools.Results: Thirty one instruments were analyzed. Fifty two percent were PC based, 26% Tablet, 13% laptop and one was mobile phone based. The most common input method was touchscreen (48%). The instruments were validated with a total of 4307 participants: 2146 were healthy older adults (M = 73.59, SD = 5.12); 1104 had dementia (M = 74.65, SD = 3.98) and 1057 mild cognitive impairment (M = 74.84, SD = 4.46). Only 6% were administered at home, 19% reported outcomes about usability and 22% about understandability. One study reported users' experience. Twenty-three percent of the instruments included information about convergent validity and 34% about discriminant validity; most of them obtained acceptable values of specificity and sensitivity. The methodological quality of the studies was good, the weakest methodological area being usability. Most of the instruments obtained acceptable values of specificity and sensitivity.3 Conclusions: It is necessary to create home delivered instruments and to include usability and users´ experience studies in their design. Involvement of people with cognitive decline in all phases of the development process is of great importance to obtain valuable and user-friendly products. It would be advisable for researchers to make an effort to provide cut-off points for their instruments.
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