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PO20. Technology

Detailed programme, abstracts and poster presentations

PO20.1. Supporting the use of gaming technology in dementia care: An online training portal for practitioners

HICKS Ben

Bournemouth University, Hove, United Kingdom

Emerging research has demonstrated the benefits of off-the-shelf gaming technology such as iPads, Nintendo Wii and Microsoft Kinect for supporting the well-being and social inclusion of people with dementia. Despite this, however, the uptake of these devices within the dementia care arena has been limited due to barriers associated with the perceived cost, a lack of training amongst dementia practitioners and a misperception that people with dementia lack the capabilities or interest to engage with them. This presentation reports on a two-year project that collaborated with 48 dementia practitioners across the South of England to develop an online training platform, named Game Plan, and accompanying face-to-face training package to support the set-up and delivery of 'Tech Clubs' to people with dementia. The training was trialled within 4 care homes and evaluated using a mixed method approach. The results suggested that the training was received positively, enhanced practitioner's knowledge of gaming technology and supported them in using it within their daily practice. This in turn had positive benefits for the residents with dementia. The study demonstrates the need to work collaboratively with dementia practitioners to raise their awareness of off-the-shelf gaming technology as a medium for enhancing the well-being of people with dementia, as well as ensure that any training developed is fit for purpose.

PO20.2. Cognitive-training App for people with Alzheimer's Disease

PÉREZ MATEO Miguel1, BRUNETE Alberto1, ARNANZ NARGANES Esther2, GARCÍA Luis2, GÓMEZ JIMENEZ Victor3, GARCÍA OLVERA Rodrigo Alberto3

1FAE-Universidad Politécnica de Madrid, Madrid, Spain, 2Fundación Alzheimer España, Madrid, Spain, 3FAE- UPM, MADRID, Spain

The offer for cognitive-training “Apps” is increasing, but the need for an application specifically designed for people with Alzheimer's has been detected. For this reason, we present a first design of a specific application that meets the following objectives:

·         To provide a cognitive training tool for people with Alzheimer's disease (AD) to delay the degenerative process, taking into account their situation

·         To offer family members of people with AD a different way of doing exercises at home

·         To provide AD professionals with a specific, flexible and adapted material for people with AD

·         To give an alternative to people who cannot go to the health center due to their physical or demographic situation.

For this reason, a tablet-based multi-platform application has been designed to meet the following functionalities:

·         To evaluate the level of capabilities of the person with AD, both initial and follow-up

·         To play games and do exercises, chosen by the person with AD or the therapist and performed independently or in sessions. Different subjects will be covered: attention, memory, concentration, calculation, language, praxies, gnosias, temporo-spatial orientation and activities of daily life (ADL). The difficulty of the exercises is adapted according to the previous evaluation

·         To create specific sessions, adapted by the therapist or caregiver (family member who has had previous training and follows the therapist's guidelines) in time and difficulty for the user

·         To manage the person with AD agenda, with reminders of sessions, activities, events and notes of the therapist /caregiver

·         To keep track of the evolution with histograms and graphs of progress.

The application aims to provide a new concept of usability and management of "Apps" for people with Alzheimer's. The first results and user impressions will be shown and discussed in this contribution.

PO20.3. A revolutionary product for people with dementia and caregivers

PALAZÓN Pedro2, ARNANZ NARGANES Esther1, LANDROVE Jose Carlos2, CASTILLO ANA1, GARCIA LUIS1

1Fundación Alzheimer España, Madrid, Spain, 2FAE-Ibermática, Madrid, Spain

Mime is born from the need to help people affected by Alzheimer's and their caregivers, an increasingly numerous group.

MiMe is basically an application for mobile devices, consisting of 2 pieces: The MiMe (My Memory) itself, for the affected users and SuMe (His/Her Memory), for the caregivers.

MiMe is preinstalled on a mobile phone to facilitate use by Alzheimer's patients. The application completely replaces the operating system of the device and avoids the confusion that other types of messages could generate in the users, assuring an optimal service and without interferences.

Among the functions included in MiMe and SuMe we highlight the real-time location of the person affected, medication supervision, day-to-day management through reminders or provide assistance in a situation of need. The main objective of this product is the maintenance of the autonomy of the person and the decrease of the overload perceived by the caregiver (burnout syndrome).

The work team brings together experts in Thinking Design, UX, designers and technologists from a technological company, as well as psychologists, therapists, caregivers and other experts from the FAE (Spanish Alzheimer's foundation), all united in a common goal: to develop the best app in the market for people with dementia and caregivers.

PO20.4. User-testing of an online lifestyle program for brain health in individuals with SCD

WESSELMAN Linda1, SCHILD Ann-Katrin2, HOOGHIEMSTRA Astrid1, MEIBERTH Dix2, VAN LEEUWENSTIJN-KOOPMAN Mardou1, PRINS Niels1, JESSEN Frank2, VAN DER FLIER Wiesje1, SIKKES Sietske2

1Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands; 2Medical Faculty, Department of Psychiatry, University Hospital Cologne, Cologne, Germany

Background: Individuals with subjective cognitive decline (SCD) are at increased risk for dementia, are motivated to participate in prevention strategies and report an intrinsic need for information on brain health.

Aim: We developed an online lifestyle program fitting the needs of the users in different European countries. We now aimed to evaluate feasibility and usability of the program in a sample of SCD individuals.

Methods: In an iterative process involving users, experts and technical developers, we developed an online lifestyle program consisting of lifestyle content in 5 categories and daily advices. Participants (N=130, 65±9y, 57% female) had access to the program for 30 executive days. User-experiences were assessed by items of the Usefulness, Satisfaction, and Ease of use (USE, range 1-7) and System Usability Scale (SUS, range 0-100) questionnaires and ratings of the daily advices (range 1-5), with higher scores indicating better ratings. Feasibility was assessed by data log of program use and qualitative feedback in questionnaires and telephone interviews.

Results: 78% of the participants (n=101) completed the questionnaires. They rated the programs’ usability 3.7±1.3, learnability 3.6±1.9 and satisfaction 4.0±1.5 points (USE, moderate scores) and usability on the SUS-scale 63.7±19.0 (marginal). Daily advices were rated with 3.5 ±1.5 points, indicating moderate usefulness. Participants on average completed 31 advices and changed the daily advice 23 times. Attitude and Physical advices were rated higher than Lifestyle (p=<.001). Although some technical issues were reported, the overall content was appreciated. Participants reported that the program induced awareness of lifestyle factors that are related to brain health, motivated reflection on current lifestyle and strengthened planned lifestyle changes.

Discussion: Our study findings suggest that offering brain health information online is feasible across countries. Online self-applied lifestyle programs seem useful in reaching large groups of motivated at-risk individuals for dementia prevention. 

PO20.6. A user centered design approach to develop a serious game for people living with dementia: A case study of the AAL project PLAYTIME

GEERTS I.A.G.M.1, SNAPHAAN L.J.A.E.2, BONGERS I.M.B.2

1Tranzo (TSB, Tilburg University), Mental Health Institute Eindhoven, Tilburg, Eindhoven, Netherlands, 2Eindhoven, Netherlands

Despite the promising results on the use of serious (SG) games for stimulating cognitive, physical, and social abilities of people with dementia (PWD), it is shown that PWD have problems in using many of the SG currently available. Hence, it is important to involve PWD in the development process of SG by adopting a user centered design (UCD) approach to ensure that their specific needs and daily context are better understood. The literature rarely describes the involvement of PWD in a UCD approach and even less is known about the methods and procedures applied in all different stages of the development process. The aim of this study is therefore to (1) describe the methods and procedures used to involve PWD and their informal caregiver in the subsequent stages of the development process of the first SG prototype developed in the AAL funded project PLAYTIME and (2) evaluate the described UCD approach by exploring its added value from the perspective of all involved stakeholders by conducting 18 semi-structured interviews with these stakeholders: PWD, their informal caregivers and the PLAYTIME project partners. The described UCD approach is based on the user-driven Living Lab of Innovate Dementia 2.0, in which PWD are involved in the stages of the development process via questionnaires, focus group meetings and in context field studies. The added value of the described UCD approach is, for example, an increased usability and appropriateness of the first prototype due to more conscious design decisions and increased motivation of project partners to live up to the expectations of the end-users. By describing and evaluating the UCD approach applied in in the development process of PLAYTIME, insights are provided into how PWD can be involved in an UCD approach to enhance the usability and succeed the implementation of SG for PWD in practice.

PO20.7. Promoting the adoption of GPS watches in the field of dementia care: From professionals to end users

FREIESLEBEN Silka Dawn, MEGGES Herlind, RÖSCH Christina, PETERS Oliver

Charité – Universitätsmedizin Berlin, Memory Clinic and Dementia Prevention Center, Berlin, Germany

Objective: At present, an untapped market of persons with dementia (PwDs) and their caregivers (CGs) who could benefit from using GPS watches exists. Obtaining the input from professionals throughout product research and development stages is one proactive way to increase future use, and was the aim of the current study.

Methods: Focus group interviews with 18 professionals working in business, healthcare and research fields related to gerontology were carried out (equal ns). Demographics, experience with dementia and assistive technologies (years), pay willingness for a GPS watch (once/per month), the technological affinity scale for electronic products (TA-EG; range 19-95), and the ISONORM 9241/10 scale (range 0-210) to examine the usability of a tested GPS watch were assessed, with professionals testing a commercial GPS watch prior to data collection. Spearman’s rank-order correlations, simple linear regressions, and one-way ANOVAs were performed. Only quantitative data are presented.

Results: Professionals’ mean age was 41.3 years (SD=10.9), half were female, and at least half had five or more years experience with dementia (66.7%) and assistive technologies (50%). A significant negative correlation between TA-EG and experience with dementia (r=-.62, p=.006) was found, and remained significant after controlling for age, gender, education, and experience with assistive technologies. Results of all simple linear regressions were non-significant. A significant one-way ANOVA between TA-EG and group membership was found [F(2, 15)=6.76, p=.008], with business (M=79.5, SD=4.4) having significantly higher scores than healthcare (M=64.7, SD=6.7, p=.008) and research (M=68.0, SD=9.9, p=.040).

Conclusion: In this sample, professionals from different fields were similar with regards to all measured assessments, except for technological affinity. For further analyses with qualitative data, this will limit the influence of demographic and other potential confound variables on professionals’ opinions regarding GPS watches when analysed by group membership.

PO20.8. How dyadic interactions influence the user experience of persons with dementia and their caregivers with GPS watches

RÖSCH Christina, MEGGES Herlind, FREIESLEBEN Silka Dawn

Charité – Universitätsmedizin Berlin, Memory Clinic and Dementia Prevention Center, Berlin, Germany

Objective: Research on the user experience (UX) of persons with dementia (PwDs) and their caregivers (CGs) with GPS watches in dementia care is encouraging. However, research on how dyadic interactions between PwDs and CGs influence one’s UX is limited. Accordingly, our aim was to examine how dyadic interdependency influences UX with GPS watches in dementia care.

Methods: 20 dyads tested two similar commercial GPS watches at home for four weeks each. At three assessments (T1, T2 and T3), dyads filled out the technological affinity scale for electronic products (TA-EG), quality of life scale (EUROHIS-QOL), self-efficacy scale, and usability ISONORM 9241/10 scale. At T2 and T3, dyads rated the tested GPS watch’s overall design features (color, font, size, weight, buttons, and battery life), it’s telephone function and their subjective frequency of use of this function. Interdependency within dyads was evaluated with actor-partner interdependence models.

Results: 17 dyads completed the study. A significant actor effect was found for CGs rating of the telephone function at T2 and T3, and for PwDs rating of overall design features between T2 and T3, and for EUROHIS-QOL and overall designs features at both time points. Significant partner effects stemming from CGs for EUROHIS-QOL and usability at T1 and T2, EUROHIS-QOL and design features at T2, TA-EG and usability at T2, usability at T1 to T2, and overall design features at T1 to T2 were found. One partner effect stemming from PwDs was found for usability at T1 to T2.

Discussion: We deliver important results on how interdependency within a dyad influences UX with GPS watches. Limited partner effects at T3 indicate that dyad members were more aligned at T3 than at T1 and T2. The further examination of dyadic interactions on UX with dementia technologies is warranted to better capture dynamic processes that may impact UX.

PO20.9. Touchscreen technology in care homes: Results on the use of art apps for entertainment of people with dementia

CAVALCANTI BARROSO Aline, RAI Harleen, SCHNEIDER Justine, ORRELL Martin

University of Nottingham, Nottingham, United Kingdom

In 2014, a report by the Alzheimer’s Society estimated that 311,730 people with dementia in the United Kingdom were living in care homes. People living in care homes are more likely to be socially isolated and experience a lack of stimulation. They are usually excluded from cultural and social activities that are widely available in the outside world. It has been argued that it should be of high importance that care homes residents living with dementia have access to meaningful activities and are supported as required to engage in them. The use of touchscreen technology could be one strategy to engage people living in care homes in enjoyable leisure activities. Previous research has indicated that people with dementia and care staff reported positive experiences when using touchscreen technology, showing improvements in quality of life, relationships and interpersonal interaction. As this type of technology could be new to people with dementia, a possible way to involve them in activity could be through the use of the visual arts. So far, very little research on the benefits of visual art interventions on touchscreen devices has been made. However, positive results on research evaluating the independent use of these interventions can be found in scientific literature, making the use of art in touchscreen devices promising idea. Our objective in this feasibility trial was to understand the effects of the use of touchscreen technology and visual art apps in activities with the residents with dementia and how such activities can be successfully implemented in care homes. We evaluated the effects of the intervention on the wellbeing of the residents with dementia and also the acceptability of the digital art apps in touchscreen technology by people with dementia and the practicality of the activity to be delivered in residential care settings by the care staff.

PO20.10. Experiences with socially assistive robot AMIGO for the motivation of playful multimodal training in dementia

PALETTA Lucas1, SCHÜSSLER Sandra2, ZUSCHNEGG Julia2, LODRON Gerald1, FELLNER Maria1, RUSSEGGER Silvia1, LAMMER Lara3, PRODROMOU Dimitrios4, STEINER Josef5, PANSY-RESCH Sandra5, BRUNSCH Sebastian4, CARNEVALE Lorenzo4

1joanneum Research Forschungsgesellschaft mbH, Graz, Austria, 2Medical University of Graz, Graz, Austria, 3Vienna University of Technology, Vienna, Austria, 4Humanizing Technologies GmbH, Vienna, Austria, 5Sozialverein Deutschlandsberg, Deutschlandsberg, Austria

The increase in dementia causes an increase of the use of health care resources. At the same time there is a decreasing number of available caregivers. Consequently, technologies, like socially assistive robots, have been developed to assist caregivers and persons with dementia (PWD) in promoting independence. Most robots were tested in laboratory settings with mainly elderly people without dementia. Therefore, there is a lack of knowledge about their use in real care situations of persons with dementia.

The project AMIGO explores the experience of PWD, relatives, caregivers and dementia trainers in using robot Pepper in private households. In Companion mode, Pepper provides entertainment, reminders and tailored dialogues. In Coach mode it specifically motivates to use a Tablet PC based playful multimodal training for intervention.

In a pilot study about the usability of the application Pepper spent 1 week in each of 3 Austrian households. In total 12 participants (3 of each target group) were included to collect questionnaire and interview data.  The results of the Technology Usage Inventory (4-28 points span) demonstrate that caregivers and dementia trainers are mainly curious about using Pepper (21.3 and 20.7 points). Relatives emphasize the application of Pepper (18.3 points) but also pronounce skepticism (17 points). PWD most often see the usefulness of Pepper (20 points) with some anxiety in the application (15.3 points). Qualitative results show that most of the participants describe positive feelings, like curiosity, interest and surprise. Pepper's principal support was seen in the areas of communication/social contacts, recreational activities, learning ability and mobility.

Overall, the AMIGO application was experienced as positive and support opportunities were seen by all participants. The results of this first pilot study support the further development of socially assistive robots to enhance motivation for playful training for persons with dementia in private households.

PO20.11. Application of toxicologic approaches to develop a test for diagnosis of Alzheimer's disease before it strikes

ROGGEN Erwin L1, VERFAILLIE Catherine2, GAJJAR Madhavsai2, PRINCEN Katrien3, DEJONCKHEERE Wannes3, BRIEDÉ Jacco4, KARRI Venkat4, WITTENS Melissa5, ENGELBORGHS Sebastiaan5

1ToxGenSolutions BV, Maastricht, Netherlands, 2Katholieke Universiteit Leuven, Leuven, Belgium, 3reMYND, Leuven, Belgium, 4Universiteit Maastricht, Maastricht, Netherlands, 5Universiteit Antwerpen, Antwerpen, Belgium

Decades of animal-based research aiming at the elucidation of the pathophysiological mechanisms driving Alzheimer's disease (AD) have not yet translated into effective therapeutic treatments for AD patients. Possible reasons behind this translational failure may be the overreliance on animal models for AD, the focus on late AD-associated features, such as amyloidosis and tauopathy, and a bias towards familial AD (<5% of all AD cases). Disproportionately little attention has been given to aging, and non-genetic and environmental risk factors believed to be responsible for >95% of the known Alzheimer’s cases

The Interreg. project ‘’Herinneringen’’ introduces a paradigm shift by implementing human-based methods to investigate the pathological processes triggered by external risk factors (e.g. environmental toxicants, life style) that have been associated with Alzheimer’s pathology. The advantage of such approach is that well established toxicological methods can be applied.

The envisaged deliverable of the project is an inexpensive and minimally invasive (e.g. blood) test method building on molecular and cellular mechanisms triggered by external risk factors and driving Alzheimer’s initiation and early development (i.e. before significant brain damage occurs). From data genetic biomarkers are selected and evaluated directly on human clinical samples and patients. The success criteria of the method as diagnostic tool include human pathophysiological relevance and accurate early diagnosis, monitoring of disease progression and drug efficacy, and useful in novel drug development strategies.

The anticipated impact of the test method is expected to be beneficial for patients, caregivers, the community and companies who want to develop Alzheimer's therapies. These benefits include: (1) better quality of life for patients and their family, (2) faster certainty about treatment (as soon as available), (3) lower costs for health care, and (4) new possibilities for the development of active drugs.

PO20.12. Developing a sustainable implementation strategy and business model for an eHealth intervention to support caregivers of people with dementia: The Partner in Balance case study

BOOTS Lizzy1, CHRISTIE Hannah1, DOUVEN Elles2, KERPERSHOEK Liselot2, PEETOOM Kirsten2, TANGE Huibert3, VERHEY Frans2, DE VUGT Marjolein2

1Alzheimer Centre Limburg, Maastricht, Netherlands, 2Alzheimer Centre Limburg, Maastricht University Medical Centre, Maastricht, Netherlands, 3School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands

Background: Given the increasing use of digital interventions in healthcare, understanding how best to implement them is crucial. However, evidence on how to implement new, academically-developed interventions into complex healthcare environments is lacking. This case study offers an illustration of how to develop a theory-based implementation plan and business model, by exploring perspectives involved in the implementation of an eHealth intervention within a Dutch dementia care context.

Methods: The case study concerns Partner in Balance, an online course to support caregivers of people with dementia, which was effective in improving caregiver self-efficacy, quality of life and care confidence. The large-scale implementation took place in the Netherlands, by being offered in local dementia case-management services, care homes, dementia support groups and select municipalities. Informed by the Consolidated Framework for Implementation Research (CFIR) and the Business Model Canvas (BMC), we combined data from a literature review, qualitative interviews with national stakeholders, iterative feedback, and user data.

Results: An implementation plan and business model to implement Partner in Balance in the Netherlands on a large scale was developed. During the implementation process, barriers related to budget and expense claims, familiarity with technology from the perspective of all users, fitting the content to specific subgroups, and support for the professionals carrying out the intervention were explored and iteratively addressed.

Conclusions: This paper offers an example of implementing a digital health intervention in dementia health care in the Netherlands. It can be used to inform others working to implement an evidence-based eHealth intervention.  We can conclude that including stakeholders during the first phases of intervention development and evaluation aids implementation in regular care practice and development of a business model. Furthermore, a flexible approach that allows response to emerging barriers is required while implementing a complex intervention in dementia health care.

PO20.13. Tablet-based playful multimodal training for activating people with dementia: Experiences of an 8-month study

FELLNER Maria1, WILD Monika2, STEINER Josef3, PALETTA Lucas1, SCHUSTER Eva4, JOS Anna5

1JOANNEUM RESEARCH - DIGITAL, Graz, Austria, 2Austrian Red Cross, Vienna, Austria, 3Sozialverein Deutschlandsberg, Deutschlandsberg, Austria, 4Sozialverein Deutschlandsberg, Deutschlandsberg, Austria, 5Sozialverein Deutschlandsberg, Deutschlandsberg, Austria

The combination of cognitive, physical and social stimulation promises significant potential for success. Serious games can support behavioural changes in a playful way. JOANNEUM RESEARCH and Sozialverein Deutschlandsberg have developed a tablet-based serious game in a series of research projects, which is used for personalized and guided trainings by dementia trainers. Each training unit starts with movement exercises for warm-up, followed by various theme-based cognitive and creative exercises, such as quizes, closes, puzzles, spot-the-difference, pairs, picture details, math, and sound riddles. The difficulty can be adjusted according to the person´s actual constitution.

This serious game has 2018 been tested by the Austrian Red Cross in an 8-month pilot study in 3 different Austrian regions. 8 professional caregivers of the Austrian Red Cross have been trained in the multimodal approach of M.A.S. dementia trainings (train-the-trainer). These professional caregivers have then instructed several persons working in their regions on a voluntary basis (visiting service).

In total 49 persons, men and women, with different stages of cognitive impairment have been visited frequently in their respective home or residential care environment by the volunteers of the Red Cross. At each visit they have been conducted through a tablet-based training unit of 50 minutes following a specific theme (e.g. spring, professions, water, past times).

On a subjective basis the caregivers observed increased cognitive and communicative capabilities, more activation and a more stable emotional status of the participants. Therefore, they would like to use the serious game on a regular basis for their visiting service for people with dementia in the future.

The caregivers of the Austrian Red Cross also had an intensive exchange of experience with the development team of Joanneum Research and Sozialverein Deutschlandsberg to optimize the serious game, which is the basis for a user-centred development process.

PO20.14. A tweet a day from @AHPDementia to support people living with dementia to remain active and independent

HUNTER Elaine, MCKEAN Alison

Alzheimer Scotland, Edinburgh, United Kingdom

Background: People living with dementia have challenges trying to access the expertise of allied health professionals (AHPs) as they are unaware of who we are or how we CAN help.  In addition to this people living with dementia are looking for information to help them stay at home and to continue to be active in their local communities.   For the benefit of AHP’s to be realized for all people living with dementia, we require new ways of thinking and working that increase our visibility and access. (Alzheimer Scotland 2017). 

Method: The poster will share an improvement project with a group of allied health professionals who tested the use of a new twitter account @AHPDementia over 12 months, with the overall aim to improve the public’s understanding of the role of AHP’s in dementia care.  The application of a model for improvement (Langley et al 2009) will be shared and data presented, considering if being active on twitter did improve people’s understanding of our contribution in dementia care. Success factors will be shared and describe how this work links to the national AHP dementia policy “Connecting people, connecting support” (Alzheimer Scotland 2017)

Conclusion: People living with dementia are using smartphones and tablets, actively engaging on online platforms to share their narratives and gain the benefits of using social media. Social media offers a real opportunity to raise awareness of the work and value of AHP’s to dementia care and has the potential to transform the way we communicate with people living with dementia.

References: Alzheimer Scotland 2017 Connecting people, connecting support. Transforming the contribution of allied health professionals in dementia in Scotland 2017-2020. Langley GJ Moen RD Nolan KM Nolan TW Norman CL Provost LP  2009 The improvement Guide A practical approach to enhancing organizational performance 2nd edition Jossey-Bass A Wiley

PO20.15. The effectiveness of e-Health solutions for Aging In Place with MCI or dementia: Results of a systematic review

DEQUANTER Samantha1-4, GAGNON Marie-Pierre2, NDIAYE Mame-Awa1-4, DION Jessica1-4, GORUS Ellen1, FOBELETS Maaike4, BUYL Ronald4

1Faculty of Medicine and Pharmacy, Department of Gerontology, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium, 2Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada, 3Faculty of Nursing sciences, Université Laval, Québec, Canada, 4Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium

Purpose: The proportion of older adults with Mild Cognitive Impairment (MCI) or dementia is growing tremendously. Recent literature shows a preference for Aging In Place (AIP). To realize AIP in people with MCI (PWMCI) or dementia (PWD), measurements need to be taken ensuring the safety and well-being of these individuals and their informal caregivers (IC). Research shows that E-Health is promising for the facilitation of AIP. Since study findings are quickly outdated, we aimed to review the most recent literature on the effectiveness of e-Health solutions for AIP in PWMCI, PWD and IC.

Methods: We conducted a systematic review using seven scientific databases. Inclusion criteria were: (1) experimental studies with a controlled trial study design, (2) published from 2013 until 2019, (3) presenting at least one e-Health solution (4) targeted at (a) community-dwelling older adults with a risk for cognitive impairment or with a diagnosis of MCI or dementia, or (b) their informal caregivers.

Results: Twenty-five out of 12497 articles were included. Excluded articles were mainly based on descriptive observational research in pilot or feasibility phase. The majority of articles were published in medical-oriented journals (84%). Most study findings were collected in The USA (25%), Australia (11%) and The Netherlands (11%). Cognitive training technologies (60%) and web-based educational and support interventions (32%) take up the largest share of represented e-Health types. Most interventions are targeted at PWMCI (44%), IC (32%) or PWD (28%), while others target older adults at risk for cognitive decline (8%). Reported effects of e-Health solutions were either positive (84%) or moderate (16%). No negative effects were reported.

Conclusion: Evidence regarding the effectiveness of e-Health solutions for AIP with cognitive impairment is still very scarce. These findings show that e-Health solutions generally have positive results. Future research should also focus on solutions other than cognitive training technology.

PO20.16. Age-friendly technological cityscapes: What is utopia?

WALLCOOK Sarah1, KOTTORP Anders2, NYGÅRD Louise3, CHARLESWORTH Georgina4, MALINOWSKY Camilla3

1Karolinska Institutet, Huddinge, United Kingdom, 2Malmö Universitet, Malmö, Sweden, 3Karolinska Institutet, Huddinge, Sweden, 4UCL, London, United Kingdom

From making use of public toilets to navigating passport control; the cityscapes of Europe are filled with a requirement to use everyday technology. While everyday technologies have been shown to be helpful in the daily lives of older adults, they have also been shown to be a hindrance. So, in meeting the Europe-wide ambition to create age- and dementia- friendly cities, it is useful to develop policies based on consideration of how technological interactions may differ between European countries.

The results of two studies mapping the out of home technological landscapes of older adults with and without dementia in urban and rural areas of Sweden and England are presented. Out of home technologies comprise 42 technologies, including public space technologies such as ticket machines, cash machines, payment card machines and so on. They also include information communication technologies, such as computer to search for information or make a transaction, a smartphone to send a message or access internet banking.

The poster presents the challenge hierarchy of out of home technologies and identifies which are more or less challenging between the country groups. The ability of each country group to use everyday technology is presented, together with a model of how the numbers of places that people go to can be influenced by the amount of out of home technology they encounter. Whether or not other factors, such as gender, driving status, or age affect the model will also be presented.

Results can be used to evidence the importance of designing accessible out of home technology that contributes to the creation of Age-friendly cities.

PO20.17. CASCADE - Community Areas of Sustainable Care & Dementia Excellence in Europe

ROBINSON Samantha1, QUINN Henry2

1Medway Community Healthcare, Gillingham, United Kingdom, 2East Kent University Foundation Trust, Dover, United Kingdom

The aim or the CASCADE project is to develop a financially sustainable approach for people living with dementia that can be replicated across the UK and Europe.  The model promotes a strengths based approach to holistic person centred care to maximise independence and quality of life in the community.  Technology solutions will be procured, utilised and developed to provide innovative solutions to support people to be as independent as possible and provide innovative methods for creation of and use of our workforce.

In the United Kingdom we are opening 2 purpose built facilities for people living with dementia in the UK; 30 residential and 6 guesthouse beds in Dover and 10 guesthouse beds in Medway.  The use of technology within these two areas in relation to telehealth and/ or telecare and its ability to support people living with dementia to be as independent as possible will provide opportunities for project partners to work with developers to create effective and adaptable systems.  Individuals will be enabled and empowered to continue living the life they wish, integrated into the community and undertaking their everyday ‘normal’ activities. 

People living with dementia need flexible care to maximise their independence, enabling them to respond to changing needs at different points in time.  At present care is either limited at home or all-encompassing in an establishment.  The CASCADE vision of enablement and empowerment will provide the means for individuals to remain integrated within the community living the life that they wish, with the support they want.  The opportunity provided to explore technological systems designed to be as inconspicuous as possible will enhance the care and support provided and enable people living with dementia to remain as independent as possible, integrated within their local

PO20.18. Nature Online provides a novel way of enjoying nature at home

LAUNIAINEN Helena1, RAHIKKA Anne1, NORONEN Paula Noronen2, SLUNGA Annika2

1Miina Sillanpää Foundation, Helsinki, Finland, 2Project Coordinator, Helsinki, Finland

Introduction: Nature Online is an internet service, which provides experiences, information and activities in connection to Finnish nature. The service is based on theories and studies in relation to nature’s effects on people’s wellbeing and health. It is known, for example, that spending time in nature has restorative effects and it helps recovering from stress. Nature Online brings elements of nature available also for people, who have limited access to the nature. The service is free of charge for the users.

Aim: The focus of Nature Online is to enhance user’s wellbeing by providing elements of nature via internet site. The aim is to enable experiences of enjoyment and restoration in connection to typical Finnish nature while staying inside.

The content of Nature Online: Service design principles were implemented in development of Nature Online. Families in informal care situations, volunteers and professionals took part in service creation, ensuring that the service meets their specific needs and have value for them.

The first page of Nature Online is a gateway guiding towards restorative effects of nature. The service is structured in five activity areas: Spring, Summer, Fall, Winter and Postcards. The seasonal areas are divided into four sections based on their focus: Sensing nature (watching, listening and experiencing), Nature related activities, Information, and Stories and narratives. The postcard area consists of greetings with pictures and messages from all over Finland. The last page of the service provides general information.

Results: Nature Online was launched in Finnish in February 2019. There have been 2700 users and the feedback indicate, that the service is well-liked and viewed beneficial for restorative moments in stressful life situations. Group counselors for elderly people have experienced Nature Online to be an inspirational and functional tool in various environments.

PO20.21. The “Snoezelen” approach in dementia: A review of the current literature

CHRYSIKAKOU Iliana1, ASPRIDIS Philippos2, ZACHARIADIS Andreas2, EFTHYMIOPOULOU Catherine2

1Karelleion Integrated Alzheimer and related disorders Unit, “Apostoli”, Holy Archdiocese of Athens, Greece, 2Athens, Greece

Our purpose is to explore how people with dementia can benefit in a multi-sensory “Snoezelen” environment, but also in which areas this can happen, through the review of the contemporary literature.

The term “Snoezelen” describes a multi-sensory therapeutic activity, which takes place in a specialized room, equipped appropriately in order to provide stimuli, aiming at the activation of all human senses.  The aforementioned term is a derivative of two words "dozing" and "sniffing". It is a method of stimulating the basic senses through optic, tactile, olfactory and auditory stimuli and aims to improve the quality of life of people with dementia, who may encounter difficulties in expressing their feelings and their needs.

It involves the use of various objects such as: fibre optics, various fabrics, balls, vibrating pillows, water beds with music, interactive wall and floor panels, water pipes, projectors, interactive fibre-optic carpets, music, perfumes, mirror balls etc.

With the use of the multi-sensory “Snoezelen” environment, the stimulation through touch, hearing, smell and vision, helps the elderly with cognitive deficits. “Snoezelen” also offers relaxation, rest and pleasure in a pleasant environment, which contributes to the improvement of the living standards of people with dementia.  It proves to offer an alternative way of communication between therapists and patients and also improves the interaction between them. During the sessions, apathy, aggression and anxiety of a patient seem to reduce, as well as depressive thoughts.

Overall, the multi-sensory “Snoezelen” environment, seems to contribute to the control, better management and eventually, the reduction of behavioral and psychological symptoms, of patients with dementia, especially when therapists and caregivers are informed and trained in such a way, in order to focus on the identification of basic needs and the description of each patient's sensory profile, individually.

PO20.22. Occupational therapy and rehabilitation of cognitive and perceptual skills of patients with dementia via pc with touch screens

CHRYSIKAKOU Iliana1, ASPRIDIS Philippos2, ZACHARIADIS Andreas2, EFTHYMIOPOULOU Catherine2

1Karelleion Integrated Alzheimer and related disorders Unit, “Apostoli”, Holy Archdiocese of Athens, Greece, 2Athens, Greece

The cognitive and perceptual status of patients with can be well evaluated during the occupational therapy practice. It is widely known that personal computers with touch screens help us observe and evaluate the functionality of people with dementia.

Personal computers with touch screens, enable patients with dementia to interact better with each other and also give therapists a better chance to assess the patients’ functionality. They may improve the patients’ level of communication, through discussions about technological innovations. With the help of this technology, the patients can recall information from past activities (e.g. Facebook) and positive feelings may be stimulated through this retrieval of information. Other positive points, are that   patients with moderate vision can work more easily on large touch screens (20 ' '-25 ' ' inches.) and older people who are unfamiliar with their Pcs are adapting faster. The limitations that may arise are that therapists may not be familiar with technology, and the cost of using a Pc with a touchscreen can be dissuasive.

In conclusion, personal computers with touch screens, help to upgrade the quality of life of people with dementia. It seems that in individual sessions, the therapist-patient relationship is improved and a more anthropocentric program is created, but working in groups as well, empower communication between patients. There is evidence of positive feedback on enhancing information retrieval through applications. Patients are facilitated in the programming of activities through visual perception involving programs displayed on computer screens.

The benefits of this technology are manifold and by using it, we are able to add to our therapeutic quiver a remarkable medium, for the reinforcement of cognitive and perceptual skills of patients with dementia.

 

 

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Last Updated: Thursday 07 November 2019

 

 
  • Acknowledgements

    The 29th AE Conference in The Hague received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe and Alzheimer Nederlands gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche
 
 

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