Personalized Citizen Assistance for Social Participation (APIC) adapted for older adults with visual impairment: results from a mixed study.

PURPOSE: To explore the effects of the Personalized Citizen Assistance for Social Participation (APIC), an intervention adapted here for visual impairment, involving weekly stimulation sessions over six to twelve months, provided by trained and supervised attendants, on seven outcomes (social participation, leisure, independence, mobility, quality of life, health-related quality of life, and empowerment) in older adults with visual impairment, and to document its facilitators and barriers. METHODS: A mixed-method design, which included a pre-experimental and an exploratory qualitative clinical research component, was used on 8 older adults (7 women) with visual impairment aged 70-86, and 8 attendants (5 women) aged 20-74. Before the intervention, directly after, and four months later, older adults completed questionnaires on the 7 outcomes. During the intervention, attendants completed diaries and participated in monthly meetings. Semi-structured interviews were administered to all participants after the intervention. RESULTS: Social participation, leisure, mobility, quality of life and empowerment had increased immediately after the APIC. These improvements were still generally observed four months later. Participants reported that the APIC improved older adults' capabilities, social participation, and social environment. CONCLUSIONS: The APIC is a promising intervention which helps older adults with visual impairment to deal with social restrictions.

In older adults, visual impairment has important consequences on active and healthy aging.Personalized citizen assistance for social participation (APIC) is an intervention that aims to foster the social participation.This study shows that APIC adapted to visual impairment influences social participation, leisure, mobility, quality of life and empowerment of older adults with visual impairment.Participants also reported improvements in their capabilities, social participation, and social environment.

Evaluation of three pedestrian phasing with audible pedestrian signals configurations in Quebec City (Canada): an exploratory study of blind or visually impaired persons' sense of safety, preferences, and expectations.

PURPOSE: This exploratory study aimed to evaluate the preferences, expectations, and sense of safety of blind or visually impaired persons regarding three types of pedestrian phasing with audible pedestrian signals configurations that exist in Quebec City (Canada). These include: 1) exclusive phasing with non-directional audible pedestrian signals; 2) exclusive phasing with directional audible pedestrian signals; and 3) concurrent phasing with directional audible pedestrian signals. METHODS: Thirty-two blind or visually impaired persons were asked to complete a survey. Their preferences and expectations regarding audible pedestrian signals were documented through a series of simulations. Their sense of safety regarding the three existing configurations were also documented. Subsequently, semi-directed, individual interviews with 11 of the individuals who had completed the survey were conducted to build off the collected information. RESULTS: No formal consensus regarding many of the issues discussed were established as participants' responses varied too significantly. However, findings suggest that the exclusive phasing with directional audible pedestrian signals configuration is perceived to be the safest option by the participants. CONCLUSION: This study may have practical implications on the design of intersections (e.g., selection of a type of pedestrian phasing with audible pedestrian signal) and the training of blind or visually impaired pedestrians.IMPLICATIONS FOR REHABILITATIONThe addition of audible pedestrian signals to pedestrian signals heightens the sense of safety of blind or visually impaired persons.This study may have practical implications on the design of intersections with audible pedestrian signals and the selection of a type of audible pedestrian signals based on intersection characteristics.Since many participants reported a lower sense of safety when faced with concurrent phasing, it is recommended that more intensive orientation and mobility interventions be provided to blind or visually impaired pedestrians who use this type of traffic signals.Educating road users about blind or visually impaired pedestrians appears also essential.

Vivre sans ma voiture : une intervention pour soutenir les Canadiens-francophones âgés.

The cessation of driving is a difficult transition for the elderly, but it can be facilitated through interventions. The purpose of this study was to explore the satisfaction, usefulness and applicability of the CarFreeMe intervention in the French-Canadian context. A qualitative clinical research device was used on ten older adults aged between 61 and 90 years. The participants had stopped driving within the last twelve months or were planning to stop driving in the near future and did not have cognitive impairments. After the intervention, the participants were generally satisfied and reported on its usefulness and applicability in a French-Canadian context. In addition, they identified the positive impacts related to their social involvement as they re-engaged in or pursued their significant activities. Further research is required to assess the intervention's effects and the practicability of implementing it in Canada.

Cognitive load of walking in people who are blind: Subjective and objective measures for assessment.

BACKGROUND: Although walking without vision seems to carry a high cognitive cost, few studies have measured the cognitive load involved in this activity in blind people. The aim of this study was to assess the cognitive load of walking in blind people, using gait analysis, a dual task paradigm and a subjective assessment of cognitive load. METHODS: In a quantitative quasi-experimental design, 25 blind adults walked 40 meters. In one trial, participants walked normally (control condition). In another, they walked while performing an auditory simple reaction time task, and in the third trial they walked, performed the simple reaction time task and avoided obstacles. In addition to the simple reaction time task performance, walking speed was recorded, and participants provided a subjective assessment of cognitive load after each trial. Performance of participants aged less than 60 years were compared with those aged over than 60 years. RESULTS: Walking significantly reduced performance of the simple reaction time task; carrying out the simple reaction time task while walking significantly reduced walking performance and increased the subjective assessment of cognitive load; and simple reaction time task performance decreased and subjective assessment increased when obstacles were present. Few significant age effects were found. SIGNIFICANCE: Walking without vision involves a cognitive load that increases when the environment becomes complex. Each of the three methods used is relevant when assessing the cognitive load involved in walking in blind people, and could be useful in rehabilitation intervention. The results obtained allowed recommendations to be suggested for the design of technological mobility devices.

Ageing effects on the attentional capacities and working memory of people who are blind.

PURPOSE: Adaptation to blindness can lead to the enhancement of the attentional capacities and working memory in young people. However, although the effects of ageing on the cognition of sighted people and people with age-related visual impairments are well-documented, no study seems to have investigated the age-related changes of these cognitive processes in people who are blind. The aim of this study was to assess the effects of age on the attentional processes and working memory in blind people. METHOD: A cross-sectional study was conducted on 43 blind participants and 42 sighted participants. The participants performed auditory computerized tests assessing selective, sustained and divided attention, attentional switching, and working memory. RESULTS: Two-way analysis of variance revealed significant visual status effect and age effect on most of the variables studied. No interaction was found between visual status and age effects. CONCLUSIONS: These results suggest that the trajectories of cognitive age-related change are similar in blind people and in sighted people. This study has implications for rehabilitation, such as cognitive intervention. Implications for Rehabilitation Blind people show improved attentional capacities compared to sighted people, even in old blind people. Old blind people have lower performances than younger blind people in tests assessing selective, sustained and divided attention, and working memory. Cognitive approaches to rehabilitation may help people who are blind to deal with age-related cognitive decline and its effects on everyday functioning. A high level of cognitive stimulation, provided by a cognitive training or a developed social participation, might reduce the age-related effects in people who are blind.

Evaluation of the attentional capacities and working memory of early and late blind persons.

Although attentional processes and working memory seem to be significantly involved in the daily activities (particularly during navigating) of persons who are blind and who use these abilities to compensate for their lack of vision, few studies have investigated these mechanisms in this population. The aim of this study is to evaluate the selective, sustained and divided attention, attentional inhibition and switching and working memory of blind persons. Early blind, late blind and sighted participants completed neuropsychological tests that were designed or adapted to be achievable in the absence of vision. The results revealed that the early blind participants outperformed the sighted ones in selective, sustained and divided attention and working memory tests, and the late blind participants outperformed the sighted participants in selective, sustained and divided attention. However, no differences were found between the blind groups and the sighted group in the attentional inhibition and switching tests. Furthermore, no differences were found between the early and late blind participants in this set of tests. These results suggest that early and late blind persons can compensate for the lack of vision by an enhancement of the attentional and working memory capacities.