Standardizing norms for 180 coloured Snodgrass and Vanderwart pictures in Kannada language.

This study presents normative data in Kannada for 180 coloured Snodgrass & Vanderwart pictures. Data are presented for naming latency, image agreement, picture-name agreement, familiarity, visual complexity, and age of acquisition (AoA). Sixty-eight native Kannada speaking adults completed all tasks. The effects of the rated variables on naming latency were examined and compared with data on the same variables in other languages. A regression analysis revealed that image agreement, name agreement, familiarity, and age of acquisition all had a significant impact on naming latency, while visual complexity and frequency did not. Although, the correlations among rated variables in Kannada were equivalent to previous normative studies, the cross-linguistic comparison revealed that only AoA was strongly correlated with other studies. The findings point to the importance of understanding the interplay of psycholinguistic variables on naming latency in different languages.

Technology for Healthy Aging and Wellbeing: Co-producing Solutions.

Methods to facilitate co-production in mental health are important for engaging end users. As part of the Technology for Healthy Aging and Wellbeing (THAW) initiative we organized two interactive co-production workshops, to bring together older adults, health and social care professionals, non-governmental organizations, and researchers. In the first workshop, we used two activities: Technology Interaction and Scavenger Hunt, to explore the potential for different stakeholders to discuss late life mental health and existing technology. In the second workshop, we used Vignettes, Scavenger Hunt, and Invention Test to examine how older adults and other stakeholders might co-produce solutions to support mental wellbeing in later life using new and emerging technologies. In this paper, we share the interactive materials and activities and consider their value for co-production. Overall, the interactive methods were successful in engaging stakeholders with a broad range of technologies to support mental health and wellbeing and in co-producing ideas for how they could be leveraged and incorporated into older people's lives and support services. We offer this example of using interactive methods to facilitate co-production to encourage greater involvement of older adults and other under-represented groups in co-producing mental health technologies and services.

Development and dissemination of an ethical guidance and person-centred isolation care planning tool to support the care of people with dementia during the COVID-19 pandemic.

BACKGROUND: Long-term care (LTC) residents have been disproportionately impacted by the COVID-19 pandemic, both from the virus itself and the restrictions in effect for infection prevention and control. Many barriers exist in LTC to prevent the effective isolation of suspect or confirmed COVID-19 cases. Furthermore, these measures have a severe impact on the well-being of LTC residents. Our aim was to develop a guide for long-term care to address the ethical challenges associated with isolating dementia patients during the pandemic. The Dementia Isolation Toolkit (DIT) was developed by members of the research team in partnership with LTC stakeholders to address: 1) the practical challenges of isolating or quarantining people with dementia in a compassionate, safe, and effective manner; and 2) the need for ethical guidance to support decision-making regarding isolation and infection control in LTC, to prevent indecision and moral distress. To develop the DIT the team reviewed and synthesized the literature on pandemic ethics in a plain-language document, which was then reviewed by our partners and stakeholders. The final ethical guidance tool includes a discussion of the ethics around infection control measures in a pandemic, an ethical decision-making tool, and a person-centred isolation care planning tool. The ethical guidance tool has been downloaded more than 6500 times since it was published (bit.ly/dementiatoolkit), and has been disseminated internationally. The worksheets are being used during outbreaks to support care and decision-making, as well as proactively, to prepare for outbreaks by developing isolation care plans. There is a need for support for ethical decision-making in the context of a pandemic, particularly in settings such as LTC. Future studies will evaluate the implementation of the tool and its impact in addressing moral distress in health care providers in long-term care.

Assessing the feasibility of heart rate variability as an objective indicator of anxiety in older adults with dementia living in care homes.

OBJECTIVE: Anxiety is reportedly prevalent in older adults with dementia living in care homes and, within this population, is most often assessed through caregiver reports. Heart rate variability (HRV) is a physiological indicator of autonomic function, whereby reduced vagally-mediated HRV is associated with a variety of anxiety symptoms and disorders. This study evaluates the feasibility of collecting HRV data within this population, presents HRV data for older adults with dementia living in a care home, and examines HRV in the context of self-reported anxiety. These data were collected during a larger study examining an exercise intervention. RESULTS: HRV data, in the form of log-transformed root mean square of the successive differences (lnRMSSD), were in line with transformed data from previous research. These data provide a promising direction for the use of wrist-worn devices in future HRV research with people living with dementia in care homes.

Kinect Project: People with dementia or mild cognitive impairment learning to play group motion-based games.

INTRODUCTION: Motion-based technologies (MBTs) could provide nonpharmacologic interventions for people with cognitive impairment (PCI; e.g., dementia or mild cognitive impairment). This study examined the use of errorless learning techniques to empower PCI to use MBT. METHODS: Thirty-eight PCI were recruited to a 10-week (20 × 1-hour sessions) Xbox Kinect bowling group. Video recorded data from first, middle, and final sessions were coded to track (1) number of prompts per turn, (2) independent turn completion, and (3) duration of turns. These values were compared using repeated measures analysis of variance. RESULTS: Learning and improvement over time was demonstrated in 23 participants who were available for final analysis by significant decreases in number of prompts per turn and turn duration and significant increases in turns completed independently. DISCUSSION: Errorless learning supported PCI to learn MBT and improve over time as evidenced by their need for fewer prompts, shorter turns, and more turns completed independently, confirming the potential of MBT to provide leisure activities for PCI.

Technology and Dementia: The Future is Now.

BACKGROUND: Technology has multiple potential applications to dementia from diagnosis and assessment to care delivery and supporting ageing in place. OBJECTIVES: To summarise key areas of technology development in dementia and identify future directions and implications. METHOD: Members of the US Alzheimer's Association Technology Professional Interest Area involved in delivering the annual pre-conference summarised existing knowledge on current and future technology developments in dementia. RESULTS: The main domains of technology development are as follows: (i) diagnosis, assessment and monitoring, (ii) maintenance of functioning, (iii) leisure and activity, (iv) caregiving and management. CONCLUSIONS: The pace of technology development requires urgent policy, funding and practice change, away from a narrow medical approach, to a holistic model that facilitates future risk reduction and prevention strategies, enables earlier detection and supports implementation at scale for a meaningful and fulfilling life with dementia.

Implementing Accessibility Settings in Touchscreen Apps for People Living with Dementia.

BACKGROUND: Accessibility options within apps can enable customisation and improve usability. The consideration of accessibility for people living with dementia has not been explored but is necessary to prevent a "digital divide" in our society. This study set out to examine whether the introduction of accessibility settings for people with dementia in two mainstream gaming apps (Solitaire and Bubble Explode) could improve the user experience. OBJECTIVES: To evaluate the effectiveness of tailored accessibility settings for people living with dementia by comparing the gameplay experience with and without the settings and measure the impact on their ability to initiate gameplay, play independently and experience enjoyment. METHODS: Thirty participants were recruited to test one of the two apps that had been adapted to include accessibility features. These features were derived from an analysis of gameplay in a previous study, from which the design of the present study was replicated. The results were compared with those from the earlier study (i.e., pre-adapted apps). RESULTS: The accessibility features significantly improved usability in Solitaire, which had been the more problematic of the two apps when evaluated in its pre-adapted form. Bubble Explode retained the high level of usability without further improvements. Initiation of gameplay was significantly improved in the adapted version of Solitaire, with no significant differences to progression or enjoyment for either app. CONCLUSIONS: This study represents the first implementation of accessibility settings for dementia in mainstream apps, whilst demonstrating the feasibility and positive impact of the approach. The findings reveal core principles of touchscreen interaction and design for dementia that can inform future app development.

Older Adults' Perspectives on Using Digital Technology to Maintain Good Mental Health: Interactive Group Study.

BACKGROUND: A growing number of apps to support good mental health and well-being are available on digital platforms. However, very few studies have examined older adults' attitudes toward the use of these apps, despite increasing uptake of digital technologies by this demographic. OBJECTIVE: This study sought to explore older adults' perspectives on technology to support good mental health. METHODS: A total of 15 older adults aged 50 years or older, in two groups, participated in sessions to explore the use of digital technologies to support mental health. Interactive activities were designed to capture participants' immediate reactions to apps and websites designed to support mental health and to explore their experiences of using technology for these purposes in their own lives. Template analysis was used to analyze transcripts of the group discussions. RESULTS: Older adults were motivated to turn to technology to improve mood through mechanisms of distraction, normalization, and facilitated expression of mental states, while aiming to reduce burden on others. Perceived barriers to use included fear of consequences and the impact of low mood on readiness to engage with technology, as well as a lack of prior knowledge applicable to digital technologies. Participants were aware of websites available to support mental health, but awareness alone did not motivate use. CONCLUSIONS: Older adults are motivated to use digital technologies to improve their mental health, but barriers remain that developers need to address for this population to access them.

Perspectives on ethnic and racial disparities in Alzheimer's disease and related dementias: Update and areas of immediate need.

Alzheimer's disease and related dementias (ADRDs) are a global crisis facing the aging population and society as a whole. With the numbers of people with ADRDs predicted to rise dramatically across the world, the scientific community can no longer neglect the need for research focusing on ADRDs among underrepresented ethnoracial diverse groups. The Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART; alz.org/ISTAART) comprises a number of professional interest areas (PIAs), each focusing on a major scientific area associated with ADRDs. We leverage the expertise of the existing international cadre of ISTAART scientists and experts to synthesize a cross-PIA white paper that provides both a concise "state-of-the-science" report of ethnoracial factors across PIA foci and updated recommendations to address immediate needs to advance ADRD science across ethnoracial populations.

Computer Interactive Reminiscence and Conversation Aid groups-Delivering cognitive stimulation with technology.

INTRODUCTION: Group-based cognitive stimulation is the only nonpharmacologic intervention recommended by the UK National Institute for Clinical and Health Excellence for people with dementia. The potential of technology to extend the availability of group-based cognitive stimulation has not been tested. METHODS: One hundred sixty-one people with dementia participated in an eight-session group activity using Computer Interactive Reminiscence and Conversation Aid (CIRCA). Cognition, quality of life, and general health were assessed before intervention, postintervention, and 3 months later. RESULTS: There was a significant improvement in cognition and quality of life at the end of the CIRCA group intervention, which was further improved at 3-month follow-up. DISCUSSION: CIRCA group sessions improved cognition and quality of life similar to group-based cognitive stimulation approved by the National Institute for Clinical and Health Excellence. These benefits were maintained at 3-month follow-up. The data confirm the potential of CIRCA, which can be populated with different cultural and language contents for different user groups.

System Development Guidelines From a Review of Motion-Based Technology for People With Dementia or MCI.

As the population ages and the number of people living with dementia or mild cognitive impairment (MCI) continues to increase, it is critical to identify creative and innovative ways to support and improve their quality of life. Motion-based technology has shown significant potential for people living with dementia or MCI by providing opportunities for cognitive stimulation, physical activity and participation in meaningful leisure activities, while simultaneously functioning as a useful tool for research and development of interventions. However, many of the current systems created using motion-based technology have not been designed specifically for people with dementia or MCI. Additionally, the usability and accessibility of these systems for these populations has not been thoroughly considered. This paper presents a set of system development guidelines derived from a review of the state of the art of motion-based technologies for people with dementia or MCI. These guidelines highlight three overarching domains of consideration for systems targeting people with dementia or MCI: (i) cognitive, (ii) physical, and (iii) social. We present the guidelines in terms of relevant design and use considerations within these domains and the emergent design themes within each domain. Our hope is that these guidelines will aid in designing motion-based software to meet the needs of people with dementia or MCI such that the potential of these technologies can be realized.

Computerized Self-Administered Measures of Mood and Appetite for Older Adults: The Novel Assessment of Nutrition and Ageing Toolkit.

The "Novel Assessment of Nutrition and Ageing" (NANA) toolkit is a computerized system for collecting longitudinal information about older adults' health and behavior. Here, we describe the validation of six items for measuring older adults' self-reported mood and appetite as part of the NANA system. In Study 1, 48 community-living older adults (aged 65-89 years) completed NANA measures of their current mood and appetite alongside standard paper measures, on three occasions, in a laboratory setting. In Study 2, 40 community-living older adults (aged 64-88 years) completed daily NANA measures of momentary mood and appetite in their own homes, unsupervised, alongside additional measures of health and behavior, over three 7-day periods. The NANA measures were significantly correlated with standard measures of mood and appetite, and showed stability over time. They show utility for tracking mood and appetite longitudinally, and for better understanding links with other aspects of health and behavior.

Independent Living Functions for the Elderly (IN-LIFE): Supporting Communication in Dementia.

Independent Living Functions for the Elderly (IN-LIFE) is a 3 year multidisciplinary, multisite European project that aims to prolong and support independent living for people with cognitive impairments, through (ICT) services. Sheffield is one of six research sites and is focused on enhancing communication and conversations using touch screen computers.

Technology for Early Detection of Depression and Anxiety in Older People.

Under-diagnosis of depression and anxiety is common in older adults. This project took a mixed methods approach to explore the application of machine learning and technology for early detection of these conditions. Mood measures collected with digital technologies were used to predict depression and anxiety status according to the Geriatric Depression Scale (GDS) and the Hospital Anxiety and Depression Scale (HADS). Interactive group activities and interviews were used to explore views of older adults and healthcare professionals on this approach respectively. The results show good potential for using a machine learning approach with mood data to predict later depression, though prospective results are preliminary. Qualitative findings highlight motivators and barriers to use of mental health technologies, as well as usability issues. If consideration is given to these issues, this approach could allow alerts to be provided to healthcare staff to draw attention to service users who may go on to experience depression.

Observing prioritization effects on cognition and gait: The effect of increased cognitive load on cognitively healthy older adults' dual-task performance.

Previous studies exploring the effects of attention-prioritization on cognitively healthy older adults' gait and cognitive dual task (DT) performance have shown DT cost in gait outcomes but inconsistent effects on cognitive performance, which may reflect task difficulty (the cognitive load). This study aimed to identify whether changing the cognitive load during a walking and counting DT improved the challenge/sensitivity of the cognitive task to observe prioritization effects on concurrent gait and cognitive performance outcomes. Seventy-two cognitively healthy older adults (Mean=73years) walked 15m, counted backwards in 3s and 7s as single tasks (ST), and concurrently walked and counted backwards as DTs. Attention-prioritization was examined in Prioritizing Walking (PW) and Prioritizing Counting (PC) DT conditions. Dual-task performance costs (DTC) were calculated for number of correct cognitive responses (CCR) in the counting tasks, and step-time variability and velocity in the gait task. All DT conditions showed a benefit (DTB) for cognitive outcomes with trade-off cost to gait. In the Serial 3s task, the cognitive DTBs increased in PC over the PW condition (p<0.05), with a greater cost to walking velocity (p<0.05). DT effects were more pronounced in the Serial 7s with a lower cognitive DTB when PC than when PW, (p<0.05) with no trade-off increase in cost to gait outcomes (p<0.05). The findings suggest that increased cognitive load during a gait and cognitive DT produces more pronounced gait measures of attention-prioritization in cognitively healthy older adults. A cognitive load effect was also observed in the cognitive outcomes, with unexpected results.

The Use of Motion-Based Technology for People Living With Dementia or Mild Cognitive Impairment: A Literature Review.

BACKGROUND: The number of people living with dementia and mild cognitive impairment (MCI) is increasing substantially. Although there are many research efforts directed toward the prevention and treatment of dementia and MCI, it is also important to learn more about supporting people to live well with dementia or MCI through cognitive, physical, and leisure means. While past research suggests that technology can be used to support positive aging for people with dementia or MCI, the use of motion-based technology has not been thoroughly explored with this population. OBJECTIVE: The aim of this study was to identify and synthesize the current literature involving the use of motion-based technology for people living with dementia or MCI by identifying themes while noting areas requiring further research. METHODS: A systematic review of studies involving the use of motion-based technology for human participants living with dementia or MCI was conducted. RESULTS: A total of 31 articles met the inclusion criteria. Five questions are addressed concerning (1) context of use; (2) population included (ie, dementia, MCI, or both); (3) hardware and software selection; (4) use of motion-based technology in a group or individual setting; and (5) details about the introduction, teaching, and support methods applied when using the motion-based technology with people living with dementia or MCI. CONCLUSIONS: The findings of this review confirm the potential of motion-based technology to improve the lives of people living with dementia or MCI. The use of this technology also spans across several contexts including cognitive, physical, and leisure; all of which support multidimensional well-being. The literature provides evidence that people living with dementia or MCI can learn how to use this technology and that they enjoy doing so. However, there is a lack of information provided in the literature regarding the introduction, training, and support methods applied when using this form of technology with this population. Future research should address the appropriate introduction, teaching, and support required for people living with dementia or MCI to use the motion-based technology. In addition, it is recommended that the diverse needs of these specific end-users be considered in the design and development of this technology.

Computer-based tools for assessing micro-longitudinal patterns of cognitive function in older adults.

Patterns of cognitive change over micro-longitudinal timescales (i.e., ranging from hours to days) are associated with a wide range of age-related health and functional outcomes. However, practical issues of conducting high-frequency assessments make investigations of micro-longitudinal cognition costly and burdensome to run. One way of addressing this is to develop cognitive assessments that can be performed by older adults, in their own homes, without a researcher being present. Here, we address the question of whether reliable and valid cognitive data can be collected over micro-longitudinal timescales using unsupervised cognitive tests.In study 1, 48 older adults completed two touchscreen cognitive tests, on three occasions, in controlled conditions, alongside a battery of standard tests of cognitive functions. In study 2, 40 older adults completed the same two computerized tasks on multiple occasions, over three separate week-long periods, in their own homes, without a researcher present. Here, the tasks were incorporated into a wider touchscreen system (Novel Assessment of Nutrition and Ageing (NANA)) developed to assess multiple domains of health and behavior. Standard tests of cognitive function were also administered prior to participants using the NANA system.Performance on the two "NANA" cognitive tasks showed convergent validity with, and similar levels of reliability to, the standard cognitive battery in both studies. Completion and accuracy rates were also very high. These results show that reliable and valid cognitive data can be collected from older adults using unsupervised computerized tests, thus affording new opportunities for the investigation of cognitive.

Does familiarity affect the enjoyment of touchscreen games for people with dementia?

INTRODUCTION: Previous research has indicated that people living with dementia are able to use touchscreen technology, which presents an opportunity to deliver meaningful and engaging activities for people to pass the time independently. The challenge is to identify suitable applications from the thousands that are currently available, and familiarity, where an app is a digital version of an existing real world game, may be one solution. OBJECTIVES: To evaluate the concept of familiarity in gameplay with people living with dementia by comparing a known game with a novel game and measuring whether users are able to play these games independently and whether they enjoy doing so. METHODS: Thirty older adults living with dementia were recruited from local care services. Each participant was assigned to one of two groups. Group 1 played a familiar game (Solitaire) and Group 2 played a novel game (Bubble Xplode). Each participant played the same game on three separate occasions within one week. Number of gameplay attempts, whether a checkpoint was reached and how much time to reach the checkpoint were measured. A brief post-session interview was conducted to assess the participants' enjoyment. RESULTS: Ninety percent of participants attempted gameplay independently with 17% of participants in the familiar group reaching the checkpoint compared with 93% playing the novel game. Regardless of which game was played or whether the checkpoint was reached, 88% of all participants reported enjoyment of the gaming sessions. DISCUSSION: People living with dementia can play touchscreen games independently, but familiarity does not ensure successful gameplay. Enjoyment appears to be independent of progression through a game. The potential of novel and unfamiliar games as meaningful activities that people with dementia can engage with independently should be further explored.

Studies Involving People With Dementia and Touchscreen Technology: A Literature Review.

BACKGROUND: Devices using touchscreen interfaces such as tablets and smartphones have been highlighted as potentially suitable for people with dementia due to their intuitive and simple control method. This population experience a lack of meaningful, engaging activities, yet the potential use of the touchscreen format to address this issue has not been fully realized. OBJECTIVE: To identify and synthesize the existing body of literature involving the use of touchscreen technology and people with dementia in order to guide future research in this area. METHODS: A systematized review of studies in the English language was conducted, where a touchscreen interface was used with human participants with dementia. RESULTS: A total of 45 articles met the inclusion criteria. Four questions were addressed concerning (1) the context of use, (2) reasons behind the selection of the technology, (3) details of the hardware and software, and (4) whether independent use by people with dementia was evidenced. CONCLUSIONS: This review presents an emerging body of evidence demonstrating that people with dementia are able to independently use touchscreen technology. The intuitive control method and adaptability of modern devices has driven the selection of this technology in studies. However, its primary use to date has been as a method to deliver assessments and screening tests or to provide an assistive function or cognitive rehabilitation. Building on the finding that people with dementia are able to use touchscreen technology and which design features facilitate this, more use could be made to deliver independent activities for meaningful occupation, entertainment, and fun.