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Evaluating an accessible web interface for older adults: the impact of mild cognitive impairment (MCI)
- Authors:
- HAESNER Marten, et al
- Journal article citation:
- Journal of Assistive Technologies, 9(4), 2015, pp.219-232.
- Publisher:
- Emerald
Purpose: Cognitive changes occur with age and cognitive limitations can negatively influence computer use. Human-interaction studies show that especially older adults benefit considerably from using web platforms. The purpose of this paper is to measure the possible impact of cognitive impairment in web usability and to analyse the differences between older adults with and without cognitive impairment. Design/methodology/approach: In the presented pilot study, 50 older adults tested a web-based interface on a PC and tablet computer that was designed based on a styleguide for this specific user group. In two sessions participants had to conduct six tasks. In a third session older adults were left unsupervised in the laboratory where they were confronted with unexpected events triggered by a principal investigator. Findings: The performance results differed significantly between the two groups. Older adults with mild cognitive impairment (MCI) needed more time and were more likely to make mistakes when using a web platform. After analysing error data, it became apparent that errors made by older adults with MCI occurred due to a lack of orientation in websites. Originality/value: The authors present valid data of this interesting target group and reveal their specific problems when handling a new online platform. The importance of a flat website hierarchy can be essential in developing senior friendly web pages. The authors also highlight methodological issues and illustrate the importance of qualitative information of the usability data, e.g. the different types of problems or errors. (Edited publisher abstract)
Motor-cognitive effects of a computerized game-based training method in people with dementia: a randomized controlled trial
- Authors:
- Wiloth Stefanie, et al
- Journal article citation:
- Aging and Mental Health, 22(9), 2018, pp.1124-1135.
- Publisher:
- Taylor and Francis
Objectives: To examine the effects of a computerized, game-based training on motor-cognitive performances, the transfer of training effects on untrained tasks, and the sustainability of training gains in people with dementia. Method: Ninety-nine individuals with a mean age of 82.9 (5.8) and dementia participated in a 10-week randomized controlled trial with three-month follow-up. The intervention group (IG) received a motor-cognitive training on (Physiomat®) including concurrent dual-tasks of balance control with cognitive demands (Physiomat®-Trail Making Tasks (PTMTs)). The control group (CG) performed non-specific, low-intensity exercises. Duration and accuracy at different complexity levels of trained and untrained PTMTs and the number of successfully performed tasks (PTMT score) were assessed. Results: Physiomat® training significantly improved the duration and accuracy at almost all complexity levels of trained (P ≤ 0.001–0.047, ηp2 = 0.065–0.589) and untrained PTMTs (P < 0.001–0.005, ηp2 = 0.073–0.459). Significant effects were also found for the PTMT score of trained (P < 0.001, ηp2 = 0.211) and untrained PTMTs (P < 0.001, ηp2 = 0.184). Training gains were partly sustained at follow-up. Conclusion: Physiomat® is feasible and has the potential to sustainably improve motor-cognitive performances in people with dementia.
Cross-sectional and longitudinal relationship between neuroticism and cognitive ability in advanced old age: the moderating role of severe sensory impairment
- Authors:
- WETTSTEIN Markus, et al
- Journal article citation:
- Aging and Mental Health, 20(9), 2016, pp.918-929.
- Publisher:
- Taylor and Francis
Objectives: Gaining a comprehensive picture of the network of constructs in which cognitive functioning is embedded is crucial across the full lifespan. With respect to personality, previous findings support a relationship between neuroticism and cognitive abilities. However, findings regarding old age are inconsistent. In particular, little is known about potentially moderating variables which might explain some of the inconsistency. The authors' aim was to examine the moderating effect of severe sensory impairment on cross-sectional and longitudinal associations between neuroticism and cognitive functioning. Method: The study sample consisted of 121 visually impaired (VI), 116 hearing impaired (HI), and 150 sensory unimpaired older adults (UI). Mean age was 82.50 years (SD = 4.71 years). Neuroticism was assessed by the NEO Five Factor Inventory, and multiple established tests were used for the assessment of cognitive performance (e.g., subtests of the revised Wechsler Adult Intelligence Scale). Results: Bivariate correlations and multi-group structural equation models indicated stronger relationships between cognitive abilities and neuroticism in both sensory impaired groups (VI and HI) compared to UI older individuals. This relationship was attenuated but still significant in both sensory impaired groups when controlling for age, education and health (number of chronic conditions). In cross-lagged panel models, higher baseline neuroticism was significantly associated with lower cognitive performance four years later in VI and HI individuals. Conclusion: Results suggest that sensory impairment moderates both cross-sectional and longitudinal associations between neuroticism and cognitive function in advanced old age. (Edited publisher abstract)
Impairment of activities of daily living requiring memory or complex reasoning as part of the MCI syndrome
- Authors:
- PERNECZKY Robert, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(2), February 2006, pp.158-162.
- Publisher:
- Wiley
Mild Cognitive Impairment (MCI) is a borderline state between age-associated cognitive decline and mild dementia. MCI is separated from mild dementia by an absence of global intellectual deterioration and the preservation of activities of daily living (ADL). However, even mild degrees of cognitive deterioration are known to have negative effects on complex ADL. The aim was to examine whether patients with MCI have impaired ADL as compared to healthy controls, which areas of ADL are particularly involved, and whether limitations on ADL are associated with demographical or clinical data. Forty-eight patients with MCI diagnosed according to research criteria and 42 cognitively unimpaired controls were enrolled. Cognitive function was inter alia assessed by the MMSE, complex ADL by the ADCS-MCI-ADL scale. Frequency distributions were compared between patients and controls using chi-square tests. Mean values were examined for statistically significant differences using Kruskal-Wallis tests. A Bonferroni correction for multiple comparisons was applied to the comparison of the 18 areas of the ADCS-MCI-ADL scale. Associations between ADL and biographical or clinical data were analysed using non-parametric correlations. The overall score on the ADCS-MCI-ADL scale was significantly lower in the MCI group. Patients performed significantly worse on 14 out of 18 activities. Activities involving memory or complex reasoning were particularly impaired, whereas more basic activities were unimpaired. There were no statistically significant associations of the ADCS-MCI-ADL overall score with age, years of formal education, gender, or number of cognitive domains affected in the group of MCI patients. However, there was a statistically significant association between the ADCS-MCI-ADL and the MMSE score. MCI patients may be impaired in complex ADL.
Behavioral variant frontotemporal dementia: advanced disease stages and death. a step to palliative care
- Authors:
- DIEHL-SCHMID J., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(8), 2017, pp.876-881.
- Publisher:
- Wiley
Objective: The aim of the present study was to gain insight into the living and care situation in advanced behavioural variant frontotemporal dementia (bvFTD), to describe symptoms and findings in advanced bvFTD, and to evaluate somatic comorbidities and circumstances of death. Methods: Standardised interviews were conducted with family caregivers of 83 patients with bvFTD. Forty-four percent of the patients were already deceased at the time of the interview. Results: At the time of the interview or death, respectively, 47% of the patients lived in a nursing home. The median time between symptom onset and nursing home admission was 5.0 ± 5.5 years. In moderate and severe dementia stages almost all patients suffered from severe disabilities including impairment of language, gait, swallowing, and of the ability to care for themselves. Sixteen percent of the patients had got enteral tube feeding. Comorbid somatic diseases were diagnosed in 46% of the patients. Twenty-three percent of the deceased patients had been admitted into a hospital before death. Cardiovascular disease and respiratory disease, mostly pneumonia, were the most frequent causes of death. Conclusions: Advanced bvFTD is characterised by severe cognitive impairment and physical disabilities. BvFTD leads to a premature death. Our findings stress the importance of strategies that maximise patient comfort in advanced disease stages and allow for a peaceful death. (Edited publisher abstract)
Does participation in art classes influence performance on two different cognitive tasks?
- Authors:
- SCHINDLER Manuel, et al
- Journal article citation:
- Aging and Mental Health, 21(4), 2017, pp.439-444.
- Publisher:
- Taylor and Francis
Objectives: Effects of two mentally stimulating art interventions on processing speed and visuo-spatial cognition were compared in three samples. Method: In a randomised 10-week art intervention study with a pre-post follow-up design, 113 adults (27 healthy older adults with subjective memory complaints, 50 healthy older adults and 36 healthy younger adults) were randomly assigned to one of two groups: visual art production or cognitive art evaluation, where the participants either produced or evaluated art. ANOVAs with repeated measures were computed to observe effects on the Symbol-Digit Test, and the Stick Test. Results: Significant Time effects were found with regard to processing speed and visuo-spatial cognition. Additionally, there was found a significant Time × Sample interaction for processing speed. The effects proved robust after testing for education and adding sex as additional factor. Conclusion: Mental stimulation by participation in art classes leads to an improvement of processing speed and visuo-spatial cognition. Further investigation is required to improve understanding of the potential impact of art intervention on cognitive abilities across adulthood. (Publisher abstract)
Suitability of the 6CIT as a screening test for dementia in primary care patients
- Authors:
- HESSLER Johannes, et al
- Journal article citation:
- Aging and Mental Health, 18,(4) 2014, pp.515-520.
- Publisher:
- Taylor and Francis
Objectives: To map the suitability of the Six Item Cognitive Impairment Test's (6CIT) as a screening instrument for dementia in primary care and to assess its feasibility, reliability, and validity in a real-world setting.Method: The present study was part of a population-based prospective trial aimed at reducing the incidence of stroke and dementia. The 6CIT was administered by general practitioners (GPs) at routine examinations every two years. Incidence of dementia was obtained from health insurance records. Psychometric qualities of the 6CIT were evaluated for two different cut-offs.Results: At baseline, 72 GPs examined 3908 patients. In total, 528 patients were diagnosed with new dementia. Less than 1% of the tests were not completed. Internal consistency (Cronbach's alpha), stability over time (Pearson's r), and the agreement between successive tests (Cohen's kappa) reached values of 0.58, 0.62, and 0.45, respectively. Sensitivity and specificity reached values of 0.49 and 0.92 at the 7/8 cut-off and of 0.32 and 0.98 at the 10/11 cut-off, respectively. Patients with dementia had significantly higher mean error scores than patients without dementia. High scores at baseline posed a more than fourfold risk of being diagnosed with dementia.Conclusion: The 6CIT's psychometric properties in a real-world setting suggest that the test is not suited as a routine screening instrument. Factors inherent to screening in primary care likely contributed to its low reliability and validity. This highlights the need for training GPs in the conduct of cognitive screening before such procedures can be implemented on a routine basis. (Publisher abstract)