Abstract
Cognitive impairments (CI), associated with the consequences of Alzheimer's disease and other dementias, are increasingly prevalent among older adults, leading to deterioration in self-care, mobility, and interpersonal relationships among them. Innovative Assistive Technologies (IAT) such as electronic reminders and surveillance systems are considered as increasingly important tools to facilitate independence among this population and their caregivers. The aim of this study is to synthesise knowledge on facilitators and barriers related to acceptance of and use of IAT among people with CI and their caregivers. This systematic review includes original papers with quantitative, qualitative, or mixed methods design. Relevant peer-reviewed articles published in English between 2007 and 2017 were retrieved in the following databases: CINAHL; PubMed; Inspec; and PsycINFO. The Mixed Method Appraisal Tool (MMAT) was used for quality assessment. We retrieved thirty studies, including in total 1655 participants from Europe, USA/Canada, Australia, and Asia, enrolled in their homes, care-residences, day-care centres, or Living Labs. Two-thirds of the studies tested technologies integrating home sensors and wearable devices for care and monitoring CI symptoms. Main facilitators for acceptance and adherence to IAT were familiarity with and motivation to use technologies, immediate perception of effectiveness (e.g., increase in safety perceptions), and low technical demands. Barriers identified included older age, low maturity of the IAT, little experience with technologies in general, lack of personalization, and support. More than 2/3 of the studies met 80% of the quality criteria of the MMAT. Low acceptance and use of IAT both independently and with caregivers remains a significant concern. More knowledge on facilitators and barriers to use of IAT among clients of health care and social services is crucial for the successful implementation of innovative programmes aiming to leverage innovative technologies for the independence of older people with CI.
Highlights
Age-related changes in mental and physical abilities can make independent living at home challenging
The design and quality of studies according to the Mixed Method Appraisal Tool (MMAT) are presented in Table 1, which includes more details on participants and type of data
Facilitators and barriers related to acceptance and adherence are presented in Table 2, including details on type of technology and outcomes
Summary
Age-related changes in mental and physical abilities can make independent living at home challenging. Deterioration in mobility, self-care, and interpersonal interaction and relationships has serious implications for independent living among older people [1], especially when a person has problems to remember, learn new things, concentrate, or make decisions that affect their everyday life. Cognitive impairments (CI) are increasingly prevalent in the ageing population [2] and are strongly associated with decline in activities of daily living (ADL) [3]. As the CI progresses, people become increasingly dependent on others to manage their everyday life and their families and relatives (informal caregivers) are at risk of burden and stress [4]. The cost and burden of caring for older people with CI are considerable, for both informal caregivers and health care and social service (care and service) systems [5]. Efforts to reduce the societal impact of CI are needed, as well as alternative solutions to maintain independence, participation, active citizenship, and quality of the life
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