Abstract
Baseline and five-year data from 37 older adults (mean age 67.5 years) with MCI regarding their perceived ability to use ET were used to generate Rasch-based ET item measures reflecting the relative challenge of 46 ETs. Actual differential item functioning in relation to time was analyzed based on these item measures. Data collection took place in 2008-2014. Seven (15%) of the ETs included were perceived to be significantly more challenging to use at year five compared to at baseline, while 39 ETs (85%) were perceived to be equally challenging to use, despite the fact that the participants' perceived ability to use ET had decreased. Common characteristics among the ETs that became more challenging to use could not be identified. The dropout rate was 43%, which limits the power of the study. Changes in the perceived challenge of ETs seem to capture functional change in persons with cognitive decline. Both easier and more challenging ETs typically used at home and in society need to be addressed to capture this functional change because significant changes occurred among ETs of all challenge levels and within all types of ETs.
Highlights
Mild cognitive impairment (MCI) is a heterogeneous clinical syndrome that lies between the cognitive functioning in normal aging and the early stage of dementia (Petersen et al, 2014)
An independent-sample t-test revealed no significant baseline differences regarding age, Mini-Mental State Examination (MMSE), or Everyday Technology Use Questionnaire (ETUQ) person measure between those who contributed with data at year five and those who had dropped out, and a χ 2 test indicated no significant relation between gender and attrition
Seven (15%) of the analyzed everyday technologies (ETs) had positive z-score differences that were outside the ±1.96 interval, i.e. they showed significant actual differential item functioning (DIF) over time
Summary
Participants were older adults with MCI diagnosed and recruited at a specialized outpatient memory clinic in Stockholm between April 2008 and May 2009 (Table 1). In the ETUQ, a relevant ET is defined as an ET that the person has access to and has used in the past, currently is using, or intends to start using In this study, both person measures and item measures were used (further explained in the data analysis section). For an ET to be included in the analysis, at least ten participants should have scored it as relevant both at baseline and at year five This was true for 46 of the 92 items in the ETUQ (50%). To adjust for changes in the mean person measure of the sample, actual DIF (Petersson et al, 2008) between baseline and year five was calculated for each ET through the use of standardized z-comparisons calculated on the individual item measures from both of these time points and their individual standard errors. To explore potential patterns in the types of ETs that presented significant actual DIF, the analyzed ETs were classified into the seven topic areas in which all ETs are organized in the latest ETUQ version (Nygård et al, 2016) – home maintenance, information/communication, self-care, maintenance/repair, accessibility, economy/purchasing, and travel
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