The effectiveness of diverse technology-based instructions in assisting people with Alzheimer’s disease with medication management

Abstract

Purpose: In patients with mild cognitive impairment and Alzheimer’s disease (AD), faculties associated with instrumental activities of daily living (IADL) decline owing to reduced cognitive function. One type of IADL is medication behaviour. Medication management is critical for patients with AD. Previous studies have reported that presentations using speech and images are effective for facilitating IADL autonomy but there are few examinations of effective presentation methods. Therefore, we examined what kind of display methods are effective in helping patients with AD with medication management.Materials and methods: Ten healthy elderly and 9 patients with mild AD were asked to perform the task of taking out medicine bags from a case at a designated time. We gave 3 kinds of instructions and examined the differences in participants’ reaction times. Task 1 included verbal instructions alone, Task 2 included verbal instructions and pictorial and written instructions, and Task 3 used a video conference system (presenting pictorial, written, and verbal instructions) at a designated time. Task 3 could be conducted remotely over the internet. The relationship between these results and neuropsychological tests was also explored.Results: Task 3 was an effective method for patients with mild AD. In addition, we found correlations between the methods of Tasks 1–3 and the Japanese version of the Mini-Mental State Examination (MMSE-J).Conclusions: The method of Task 3 may lead to home support for patients with AD. The MMSE-J could be used to identify changes in the adaptive functioning of patients exposed to distinct presentation methods.Implications for rehabilitationAppropriate transmission methods will increase the IADL autonomy of patients with mild AD who have memory impairment. While still images alone are not effective for patients with mild AD, when combined with verbal instructions, they prove effective for this group.The results of this study are useful for providing patients with mild AD with support in their IADLs, especially when methods that use images plus speech are employed. As participants were instructed via the internet, this study shows a way to help patients with mild AD even from a remote location.Until now, no studies have examined the adaptation criteria for instructive methods for patients with mild AD. This study shows that the MMSE could be used to determine the applicability of these instructive methods. The identification of cut-off values in future research could lead to more effective IADL support.