Advanced Cognitive Impairment Research Articles

Analysis of the Occurrence and Influencing Factors of Oral Frailty in Elderly Residents of Elderly Care Facilities

To investigate the occurrence and influencing factors of oral frailty in elderly residents of elderly care facilities and to provide a basis for the development of effective intervention programs for oral frailty in this population. A combination of subjective and objective measurements of oral frailty, a general information questionnaire, a leisure activity questionnaire, the Dietary Variety Score (DVS), the Short Nutritional Assessment Questionnaire (SNAQ), the Short-Form Mini Nutritional Assessment (MNA-SF), Barthel Index (BI), the Mini-Mental State Examination (MMSE), 15-Item Geriatric Depression Scale (GDS-15), and the Generalized Anxiety Disorder Scale-2 (GAD-2) were used to survey 348 elderly residents in three elderly care facilities in Chengdu and to analyze the factors related to oral frailty. The prevalence of oral frailty in elderly residents of elderly care facilities was 31.0% (108/348). Multivariate logistic regression analysis revealed that advanced age (odds ratio [OR]=1.347, 95% confidence interval [CI]: 1.237-1.496, P<0.001), cognitive impairment (OR=6.769, 95% CI: 2.628-18.916, P<0.001), and depression (OR=8.632, 95% CI: 1.931-44.387, P=0.007) were risk factors for oral frailty in elderly residents of elderly care facilities. High scores in leisure activities (OR=0.883, 95% CI: 0.786-0.986, P=0.030), and dietary diversity (OR=0.199, 95% CI: 0.069-0.530, P=0.002) were protective factors against oral frailty. The prevalence of oral frailty is relatively high among elderly residents of elderly care facilities. Risk factors for oral frailty include advanced age, cognitive impairment, and depression, while increased levels of leisure activities and dietary diversity can help prevent the occurrence of oral frailty in elderly individuals.

QOL-13. RETURNING TO SCHOOL TO REDUCE LATE COGNITIVE SIDE EFFECTS IN SURVIVING CHILDREN WITH BRAIN TUMORS AFTER RADIOTHERAPY

Abstract OBJECTIVE To investigate whether returning to school can reduce advanced cognitive impairment related to chemo-radiotherapy in children with brain tumors. METHOD From 2013 to 2018, 132 children with brain tumors aged 3-14 who received chemo-radiotherapy for brain tumors were retrospectively analyzed for gender, tumor type, age of radiotherapy, education level, place of residence, and return to school. The Wechsler Intelligence Test was conducted before and 5-10 years after radiotherapy and chemotherapy, and they were divided into a return to school regular class group, a return to school family/community education group, and a non return to school no education group. RESULT 78 cases were in the group of returning to school for regular classes, 30 cases were in the group of returning to school for family/community education, and 24 cases were in the group of not returning to school without teaching. The verbal intelligence, operational intelligence, and overall intelligence of the group returning to school and attending regular classes were significantly higher than the other two groups. The return to school situation of urban children is better than that of rural children (p=0.028&amp;lt;0.05). Children with germ cell tumors had the best return to school, while those with glioma had the worst return to school (p&amp;lt;0.05). The quality of life score of returning to school children was significantly higher than that of out of school children (p&amp;lt;0.05). CONCLUSION Children returning to school are significantly better than those of out of school children in terms of physiological, emotional, social, and school functions. After 5 years of radiotherapy, the cognitive level of the returning children significantly improved, and the overall quality of life was relatively high.

Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis.

Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis.

Impact of Parkinsonism comorbid depression on cognitive functions

BackgroundParkinson's disease (PD) is a chronic progressive neurodegenerative disabling disease and involves about 1–3% of the worldwide population over the age of 60. A significant prevalence of psychopathological symptoms has been recorded as most patients with PD developed over their disease course neuropsychiatric symptoms such as depression, anxiety, sleep disorders, psychosis, and cognitive and behavioral abnormalities. These non-motor symptoms, which could appear decades before motor ones, become disturbing symptoms during the later phases of the disease. Hence, the current research aims to study depressive symptoms in Parkinson's disease patients. Thirty-six patients with Parkinson’s disease aged from 40 to 65 years (20 males and 16 females) and 36 age and sex-matched controls (19 males and 17 females) were included in the study. Unified Parkinson’s Disease Rating Scale (UPDRS), Hoehn and Yahr scale, Schwab and England’s scale, Mini-Mental State Examination, Cognitive Ability Screening Instrument, and Hamilton Depression Rating Scale were applied to assess depression in both groups.ResultsPatients were 20 males and 16 females (mean age 52.44 ± 7.45), mean duration of Parkinsonism was 3.88 years. The mean value for Hoehn and Yahr scale was 1.97 ± 1.42, for UPDRS T was 42.41 ± 20.91 and Schwab England's scale was 74.77 ± 17.78. Concerning cognition, MMSE was significantly lower among patients 25.33 ± 3.63, than in the control group and CAS total was significantly lower in patients (16 ± 71.35) than in the control group 9.81 ± 84.62.ConclusionDepressive symptoms are widespread in Parkinson's disease. Depression should be strictly determined and addressed, particularly in patients with more advanced cognitive impairment who are at a higher risk of developing or worsening depression.

Altered resting state hippocampal connectivity associated with amyloid and tau in older adults without dementia from a population‐based cohort study

AbstractBackgroundAlzheimer’s disease (AD) is characterized by amyloid beta plaques and tau‐containing neurofibrillary tangles with disrupted (high and low) resting state hippocampal connectivity. One potential factor that may underlie these differences is that early stages of disease may contribute to greater connectivity and later stages may contribute to lower connectivity (i.e., quadratic associations between amyloid/tau and connectivity). Early stages may be associated with greater recruitment of intranetwork connectivity to compensate, which fails at later stages. Late stages may be associated with greater recruitment of internetwork connectivity, that fails in advanced cognitive impairment. Understanding these dynamics may help us understand resilience to amyloid and tau in cognitively unimpaired individuals.MethodWe recruited 115 adults &gt;65 years old (67‐96, mean 76years) from a population‐based study into a neuroimaging sub‐study. The study area is a formerly heavy manufacturing industrial small‐town area. Participants (106 (92%) CU with CDR = 0) underwent PET imaging for amyloid (PiB) and tau (AV‐1451) and global SUVR measures were computed after appropriate preprocessing. Participants underwent resting state fMRI and hippocampal connectivity was computed for the left/right and anterior/posterior hippocampus. Regression analyses between connectivity and both linear and quadratic terms for amyloid and tau were adjusted for age, sex, race, and education. We adjusted for multiple comparisons using SnPM with FWE correction with α = 0.05 (p‐value threshold of 0.001).ResultWe found a negative quadratic association between left anterior hippocampus with default mode network (DMN) including the posterior cingulate and supramarginal gyrus, where greater amyloid and lower amyloid was associated with low connectivity. Similar effects were found for the right anterior hippocampus. Right anterior hippocampus to cuneus connectivity shows positive U‐shape with amyloid but negative linear relationship with tau. Greater right anterior hippocampus‐inferior parietal and right posterior hippocampus‐inferior temporal connectivity was associated with greater tau. Left posterior hippocampus to left middle temporal showed negative U‐shape with tau.ConclusionAmyloid and tau showed complex inverse U‐shaped associations between heightened intranetwork connectivity and moderate amyloid/tau, but low connectivity with higher severity. Internetwork connectivity was heightened with greater tau. These may reflect altered connectivity due to changes in amyloid and tau in older adults without dementia.

Development of a remotely applied app‐based cognitive training for early Alzheimer’s disease

AbstractBackgroundCognitive training (CT) has been proposed to attenuate cognitive decline in early Alzheimer’s disease and can be administered remotely. Here, we describe the design and development of an adaptive app‐based CT to remotely train cognitive functions that are affected early in the course of Alzheimer’s disease. We furthermore present interim results of CT acceptance and adherence in a group of participants with subjective cognitive decline (SCD).MethodWe used the Unity Game Engine software and the programming language C# to design a CT app with 16 games that target AD‐typical impairments in episodic and semantic memory and spatial processing, including working memory tasks to facilitate transfer processes (Figure 1). During each training session three games (each 10 min) are played. The training is adaptive to ensure a constant level of challenge, i.e., players progress to higher levels when they win rounds and decrease to lower levels when they lose rounds. The broad range of tasks ensures continued motivation and adherence of the participants over a prolonged training period. We aimed to design the game interfaces and navigation as user‐friendly as possible to maximize usability. Via an integrated help button participants can furthermore ask for help during home training. CT adherence can be assessed remotely.ResultPreliminary results on adherence and game experience show that participants with SCD (n = 62) like the games (5.49±0.13) and are motivated to perform well (6.3±0.08), despite being challenged (5.84±0.09) (7‐point Likert scale). After a 10‐week CT intervention, cognitive improvement is rated at 4.94±0.24 and participants would recommend the CT to a friend at 7.01±0.37 (9‐point Likert scale). Moreover, they would recommend that the games should be played for 32±2.64 min per day. The drop‐out rate is very low (4.6%). At the time of AAIC we will present additional data on acceptance/adherence and feasibility.ConclusionRemotely administered app‐based CT is applicable in the home setting and successful in motivating participants with early AD, which is also reflected in high adherence rates and acceptability. Future research should extend app‐based interventions to also target individuals with advanced cognitive impairment and applications for use in care‐home settings.

Long-Term Krill Oil Administration Alleviated Early Mild Cognitive Impairment in APP/PS1 Mice.

Alzheimer's disease is an age-dependent neurodegenerative disorder. Mounting studies focus on the improvement of advanced cognitive impairment by dietary nutrients. Krill oil (KO), a rich source of DHA/EPA and astaxanthin, is effective in improving cognitive function. The study mainly investigates the protective effects of long-term KO administration on early cognitive impairment. Results show that 2 months KO administration (50 and 100mgkg-1 BW) can dramatically promote learning and memory abilities. Mechanism studies demonstrate that KO reduces amyloid β concentration by regulating the amyloidogenic pathway, inhibits neuro-inflammation via regulating TLR4-NLRP3 signaling pathway, and prevents neuron injure. KO supplementation also enhances gut barrier integrity, reduces serum lipopolysaccharide leakage, and alters the gut microbiota by reducing Helicobacteraceae, Lactobacillaceae proportion, increasing Dubosiella and Akkermansia relative abundance. Particularly, a significant increase of isovaleric acid, propionic acid, and acetic acid levels is observed after KO supplementation. Correlation analysis shows that short-chain fatty acids (SCFAs), gut microbiota, and cognitive function are strongly correlated. The results reveal that KO relieves early mild cognitive impairment possibly for its role in mediating the gut microbiome-SCFAs-brain axis. Thus, KO may provide potential intervention strategies to prevent cognitive impairment in the early stages through the microbiota-gut-brain axis.

Application of a Decisional Capacity Assessment for Older Research Participants with Cognitive Impairment.

Decisional capacity assessment is important for older adult participants who have cognitive impairment. This paper reports the implementation of the University of California, San Diego Brief Assessment of Capacity to Consent (UBACC) and its potential for practice and research. Nine of the 10 items remained to use except for adapting the last item. Approximately 130 older adults with cognitive impairment completed the UBACC screening. Item-by-item descriptive statistics, exploratory factor analysis (EFA), group comparisons of each item, as well as total sum scores of the UBACC were conducted. Results showed that the items that were most often answered correctly included item #10 (participant will be paid), item #4 (study is voluntary), and item #5 (can withdraw at any time). Conversely, the items that were most often answered incorrectly included item #9 (not any benefit potentially), item #7 (potential risk or discomfort), and item #6 (tasks during participation). Respondents with mild cognitive impairment had higher correct answer rates than those with advanced cognitive impairment. The UBACC screening tool has relative utility for older participants with cognitive impairment.

186 Experiences of implementing a group intervention targeting sarcopenia in an integrated care for older persons hub

Abstract Background Sarcopenia is associated with declining mobility, falls, frailty, and increased mortality. Research suggests resistance exercises and ensuring adequate protein intake can improve muscle mass, strength and function. Methods Screening for probable sarcopenia was introduced as part of the comprehensive geriatric assessment in the hub. Suitable candidates who screened as having probable sarcopenia were offered a group intervention facilitated by a physiotherapist and a dietitian, followed by an 8 week at home self-management programme. Alongside objective assessments of outcomes, the clinicians conducting the program also undertook a process of reflection on the experience, to provide a qualitative analysis that might inform future work. Results The main barrier identified to the group intervention was enrolment. The primary reason for this appeared to be the presence of other comorbidities that precluded participation. These included active medical conditions, complex social issues, advanced cognitive impairment, complex falls, or malnutrition requiring more specialist intervention. The main facilitator identified was an engaged multidisciplinary team (MDT), willing to upskill to screen for sarcopenia and proactive about discussing the intervention with potential participants. Another facilitator was the practice of contacting participants at the midpoint, to check on compliance and provide encouragement. Conclusion Several conclusions were achieved through a qualitative reflection on the experience. Engaging and upskilling team members and therapist support were seen as facilitators, whilst recruitment was the most significant barrier. During reflection it was suggested that excluding those that did not screen for probable sarcopenia (53% of all screened) may have been a missed opportunity for promotion and prevention. These learnings will be used to inform the design of future such interventions. Despite the challenges encountered, there was a consensus among the MDT that offering a group intervention is a practical way to begin to address sarcopenia within the limited resources of a community hub.

Overcoming barriers to technology in special groups

AbstractDiabetes demands a high volume of self‐care and management, which poses many obstacles for those with advanced age, cognitive impairment, or physical disability. The latest diabetes technologies, including smart insulin pens, continuous glucose monitoring and insulin pumps, have great potential to improve glycaemic control and quality of life, particularly for those affected by impairment or disability. Although these groups may face barriers to using diabetes technology, accessing and harnessing the benefits and opportunities of the technologies can be achieved with appropriate support and education. This article explores the role of diabetes technology in the care of individuals in special groups, including those with visual impairment, learning disability, cognitive impairment, or reduced dexterity, and elderly people. Copyright © 2023 John Wiley &amp; Sons.

Efficacy of immunotherapy and prognosis in anti-LGI1 encephalitis patients: A meta-analysis.

To assess the efficacy and safety of immunotherapy for LGI1 antibody encephalitis, and consider the predictors of poor outcomes following immunotherapy. We searched PubMed and Embase for articles reporting the immunotherapy data of anti-LGI1 encephalitis patients. The proportions of patients with poor outcomes (modified Rankin Scale [mRS] score > 2) at 3 months, 12 months, and the last follow-up, as well as the odds ratio [OR] of predictors were pooled. The review included 162 articles with 1066 patients. The proportion of patients with poor functional outcomes was 21% at 3 months, 14% at 12 months, and 14% at the last follow-up after receiving immunotherapy. The proportion of patients with reported relapse was 16.6%. The mean duration from onset to the first relapse was 15.6 months. Predictors significantly associated with poor outcomes were age (increase of 1 year), the presence of cognitive impairment, and CSF LGI1 antibody positive. We did not find a statistically significant association between the worst mRS score in the acute phase, the presence of faciobrachial dystonic seizures (FBDS), days from symptom onset to immunotherapy, second-line treatment, maintenance immunotherapy, or follow-up time and outcomes. Although most patients respond to immunotherapy, a minority of patients still have poor outcomes. Advanced age, cognitive impairment, and CSF LGI1 antibody positive are associated with an increased risk of poor outcomes. However, due to the insufficiency of the data, these conclusions need to be interpreted with caution.

A history of repeated alcohol intoxication promotes cognitive impairment and gene expression signatures of disease progression in the 3xTg mouse model of Alzheimer's disease.

The impact of alcohol abuse on Alzheimer's disease (AD) is poorly understood. Here, we show that the onset of neurocognitive impairment in a mouse model of AD is hastened by repeated alcohol intoxication through exposure to alcohol vapor, and we provide a comprehensive gene expression dataset of the prefrontal cortex by the single-nucleus RNA sequencing of 113,242 cells. We observed a broad dysregulation of gene expression that involves neuronal excitability, neurodegeneration, and inflammation, including interferon genes. Several genes previously associated with AD in humans by genome-wide association studies were differentially regulated in specific neuronal populations. Gene expression patterns of AD mice with a history of alcohol intoxication were more similar to gene expression signatures of older AD mice with more advanced disease and cognitive impairment than those of younger AD mice with prodromic disease, suggesting that alcohol promotes transcriptional changes consistent with AD progression. Our gene expression dataset at the single-cell level provides a unique resource for investigations of the molecular bases of the detrimental role of excessive alcohol intake in AD.Significance statementAlzheimer's disease (AD) is the most common neurodegenerative disease worldwide. Many efforts have been geared toward the identification of environmental and genetic risk factors. However, alcohol has received limited attention as a potential risk factor for AD. We explored effects of the interaction of a history of alcohol intoxication with genetic AD susceptibility on cognitive performance and gene expression at the single-cell level. We found that a history of repeated alcohol intoxication promotes the emergence of spatial learning and memory impairments in pre-symptomatic triple transgenic AD (3xTg-AD) mice. We also show that a history of repeated alcohol intoxication induces prefrontal cortex transcriptional changes associated with AD progression.

New Directions to Approach Oxidative Stress Related to Physical Activity and Nutraceuticals in Normal Aging and Neurodegenerative Aging.

Oxidative stress (OS) plays, perhaps, the most important role in the advanced aging process, cognitive impairment and pathogenesis of neurodegenerative disorders. The process generates tissue damage via specific mechanisms on proteins, lipids and nucleic acids of the cells. An imbalance between the excessive production of oxygen- and nitrogen-reactive species and antioxidants leads to a progressive decline in physiological, biological and cognitive functions. Accordingly, we need to design and develop favourable strategies for stopping the early aging process as well as the development of neurodegenerative diseases. Exercise training and natural or artificial nutraceutical intake are considered therapeutic interventions that reduce the inflammatory process, increase antioxidant capacities and promote healthy aging by decreasing the amount of reactive oxygen species (ROS). The aim of our review is to present research results in the field of oxidative stress related to physical activity and nutraceutical administration for the improvement of the aging process, but also related to reducing the neurodegeneration process based on analysing the beneficial effects of several antioxidants, such as physical activity, artificial and natural nutraceuticals, as well as the tools by which they are evaluated. In this paper, we assess the recent findings in the field of oxidative stress by analysing intervention antioxidants, anti-inflammatory markers and physical activity in healthy older adults and the elderly population with dementia and Parkinson's disease. By searching for studies from the last few years, we observed new trends for approaching the reduction in redox potential using different tools that evaluate regular physical activity, as well as antioxidant and anti-inflammatory markers preventing premature aging and the progress of disabilities in neurodegenerative diseases. The results of our review show that regular physical activity, supplemented with vitamins and oligomolecules, results in a decrease in IL-6 and an increase in IL-10, and has an influence on the oxidative metabolism capacity. In conclusion, physical activity provides an antioxidant-protective effect by decreasing free radicals and proinflammatory markers.

Reader Response: Association of Diabetes and Hypertension With Brain Structural Integrity and Cognition in the Boston Puerto Rican Health Study Cohort.

The research by Guan et al.1 reports that older patients with type 2 diabetes (T2D) and hypertension (HTN) comorbidity presented with increased brain structural change and advanced cognitive impairment. I have a few comments.

Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis.

Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis.

Spousal Mourning for Partners Living with Cognitive Impairment: The Interplay of Attachment and the Two-Track Model of Dementia Grief.

The aim of the present research was to study the interplay of Attachment Theory and the Two-Track Model of Dementia Grief. To examine the research hypotheses, a cross-sectional study was designed and included 122 participants (Mean age = 72.77) drawn from four groups: spouses of people living with mild to moderate cognitive impairment, spouses of people living with advanced cognitive impairment, widowed spouses of deceased dementia patients, and a control group. Participants completed a battery of self-report questionnaires. Results showed that secure attachment constitutes a significant protective factor with regard to bio-psycho-social symptomatology (Track I) as well as difficulties in the relational bond with the spouse and grief over their deterioration (Track II). The results of the research support integrating attachment-based insights into clinical work with spouses coping with the losses accompanying cognitive decline and the grief processes that are operant in these losses.

The Two-Track Model of Dementia Grief and spousal response to illness and death

This cross-sectional study examined the experiences of healthy spouses caring for their partners via the Two-Track Model of Dementia Grief thereby broadening our understanding of the functional and relational aspects of this process. The 122 participating older adults had spouses drawn from four groups: mild to moderate cognitive-impairment; advanced cognitive-impairment; deceased following dementia; and, healthy controls. They completed a battery of self-report measures. Results showed elevated scores on both tracks of the model for all affected groups. Assisting spouses of those living with cognitive-impairment begins with the earliest symptoms of decline and continues after the death of the loved one.

The Pain Clinic for Older People.

Multidisciplinary pain clinics have an established role in the management of persistent pain, but there is little evidence to support this approach in an older population. This study describes the characteristics and pain outcomes of patients attending a pain clinic designed exclusively for older people. A retrospective audit was performed of outcomes of the Pain Clinic for Older People (PCOP) in 2015-2019. Response to treatment was determined by change in Brief Pain Inventory (BPI) scores at initial attendance and after a treatment program. Clinically meaningful improvement was defined by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) consensus criteria of ≥30% improvement in average pain and one-point improvement in pain interference. Results were compared with the national benchmark collated by the electronic Persistent Pain Outcomes Collaboration (ePPOC), which reports the combined results from 67 participating Australian and New Zealand pain services. Patients attending the PCOP had a mean age of 80.5 years and had high rates of frailty (84%), cognitive impairment (30%), and multimorbidity. Significant reductions in BPI average pain and BPI pain interference scores were achieved. Clinically meaningful improvement in BPI average pain was achieved in 63% of patients attending the PCOP who were 65-74 years of age and in 46% of patients who were ≥75 years of age, which met the national benchmark set by ePPOC of 40% for both age groups. Clinically meaningful improvement in BPI pain interference was achieved in 69% of those attending the PCOP who were 65-74years of age and in 66% of those who were ≥75 years of age, comparable to the ePPOC benchmark of 71% and 65% for the respective age groups. PCOP clients achieved significant and meaningful improvements in their pain outcomes that satisfied the national benchmark. Advanced age, cognitive impairment, frailty and multimorbidity should not be regarded as barriers to benefit from a pain clinic specifically designed for older people.

Which objective itch-assessment tools are applicable to patients with advanced cognitive impairments? A scoping review.

Itching is an irritating and uncomfortable sensation that has a profound effect on patients' physical and mental health. It is a major under-recognised problem in older patients who cannot express their pain due to advanced cognitive impairment. Therefore, objective itch-assessment tools that do not rely on patients' reports of itching may be of value for this patient group. To summarise the characteristics of validated objective itch-assessment tools for patients with advanced cognitive impairment. This scoping review was conducted according to the PRISMA extension for scoping reviews checklist. The PubMed, CINAHL and Cochrane Library databases were searched, via database-specific search strategies, for articles published in English between January 1, 1990 and March 11, 2020. Based on the eligibility criteria, two authors independently screened the articles for inclusion. Thereafter, the lead author performed data extraction and analysis. Three validated scratch-monitoring using accelerometers and a sound sensor and one validated scratch-mark assessment have been reported. The Actiwatch Plus, ActiTrac® , body-conducted sound sensor and Scoring Atopic Dermatitis index for scratching (SCORAD-scratch) had positive criterion validity outcomes. The Actiwatch Plus, ActiTrac® and body-conducted sound sensor were significantly correlated with scratch behaviour (r=0.91, p<0.001; r=0.71, p=0.042; r=0.99, and p-value not shown, respectively). The SCORAD-scratch was significantly correlated with subjective itch-assessment scores (r=0.78-0.80, p=<0.0001-0.010). This scoping review summarises the characteristics of validated objective itch-assessment tools to investigate which of these are applicable to older patients with advanced cognitive impairments. Although there are limitations and further verification is required, the ActiTrac® , Actiwatch Plus and body-conducted sound sensor may be useful for measuring scratch movements and itching. Nurses and patients' families may better understand the characteristics and validity of each objective itch-assessment tool and select the optimal tool for patients with advanced cognitive impairment who cannot express their discomfort caused due to itching.

Interface Design for Products for Users with Advanced Age and Cognitive Impairment.

The aim of this study is to investigate the problems and needs of users with advanced age and cognitive impairment regarding the design and operation of daily living products. Television remote controls and an electric rice cooker were applied as the research tools, and focus group interviews with control older adults and interviews with individuals with MCI or mild dementia were conducted regarding the operation of the products. The control participants stressed that the operating procedures should not be excessively complex, the number of functions and buttons should not be overly high, and buttons and text should be enlarged. For those with MCI or mild dementia, in addition to the size and number of buttons, text size, and functions, their operation of product interfaces was affected by the complexity of the operating procedures. The solutions recommended by the participants included interface design involving direct operation and voice control.