Acceptance and Use of Innovative Assistive Technologies among People with Cognitive Impairment and Their Caregivers: A Systematic Review
Table 1
Description of study details and design.
First author, title. MMAT -design/ score1
Study design, duration and participants (n, age)2
Type of data
(1) Boise et al 2013 [19] Willingness of older adults to share data and privacy concerns after exposure to unobtrusive home monitoring. 3/
Cross sectional survey after monitoring for 1 year in clients homes (n=119), mean age 83 years. Groups: Cognitively Intact n= 92 Cognitively impaired n=27 (MMSE≤24)
34 questions on e.g. computer use, attitudes about unobtrusive monitoring and monitoring of computer use, attitudes about sharing monitoring information with one’s family or doctor, and concerns about privacy or security.
(2) Cahill et al 2007 [20] “It gives me a sense of independence” – Findings from Ireland on the use and usefulness of assistive technology for people with dementia. 5/
Semi-structured questionnaire after 3 months of use in clients homes, client/family caregiver dyad3 (n=40), 60-90 years old.
Baseline and follow-up data on use and usefulness of the product both from the individual’s perspective along with from the perspective of the primary family caregiver.
(3) Cavallo et al 2015 [21] An Ambient Assisted Living Approach in Designing Domiciliary Services Combined With Innovative Technologies for Patients With Alzheimer’s Disease: A Case Study. 4/
Experimental study at home and in residential living, client/formal caregiver dyad (n=30), mean age of client 84.5 years.
Interviews with 15 socio-medical operators before and after the experimentation phase. Information on study duration not provided
(4) Chen et al 2012 [22] Exploring functions of the lost seeking devices for people with dementia. 4/
User-centred design for 12-36 months among family – or formal caregivers (n=37), mean age 58.8 years.
In depth interview and survey on experiences and requirements of caregivers.
(5) Engström et al 2009 [23] Staff members perceptions of a ICT support package in dementia care during the process of implementation. 1/
Descriptive study for18 months at a residential home among formal caregivers (n=14), 25-56 years old.
Interviews in groups, once before the new ICT, twice during its implementation and once after.
(6) Granata et al 2013 [24] Robot services for elderly with cognitive impairment: Testing usability of graphical user interfaces. 4/
Usability testing comparing two groups - one trial only in clients homes (n=22), mean age 76.5 years. Groups: Elderly with MCI (n=11) Elderly cognitively healthy (n=11)
Performance measures (task completion time and number of errors) were collected
(7) Hattink et al 2016 [25] The electronic, personalizable Rosetta system for dementia care: exploring the user-friendliness, usefulness and impact. 2/-
Controlled trial with pre- and post-test measures in clients homes for 0-8 months, among clients, family- and formal caregivers (n=80, 32+42+6) mean age of clients 79.5 years.
Self-developed semi-structured questionnaires
(8) Hebesberger et al 2017 [26] A Long-Term Autonomous Robot at a Care Hospital: A Mixed Methods Study on Social Acceptance and Experiences of Staff and Older Adults. 5/
Mixed-method design; 15-day-trial following a 5-day-pilot testing phase at a care-hospital among formal caregivers (n=70).
Observations (12 h), questionnaires and in-depths interviews(n=10)
(9) Imbeult et al 2013 [27] Electronic organiser and Alzheimer’s disease: Fact or fiction? 4/
Experiment at home with 2 clients aged 71 and 80 years old; 8-20 tests each <12 months.
Qualitative interviews and quantitative analysis of sensor and camera-based data on activity and behaviour.
(10)Karlsson et al 2015 [28] The Challenge of Coming to Terms with the Use of a New Digital Assistive Device: A Case Study of Two Persons with Mild Dementia. 1/
Explorative user study in the home of 2 clients 60 and 80 years old for 6-18 months.
Participant observations and interviews
(11) Kerkhof et al 2015 [29] Experiences of using a memory aid to structure and support daily activities in a small-scale group accommodation for people with dementia. 1/
Explorative study for 3 months at a residency among clients 60-80 years old and their family- and formal caregivers (n=17, 6+5+6).
Individual interviews with residents, focus groups interviews with family- and formal caregivers.
(12) Kerssens et al 2015 [30] Personalized Technology to Support Older Adults With and Without Cognitive Impairment Living at Home. 4/
Exploratory intervention for 1-2 months in 7 homes with client and family caregiver dyads (n=14) 60-88 years old.
Life Story and Care Needs interviews Engagement assessment and robot acceptability survey.
(13) Khosla et al 2017 [31] Human Robot Engagement and Acceptability in Residential Aged Care. 3/
Technology development and action research trial for 3 years among clients at a residency (n= 115), 65-90 years old.
Observations and questionnaires
(14) Lazar et al 2015 [32] Involving Family Members in the Implementation and Evaluation of Technologies for Dementia: A Dyad Case Study. 1/
Explorative use of touch screen at a residency with a client/family caregiver dyad, 86/ 60 years old.
Interview with a family member at baseline, 3 months and 6 months.
(15) Lazar et al 2016 [33] Evaluation of a multifunctional technology system in a memory care unit: Opportunities for innovation in dementia care. 5/
Explorative use of touch screen, at a residency with client, family- and formal caregiver (n= 16, 5+4+7) age 32-88 years,
Interviews at baseline and 6 months, with an optional interview at 3 months.
(16) Lim et al 2013 [34] Usability of Tablet Computers by People with Early-Stage Dementia. 4/
7-day trials of use of a tablet computer at home with client/family caregiver dyads (n=48), ages 34-91.
Questionnaires
(17) Lindquist et al 2013 [35] Significant junctures on the way towards becoming a user of assistive technology in Alzheimer’s disease. 1/
Explorative usability testing for 6 months in the home with client/family caregiver dyads (n=20). Mean age of client 67 years.
Semi-structured interviews
(18) Lindquist et al 2015 [36] Experienced usability of assistive technology for cognitive support with respect to user goals. 1/
Explorative usability testing – 2x 6-month interventions in the home with client/family caregiver dyads (n=28). Mean age of client 69.6 years
Semi-structured interviews on expectations, interviews on experience and field notes
(19) Magnusson et al 2014 [37] Extended safety and support systems for people with dementia living at home. 4/
Intervention study with a pre-post design, 8 months at home with clients, family-and formal caregivers (n=155, 63+62+30) mean age of clients 75.7 years
Questionnaires and Extended Safety and Support (ESS) logs.
(20) Mitseva et al 2012 [38] Gerontechnology: Providing a Helping Hand When Caring for Cognitively Impaired Older Adults—Intermediate Results from a Controlled Study on the Satisfaction and Acceptance of Informal Caregivers. 3/
Controlled study in the home with client/family caregiver dyads (n=142). Mean age of client 77.4 years. Follow-up at 15 months with intermediate evaluation.
Questionnaires, interviews and structured observations
(21) Niemeijer et al 2014 [39] The Use of Surveillance Technology in Residential Facilities for People with Dementia or Intellectual Disabilities: A Study Among Nurses and Support Staff-Exploring the benefits and drawbacks. 1/
Ethnographic field study among nurses and support staff (n=38) using surveillance technology for 4 months at a residential home.
Field observations, formal interviews and informal conversations
(22) Nijhof et al 2012 [40] How assistive technology can support dementia care: A study about the effects of the IST Vivago watch on patients’ sleeping behavior and the care delivery process in a nursing home. 5/
Explorative mixed-method design for 6 months at a residential home, with client/ formal caregiver dyads (n=14), 45-95 years old.
Monitor log of sleep/wake rhythm, a diary about usage, care- interventions related to the monitoring data; observations, and in-depth interviews with caregivers about implementation and usage.
(23) Nijhof et al 2013 [41] A personal assistant for dementia to stay at home safe at reduced cost. 5/
Explorative mixed-method design for 9 months at home with client/family caregiver dyads (n=14), 35-86 years old.
Log files, interviews with family caregivers, a focus group made up of professional caregivers, observations of project group meetings and a cost analysis
(24) Oderud et al 2015 [42] Persons with Dementia and Their Caregivers Using GPS. 5/
Cohort study, 36 months between in/outside the home with clients/family caregiver dyads (n= 416), 59-90 years old.
Questionnaires, semi-structured interviews, focus groups, discussion groups and home visits.
(25) Olsson et al 2013[43] A passive positioning alarm used by persons with dementia and their spouses – a qualitative intervention study. 1/
Qualitative intervention study 6 months, client/family caregiver dyads (n=10), 55-73 years old.
Interview text transcripts and field notes analysed using qualitative content analysis.
(26) Perilli et al 2013 [44] A computer-aided telephone system to enable five persons with Alzheimer’s disease to make phone calls independently. 4/
Explorative intervention with a non-concurrent multiple baseline design, individual sessions across two groups at a daycentre, n=40, mean age 80 years old.
A social validation assessment: rate the patients’ performance with the technology and with the help of a caregiver. Group 1=28 sessions; Group 2=58 sessions.
(27) Pot et al 2012 [45] A pilot study on the use of tracking technology: Feasibility, acceptability, and benefits for people in early stages of dementia and their informal caregivers. 4/
Quasi-experimental pre-post pilot study -three-month use of GPS at home/outdoor with client /family caregiver dyads (n=56), 63-73 years old.
Impression of the device on a scale ranging from 1 to 10. Several questions on the use of the device with structured response categories ranging from ‘Totally agree’ to Totally disagree’ and agree to disagree, respectively.
(28) Thorpe et al 2016 [46] Pervasive assistive technology for people with dementia: a UCD case. 4/
Controlled usability testing for one week at home with client/family caregiver dyads (n=10), 61-73 years old.
Video recordings, interaction logs, system usability scales, logbooks and interviews.
(29) Topo et al 2007 [47] “I don’t know about the past or the future, but today it’s Friday” – Evaluation of a time aid for people with dementia. 4/
Assessment study for 3 months at home with client/family caregiver dyads (n= 74), 29-99 years old
Findings from the first three months, interviews and home visits
(30) Wu et al 2014 [48] Acceptance of an assistive robot in older adults: a mixed-method study of human–robot interaction over a 1-month period in the Living Lab setting. 5/
Explorative mixed methods study on robot-acceptance in a Living Lab once a week for 4 weeks, n=11, 76-85 years old.
Questionnaire, semi-structured interviews, usability-performance measures, and a focus group
The number/asterisk refer to design/quality according to the Mixed Method Appraisal Tool (MMAT) [18]. Diagnosis is presented in comparative studies. Dyads are equally represented by a client and a caregiver, unless otherwise specified.
