Cognitive Digital Intervention for Older Patients with Parkinson's Disease during COVID-19: A Mixed-Method Pilot Study.

Mild cognitive impairment is frequent among people with Parkinson's disease. Cognitive training seems effective for cognitive status and for mitigating anxiety and depression. With the COVID-19 outbreak, such therapeutic interventions were delivered online. This longitudinal mixed-method study was aimed at evaluating the effectiveness of an online cognitive treatment, carried out during COVID times and based on Parkinson's-Adapted Cognitive Stimulation Therapy, on cognitive domains and mood of 18 older people with Parkinson's disease. After screening, the cognitive status and mood were assessed three times by Addenbrooke's Cognitive Examination-Revised scale and the Geriatric Depression Scale-Short Form. At the follow-up, patients were also interviewed for understanding their experience with the technology. Such treatment was effective on the participants' cognitive functions, but not on their mood. Despite some initial problems with the technology, the online intervention was experienced as a way of not being 'left behind', staying in contact with others, and being safe during the lockdown. This suggests that online cognitive treatment can be adopted to integrate face-to-face interventions by increasing their efficacy, accessibility, and long-term outcomes. Suggestions for future research are given.

User Perceptions and Needs Analysis of a Virtual Coach for Active and Healthy Ageing-An International Qualitative Study.

Virtual coaching systems show great potential for meeting the challenges of demographic change. However, the proportion of older users in the field of digital technologies is far behind that of younger people. As part of the e-VITA project, semi-structured interviews were conducted in Japan, France, Italy and Germany with 58 people aged 65 and over, and the content was analyzed with the aim of obtaining information about how older adults organize their everyday lives, also with regard to the COVID-19 pandemic, how they deal with their health, what role digital technologies play in the lives of the interviewees and why they oppose progressive digitization. Second, the survey asked why the older adults oppose a virtual coach, which is to be developed in the e-VITA project to support older adults in healthy and active aging, and what barriers they see in a possible implementation. It was found that older respondents lead active, varied lives and that the COVID-19 pandemic contributed to the increased use of digital solutions. In addition, respondents were consciously addressing their own health. With regard to a virtual coach, barriers were seen primarily in the area of data security and sharing. It can be concluded from this that heterogeneity among older user groups should be taken into account when developing virtual coaches. In addition, aspects of data security and data protection should be presented in a clearly understandable and transparent manner.

Toward the Integration of Technology-Based Interventions in the Care Pathway for People with Dementia: A Cross-National Study.

BACKGROUND: The integration of technology-based interventions into health and care provision in our aging society is still a challenge especially in the care pathway for people with dementia. OBJECTIVE: The study aims to: (1) identify which socio-demographic characteristics are independently associated with the use of the embodied conversational agent among subjects with dementia, (2) uncover patient cluster profiles based on these characteristics, and (3) discuss technology-based interventions challenges. METHODS: A virtual agent was used for four weeks by 55 persons with dementia living in their home environment. RESULTS: Participants evaluated the agent as easy-to-use and quickly learnable. They felt confident while using the system and expressed the willingness to use it frequently. Moreover, 21/55 of the patients perceived the virtual agent as a friend and assistant who they could feel close to and who would remind them of important things. CONCLUSIONS: Technology-based interventions require a significant effort, such as personalized features and patient-centered care pathways, to be effective. Therefore, this study enriches the open discussion on how such virtual agents must be evidence-based related and designed by multidisciplinary teams, following patient-centered care as well as user-centered design approaches.

User Requirements Analysis of an Embodied Conversational Agent for Coaching Older Adults to Choose Active and Healthy Ageing Behaviors during the Transition to Retirement: A Cross-National User Centered Design Study.

BACKGROUND: Retirement is recognized as a factor influencing the ageing process. Today, virtual health coaching systems can play a pivotal role in supporting older adults' active and healthy ageing. This study wants to answer two research questions: (1) What are the user requirements of a virtual coach (VC) based on an Embodied Conversational Agent (ECA) for motivating older adults in transition to retirement to adopt a healthy lifestyle? (2) How could a VC address the active and healthy ageing dimensions, even during COVID-19 times? METHODS: Two-wave focus-groups with 60 end-users aged 55 and over and 27 follow-up telephone interviews were carried out in Austria, Italy and the Netherlands in 2019-2020. Qualitative data were analysed by way of framework analysis. RESULTS: End-users suggest the VC should motivate older workers and retirees to practice physical activity, maintain social contacts and emotional well-being. The ECA should be reactive, customizable, expressive, sympathetic, not directive nor patronizing, with a pleasant and motivating language. The COVID-19 outbreak increased the users' need for functions boosting community relationships and promoting emotional well-being. CONCLUSIONS: the VC can address the active and healthy ageing paradigm by increasing the chances of doing low-cost healthy activities at any time and in any place.