Influence of Music Therapy and Music-Based Interventions on Dementia: A Pilot Study.

According to national dementia plan in many countries, the music implementation into the daily routine as an adjunctive therapy to medication treatment is common. However, the ability of long-term care facilities to implement individualized music therapy (MT) and music-based interventions is not sufficiently taken into account. This pilot study examined the frequency of use and acceptance of MT and technology-based music interventions (TBMI) as well as the influence of high and low usage of both interventions of dementia on behavioral and psychological symptoms (BPSD) at two timepoints. Furthermore, the influence on the combination of MT and TBMI of dementia within the nursing home setting on BPSD with a focus on agitation, apathy, depression, and quality of life at all timepoints was considered. In the present study, data from 30 people with dementia (PwD) aged on average 81 years were analyzed within an eight-week noncontrolled intervention study, including four-week follow-up. Initial outcome data indicated significant decreases at times T2 and T3 in agitation and apathy among PwD with a high usage of MT and TBMI than among those with a low usage. In general, reductions were obtained from all observed BPSD at all timepoints. Significant results were found only for agitation over time. Considering the demonstrated results, a long-term implementation of music within daily routines in nursing homes for PwD should be strived for.

Effects of a long-term smartphone-based self-monitoring intervention in patients with lipid metabolism disorders.

The majority of lipid metabolism disorders can be managed well if patients adhere to their therapies. Self-monitoring can drive adherence with regards to medication intake, physical activities, and nutrition. Technical devices like smartphones can further support its users to achieve health-related goals. In a clinical trial, 100 patients with lipid metabolism disorders were asked to use a smartphone application over a duration of 12 months. Users of this app could set reminders to keep track of their medication and other disease-related variables, such as weight and cholesterol. More than half of all patients that started to use the app continued to use the app over the full 12 months. However, 43% of the patients that were asked to use the app stated that they never started to use the app. The reasons cited were lack of time, health problems, lack of motivation, and technical problems. The number of patients with high medication adherence increased significantly due to the use of the app. Health apps might benefit patients by enabling them to better manage chronic diseases, but successful digital health concepts will need to address efficient onboarding as well as long-term motivation.

Usability and acceptability by a younger and older user group regarding a mobile robot-supported gait rehabilitation system.

The aim of the study was to identify differences regarding usability, acceptability, and barriers of usage of a robot-supported gait rehabilitation system between a younger and older group of patients with gait impairments. A mobile robot-supported gait rehabilitation prototype was tested on a group of geriatric patients aged 60 and above, and on a group of young patients aged 59 and below in a clinical setting during five therapy sessions. The involved therapists received 2 days training with the system and could test it profoundly. Data on usability, acceptability, and barriers to system usage were collected with questionnaires and structured interviews with the patients. The robotic system received overall moderate usability and good acceptability ratings; it was rated as clearly structured, practical, and safe. Analyses identified a few barriers, such as time-intensive setup of the system or tight leg shells, which can be minimized with regular training and system adaptations. Differences between the two user groups could be revealed and will be used for future investigation. This study showed the potential of the mobile robot-supported system for gait rehabilitation, but also pointed out further need for action. Efficacy studies are the next step in the evaluation process.

An eye movement analysis of web usability: Differences between older adults with and without mild cognitive impairment.

Older adults are exposed to computer-based applications daily. However, most websites and applications are not specifically developed for older adults. Studies have shown that older adults with mild cognitive impairment (MCI) behave differently from older adults without MCI in website usage. Eye tracking is a valuable tool to assess users' eye movement behavior in relation to website usability. Understanding the differences in web navigational behavior between older adults with and without MCI would be helpful for developing websites for this target group. This article presents eye tracking data from several tasks while using a cognitive training application. Overall results revealed that older adults with MCI required significantly longer to complete the tasks (U = 116.0, p < 0.05) and were significantly less successful in completing the tasks than those without MCI (U = 101.5, p < 0.05). However, there were no significant differences in eye movement patterns for any of the individual tasks, except one that required participants to use several pathways in order to successfully complete it. These findings demonstrate that eye tracking is an effective method for accessing users' eye movement patterns and the usability of a platform. However, the method was not successful in differentiating eye movement behavior between older adults with and without MCI.

Taking control! Structural and behavioural plasticity in response to game-based inhibition training in older adults.

While previous attempts to train self-control in humans have frequently failed, we set out to train response inhibition using computer-game elements. We trained older adults with a newly developed game-based inhibition training on a tablet for two months and compared them to an active and passive control group. Behavioural effects reflected in shorter stop signal response times that were observed only in the inhibition-training group. This was accompanied by structural growth in cortical thickness of right inferior frontal gyrus (rIFG) triangularis, a brain region that has been associated with response inhibition. The structural plasticity effect was positively associated with time spent on the training-task and predicted the final percentage of successful inhibition trials in the stop task. The data provide evidence for successful trainability of inhibition when game-based training is employed. The results extend our knowledge on game-based cognitive training effects in older age and may foster treatment research in psychiatric diseases related to impulse control.

Evaluating an Online Cognitive Training Platform for Older Adults: User Experience and Implementation Requirements.

Decline of cognitive function is a part of aging. However, intensive cognitive training can improve important cognitive functions, such as attention and working memory. Because existing systems are not older adult-friendly and are usually not based on scientific evidence, an online platform was developed for cognitive training with information and communication features and evaluated in an 8-week field test. In a randomized clinical trial with 80 older adults, findings from log data analysis and questionnaires revealed a good use of the online platform. Communication or assistive features were not used often. Good usability ratings were given to the cognitive exercises. Subjective improvements of cognitive functions due to the training were reported. The current article presents concrete requirements and recommendations for deploying cognitive training software in older adult residential homes.

[Analysis of how elderly internet users react to unexpected situations]. / Analyse des Umgangs älterer Internetnutzer mit unerwarteten Situationen.

BACKGROUND: Although internet usage among older adults is steadily increasing, there is still a digital divide between generations. Younger internet users seem to be more open towards new media. Recent studies showed the negative influence of computer anxiety on internet usage. It is not known how older adults deal with computer and internet issues in their home environment and which problem-solving strategies they apply. AIM: The behavior of elderly people in unexpected situations when using an internet portal was analyzed to establish whether older users can solve the problems without assistance and what individual reactions (e.g. facial expressions and gesticulations) they show during the interaction. MATERIAL AND METHODS: In a clinical trial with 50 older adults aged 60 years and older various typical problems which may occur while using web platforms were simulated and user behavior was analyzed using logging data, videography and with questionnaires to measure the subjective opinion of the study participants. RESULTS: The study participants had severe problems in solving the tasks on their own and many of them could not find a suitable solution at all. Overall, the videography data indicated an increased concentration of the participants during the whole session, which is in contrast to the low levels of perceived mental workload reported by the participants. Regarding task completion, no differences were found between seniors with and without cognitive impairment. CONCLUSION: The results showed the serious difficulties of older adults when dealing with unexpected events while using a web platform. For developers of internet platforms for inexperienced seniors, it seems to be crucial to incorporate a simple integration of all available features within the platform, without including features requiring high multi-tasking skills.

Implementation of a home-based interactive training system for fall prevention: requirements and challenges.

A critical need exists for rehabilitation for improving older adults' physical abilities, especially in the field of fall prevention. Although virtual reality and ambient-assistive technology-based approaches are promising, they are cost intensive and frequently face significant obstacles during the developmental process. The authors of the current article developed a motivational interactive training system for fall prevention and stroke rehabilitation and planned a pilot study to measure its usability, user acceptance, and effect on physical abilities and quality of life. Usability results from a field trial are presented. The purpose of the current article is to describe the technological and organizational problems during the development process and field trial. Recommendations for overcoming these barriers are described. These experiences should be taken into account when planning further field trials with assistive technology and older adults.

Requirements of older adults for a daily use of an internet-based cognitive training platform.

A decline of cognitive abilities is a part of normal human ageing. However, recent research has demonstrated that an enriched environment can have a beneficial impact on cognitive function in old age. Accordingly, mentally and socially active lifestyles are associated with less cognitive decline in old age. Specific interventions such as computerized cognitive training programs for older adults are also known to have a positive effect on the level of cognitive functioning. Therefore, online platforms combining cognitive training with web 2.0 features may yield multiple benefits for older users. However, to date only little research exists on technological acceptance and media use in this age-group especially for cognitively-impaired seniors. Therefore, in order to assess specific preferences and potential barriers of older adults regarding a web-based platform for cognitive training, we conducted qualitative interviews with 12 older adults. Half of the participants were diagnosed with mild cognitive impairment (MCI). Most importantly, our results show that cognitive exercises should incorporate themes and topics older adults are interested in. Additional communication features could serve as ideal methods for increasing user motivation. Furthermore, we derived eight critical requirements of older adults concerning daily use of a web-based cognitive training platform. Implications for future research and development are discussed.

Comparison of four different mobile devices for measuring heart rate and ECG with respect to aspects of usability and acceptance by older people.

In the area of product design and usability, most products are developed for the mass-market by technically oriented designers and developers for use by persons who themselves are also technically adept by today's standards. The demands of older people are commonly not given sufficient consideration within the early developmental process. In the present study, the usability and acceptability of four different devices meant to be worn for the measurement of heart rate or ECG were analyzed on the basis of qualitative subjective user ratings and structured interviews of twelve older participants. The data suggest that there was a relatively high acceptance concerning these belts by older adults but none of the four harnesses was completely usable. Especially problematic to the point of limiting satisfaction among older subjects were problems encountered while adjusting the length of the belt and/or closing the locking mechanism. The two devices intended for dedicated heart rate recording yielded the highest user ratings for design, and were clearly preferred for extended wearing time. Yet for all the devices participants identified several important deficiencies in their design, as well as suggestions for improvement. We conclude that the creation of an acceptable monitoring device for older persons requires designers and developers to consider the special demands and abilities of the target group.