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Advances in technology have made continuous/remote monitoring of digital health data possible, which can enable the early detection and treatment of age-related cognitive and health declines. Using Arksey and O'Malley's methodology, this scoping review evaluated potential barriers to the collection of mobile and wearable device data to monitor health and cognitive status in older adults with and without mild cognitive impairment (MCI). Selected articles were US based and focused on experienced or perceived barriers to the collection of mobile and wearable device data by adults 55 years of age or older. Fourteen articles met the study's inclusion criteria. Identified themes included barriers related to usability, users' prior experiences with health technologies, first and second level digital divide, aesthetics, comfort, adherence, and attitudinal barriers. Addressing these barriers will be crucial for effective digital data-collection among older adults to achieve goals of improving quality of life and reducing care costs.
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PURPOSE: Age associated cognitive impairments (CIs) result in difficulties with a wide range of daily activities. As the older adult population increases, so does the importance of understanding and supporting the needs and disabilities of those with CIs. The Enhancing Neurocognitive Health, Abilities, Networks, and Community Engagement (ENHANCE) Centre was established with a focus on developing assistive technology to support the socialisation, transportation, and prospective memory needs of older adults with CIs. The extent to which relevant literature in these domains existed was unknown. MATERIALS AND METHODS: A scoping review identified existing research meeting the following criteria: participants aged 50+ years classified as having a CI due to mild cognitive impairment (MCI), traumatic brain injury (TBI), or stroke; and a focus on technology-based support for socialisation, transportation, and/or prospective memory activities. RESULTS: Qualitative and quantitative data are reported from relevant studies. In addition to few studies available, it was common for studies to include 20 or fewer participants. Most assessed technology interactions at one time and few studies examined longitudinal use and benefit. While each paper examined one aspect of user-centred design, no technologies were reported that underwent all stages of the user-centred design process, from needs assessment to iterative design and usability testing, to efficacy trial. CONCLUSIONS: Gaps highlight notable directions for future research and the important role ENHANCE can play in addressing the needs and disabilities of older adults with CIs. IMPLICATIONS FOR REHABILITATIONAlthough older adults with common cognitive impairments often experience challenges in the domains of socialisation, transportation, and/or prospective memory, few studies exist that examine assistive technology solutions in these domains.Additional research with more robust designs and larger sample sizes is needed to discover and assess assistive technology solutions for the needs and disabilities of older adults with mild cognitive impairment (MCI), traumatic brain injury (TBI), and post-stroke cognitive impairment (PSCI).The ENHANCE Centre will employ a systematic process of needs assessments, user testing, and efficacy tests to develop novel technology solutions to support the needs of older adults with common cognitive impairment.
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Interventions designed to preserve cognition have become increasingly popular as our population ages. In exploring intervention effectiveness, however, researchers have often overlooked a potentially important factor: willingness to engage. Recent findings from Harrell, Kmetz, Boot (2019) showed that perceived cognitive deficits and perceived training efficacy were significant predictors of willingness to engage in a brain training intervention designed to preserve cognition. However, they did not explore another potentially important factor: anticipated intervention enjoyment. In the current study, younger, middle-aged, and older adults (N = 169) completed surveys that assessed their willingness to engage in different types of training (aerobic exercise, brain, meditation) to improve cognition and the extent that factors such as health, perceived cognitive deficits, belief in training efficacy, and personality contributed to willingness to engage. Participants reported being least willing to engage in meditation training and meditation training was rated by participants as the least likely to improve cognition. Anticipated training enjoyment was the overriding factor that predicted willingness. These findings provide additional insights into why, and for how long, individuals may be willing to engage in training to prolong independence and have implications for understanding intervention adoption and adherence.
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Research suggests that metacognitive monitoring ability does not decline with age. For example, judgments-of-learning (JOL) accuracy is roughly equivalent between younger and older adults. But few studies have asked whether younger and older adults' metacognitive ability varies across different types of memory processes (e.g., for items vs. pairs). The current study tested the relationship between memory and post-decision confidence ratings at the trial level on item (individual words) and associative (word pairs) memory recognition tests. As predicted, younger and older adults had similar metacognitive efficiency, when using meta-d'/d', a measure derived from Signal Detection Theory, despite a significant age effect favoring younger adults on memory performance. This result is consistent with previous work showing age-equivalent metacognitive efficiency in the memory domain. We also found that metacognitive efficiency was higher for associative memory than for item memory across age groups, even though associative and item recognition memory (d') were statistically equivalent. Higher accuracy on post-test decision confidence ratings for associative recognition relative to item recognition on resolution accuracy itself (meta-d') and when corrected for performance differences (meta-d'/d') are novel findings. Implications for associative metacognition are discussed.
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OBJECTIVES: If older adults (OAs) are focused on emotionally meaningful goals in late life, they should demonstrate memory biases for positive stimuli over neutral and negative stimuli and, arguably, these cognitive biases should be reflected in their metacognitive judgments of learning (JOLs). To address this question, we examined age differences in metacognitive monitoring of emotionally valenced stimuli. METHOD: Younger adults (YAs) and OAs (N = 85) studied positive, neutral, and negative words and made immediate JOLs, followed by a 2-alternative forced choice (2AFC) recognition memory task. RESULTS: Analyses of JOLs revealed evidence for a positivity effect in metacognitive judgments for OAs and an emotional salience effect in YAs. YAs recognized more words than OAs, but valence did not affect number of words recognized and did not moderate age differences in memory (p = .055). Memory monitoring as measured by resolution accuracy was equivalent in YAs and OAs. Positive affect was higher and negative affect was lower in OAs relative to YAs, lending additional evidence to the emergence of a positive orientation in older adulthood. DISCUSSION: These results provide intriguing and novel support for the positivity effect in the domain of metacognitive aging, adding to what is known in memory, attention, and emotion domains. Our findings fall squarely within socioemotional and metacognitive theoretical frameworks from which they were derived. We discuss research directions that might identify mechanisms by which affective states and stimuli interact to produce metacognitive outcomes in late life.
