CoChat
Sign Up
Cited by 169Technology Use by Older AdultsAssistive Technology in Communication and MobilityDementia and Cognitive Impairment Research

Acceptance and use of innovative assistive technologies among people with cognitive impairment and their caregivers: a systematic review

Open access
Thordardottir, Björg, Malmgren Fänge, Agneta, Lethin, Connie, Rodriguez Gatta, Danae, Chiatti, Carlos·2019·BioMed Research International
DOI 10.1155/2019/9196729PMC PMC6431399
Open this paper in CoChat — free accountOpen PDF

Abstract

Cognitive impairments (CI), associated with the consequences of Alzheimer’s disease and other dementias, are increasingly prevalent among older adults, leading to deterioration in self-care, mobility, and interpersonal relationships among them. Innovative Assistive Technologies (IAT) such as electronic reminders and surveillance systems are considered as increasingly important tools to facilitate independence among this population and their caregivers. The aim of this study is to synthesise knowledge on facilitators and barriers related to acceptance of and use of IAT among people with CI and their caregivers. This systematic review includes original papers with quantitative, qualitative, or mixed methods design. Relevant peer-reviewed articles published in English between 2007 and 2017 were retrieved in the following databases: CINAHL; PubMed; Inspec; and PsycINFO. The Mixed Method Appraisal Tool (MMAT) was used for quality assessment. We retrieved thirty studies, including in total 1655 participants from Europe, USA/Canada, Australia, and Asia, enrolled in their homes, care-residences, day-care centres, or Living Labs. Two-thirds of the studies tested technologies integrating home sensors and wearable devices for care and monitoring CI symptoms. Main facilitators for acceptance and adherence to IAT were familiarity with and motivation to use technologies, immediate perception of effectiveness (e.g., increase in safety perceptions), and low technical demands. Barriers identified included older age, low maturity of the IAT, little experience with technologies in general, lack of personalization, and support. More than 2/3 of the studies met 80% of the quality criteria of the MMAT. Low acceptance and use of IAT both independently and with caregivers remains a significant concern. More knowledge on facilitators and barriers to use of IAT among clients of health care and social services is crucial for the successful implementation of innovative programmes aiming to leverage innovative technologies for the independence of older people with CI.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review synthesizes 30 studies with 1,655 participants on acceptance and use of innovative assistive technologies (IAT) among older people with cognitive impairment and their caregivers. It finds that familiarity, motivation, perceived effectiveness, and low technical demands facilitate acceptance, while adherence remains limited and is hindered by older age, inexperience, immature technology, and lack of personalization or support.

Key findings

  • Across 30 included studies (1,655 participants), 12 studies reported IAT that was both accepted and used, 11 reported acceptance but poor adherence, and 7 reported neither acceptance nor adherence.
  • Main facilitators for acceptance and adherence were ease of use, familiarity with technology, improvement of care, low technical demands, personalized fit to daily routines, enjoyment, new interactions, and feelings of safety.
  • Main barriers included older age, lack of experience with technology in general, need for further technology development, more learning time, lack of clarity/feedback, lack of personalization, and insufficient support.
  • Most IAT were 3rd generation (n=16), followed by 2nd generation (n=5), 1st generation (n=5), and 4th generation/social robots (n=4); the largest proportion of studies showing acceptance and adherence targeted 3rd generation IAT, while 2nd generation was less accepted, followed by 1st and 4th generation.

Methods

  • Systematic review of peer-reviewed primary studies with quantitative, qualitative, or mixed methods designs, published in English between 2007 and 2017 and retrieved from CINAHL, PubMed, Inspec, and PsycINFO.
  • Inclusion criteria used a PICO framework: participants aged 65+ with any form of cognitive impairment and/or their informal/formal caregivers; interventions using IAT exclusively or predominantly; outcomes addressing acceptance, adoption, attitude, perception, or use.
  • From 2,538 initial titles (452 duplicates), 2,086 titles were screened, 88 abstracts assessed, 36 full texts reviewed, and 30 papers included; data were synthesized in a Summary of Findings table and quality was assessed with the Mixed Methods Appraisal Tool (MMAT), with disagreements on 4 papers resolved by discussion.

Limitations

  • The paper states that the search strategy was prepared with a university librarian, that abstract revision was demanding due to the study’s multidisciplinary nature, and that included studies and journals were highly diverse; MMAT assessment further highlighted heterogeneity.
  • The paper states that results are based to a minimal extent on randomized controlled trials, which are difficult in this population due to drop-out, making data on technology acceptance and adherence difficult to retrieve.
  • Evident from the text: most findings relate to the individual user level, many reviewed studies lacked follow-up or had short time-spans, and the only included RCT received no MMAT star, limiting conclusions about mid- and long-term adherence.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1155/2019/9196729

Cites

51 of 51 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 84 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    In eleven studies, the IAT was accepted but not used in the following implementation period, resulting in poor adherence.

    “In eleven studies, the IAT was accepted but not used in the following implementation period, therefore resulting in poor adherence [24, 29, 34–38, 41, 44, 46, 47].”
    Quote in the paperSubstantial claim0 of 10 sources checked
    • cites [24] Granata C. Pino M. Legouverneur G. Vidal J.-S. Bidaud P. Rigaud A.-S. Robot services for elderly with cognitive impairment: testing usability of graphical user interfaces Technology and Health Care 2013 21 217 231 2-s2.0-84884362358 23792795 source

      Not checked in the free run.

    • cites [29] Kerkhof Y. J. Rabiee F. Willems C. G. Experiences of using a memory aid to structure and support daily activities in a small-scale group accommodation for people with dementia Dementia 2015 14 5 633 649 2-s2.0-84942933321 10.1177/1471301213504210 24339118 source

      Not checked in the free run.

    • cites [34] Lim F. S. Wallace T. Luszcz M. A. Reynolds K. J. Usability of tablet computers by people with early-stage dementia Gerontology 2013 59 2 174 182 2-s2.0-84874771331 10.1159/000343986 23257664 source

      Not checked in the free run.

    • cites [35] Lindqvist E. Nygård L. Borell L. Significant junctures on the way towards becoming a user of assistive technology in Alzheimer's disease Scandinavian Journal of Occupational Therapy 2013 20 5 386 396 2-s2.0-84883313772 10.3109/11038128.2013.766761 23394183 source

      Not checked in the free run.

    • cites [36] Lindqvist E. Larsson T. J. Borell L. Experienced usability of assistive technology for cognitive support with respect to user goals NeuroRehabilitation 2015 36 1 135 149 2-s2.0-84922948433 10.3233/NRE-141201 25547777 source

      Not checked in the free run.

    • cites [37] Magnusson L. Sandman L. Rosén K. G. Hanson E. Extended safety and support systems for people with dementia living at home Journal of Assistive Technologies 2014 8 4 188 206 2-s2.0-84926457193 10.1108/JAT-10-2014-0021 source

      Not checked in the free run.

    • cites [38] Mitseva A. Peterson C. B. Karamberi C. 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 Current Gerontology and Geriatrics Research 2012 2012 19 401705 2-s2.0-84859723823 PMC3318209 22536230 source

      Not checked in the free run.

    • cites [41] Nijhof N. van Gemert-Pijnen J. E. W. C. Burns C. M. Seydel E. R. A personal assistant for dementia to stay at home safe at reduced cost Gerontechnology 2013 11 469 479 2-s2.0-84876453799

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [44] Perilli V. Lancioni G. E. Laporta D. A computer-aided telephone system to enable five persons with Alzheimer's disease to make phone calls independently Research in Developmental Disabilities 2013 34 6 1991 1997 2-s2.0-84876301914 10.1016/j.ridd.2013.03.016 23584179 source

      Not checked in the free run.

    • cites [46] Thorpe J. R. Rønn-Andersen K. V. H. Bień P. Özkil A. G. Forchhammer B. H. Maier A. M. Pervasive assistive technology for people with dementia: a UCD case Healthcare Technology Letters 2016 3 4 297 302 10.1049/htl.2016.0057 2-s2.0-85032032497 28008366 PMC5168821 source

      Not checked in the free run.

  • Findingnone given

    More than two-thirds of the included studies met 80% of the quality criteria of the MMAT.

    “More than 2/3 of the studies met 80% of the quality criteria of the MMAT.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Ten papers were rated as high-quality studies meeting all five MMAT quality criteria.

    “Ten papers were rated as high-quality studies (∗∗∗∗∗), meeting all five quality criteria.”
    Quote in the paperNot a substantial claim
  • Findingown data

    A total of 1655 individuals participated in the 30 included studies.

    “A total of 1655 individuals participated in the 30 included studies (Table 1).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Two-thirds of the 30 included studies tested technologies integrating home sensors and wearable devices for care and monitoring CI symptoms.

    “Two-thirds of the studies tested technologies integrating home sensors and wearable devices for care and monitoring CI symptoms.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 40
  • Classified as probably not a substantial claim. 21
  • The quote only partly states this claim. 1

  • May combine two claims.

    Findingcitation

    Four studies addressed social robots and could not be categorized according to Blackman et al., while all other studies could be classified into 1st, 2nd, or 3rd generation; the four remaining studies were categorized as 4th generation.

    “Four studies addressed the use of social robots and could thus not be categorized according to Blackman et al. (7), while the IAT in all other studies could be classified into 1st, 2nd, or 3rd generation. The IAT included in the four remaining studies thus were categorized as 4th generation.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Eight studies had a qualitative design, while 22 applied a quantitative or mixed methods design: one randomized controlled trial, three nonrandomized trials, eleven observational studies using quantitative measures only, and seven studies using a mixed methods design.

    “Eight studies had a qualitative design, while 22 applied a quantitative or mixed methods design: one randomized controlled trial, three nonrandomized trial, eleven observational studies using quantitative measures only, and seven studies using a mixed methods design.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Barriers to acceptance and adherence to IAT included older age, low maturity of the IAT, little experience with technologies in general, lack of personalization, and support.

    “Barriers identified included older age, low maturity of the IAT, little experience with technologies in general, lack of personalization, and support.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Eleven papers were rated with four stars, meeting 80% of the quality criteria; three articles met 60%, two met 40%, and three studies met only 20% of the quality criteria.

    “Eleven papers were rated with four stars (∗∗∗∗), meeting 80% of the quality criteria; three articles met 60% of the criteria (∗∗∗), two met 40% (∗∗), and three studies met only 20% of the quality criteria (∗).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Out of the 30 included studies, 20 had a dyads-based approach involving people with cognitive impairment and informal or formal caregivers, while the remaining 10 included either people with cognitive impairment (6), formal caregivers (3), or informal caregivers (1) only.

    “Out of the 30 studies included, n= 20 had a dyads-based approach, i.e., involved people with CI and informal or formal caregivers, while the remaining 10 studies included either people with CI (6), formal (3), or informal caregivers (1) only”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The studies were conducted in people's own home (20), formal residence (8), day-care centre (1), and Living Lab (1).

    “The studies were conducted in people's own home (20), formal residence (8), day-care centre (1), and Living Lab (1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    The study that received no star was the only randomized controlled trial included.

    “This study was the only randomized controlled trial (RCT) included.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    One article received no star, meeting none of the quality criteria.

    “One article received no star, i.e., met none of the quality criteria.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The participants were people diagnosed with mild cognitive impairment, or advanced or severe dementia or Alzheimer Disease, and their formal and/or informal caregivers.

    “They were people diagnosed with mild cognitive impairment (MCI), or advanced or severe dementia or Alzheimer Disease (AD), their formal and/or their informal caregivers.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Main facilitators for acceptance and adherence to IAT were familiarity with and motivation to use technologies, immediate perception of effectiveness (e.g., increase in safety perceptions), and low technical demands.

    “Main facilitators for acceptance and adherence to IAT were familiarity with and motivation to use technologies, immediate perception of effectiveness (e.g., increase in safety perceptions), and low technical demands.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The included studies were performed in Europe (22), USA/Canada (5), Australia (2), and Asia (1).

    “The included studies were performed in Europe (22), USA/Canada (5), Australia (2), and Asia (1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    How and when the IAT was introduced, as well as the provision of support before and during the implementation, were highly relevant for acceptance and adherence of the IAT.

    “Moreover, how and when the IAT was introduced as well as the provision of support before and during the implementation were highly relevant for acceptance and adherence of the IAT”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Enjoyment, possibilities for new interactions, and feelings of safety also motivated the participants to use IAT.

    “In addition, enjoyment, possibilities for new interactions, and feelings of safety also motivated the participants to use IAT.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The main factors hindering adherence to IAT were the participants' lack of experience of technology in general and the age of the person using the technology.

    “the main factors hindering adherence to IAT were the participants' lack of experience of technology in general, and the age of the person using the technology [24].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] Granata C. Pino M. Legouverneur G. Vidal J.-S. Bidaud P. Rigaud A.-S. Robot services for elderly with cognitive impairment: testing usability of graphical user interfaces Technology and Health Care 2013 21 217 231 2-s2.0-84884362358 23792795 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Participants had to be motivated and encouraged to make adjustments to everyday routines, and to trust their own capacity to use the technology.

    “The participants had to be motivated and encouraged to make adjustments to everyday routines, and to trust their own capacity to use the technology [35].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Lindqvist E. Nygård L. Borell L. Significant junctures on the way towards becoming a user of assistive technology in Alzheimer's disease Scandinavian Journal of Occupational Therapy 2013 20 5 386 396 2-s2.0-84883313772 10.3109/11038128.2013.766761 23394183 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Other contextual factors potentially influencing the use of IAT include mobile network issues and internet-access.

    “Other contextual factors potentially influencing the use of IAT include mobile network issues and internet-access (see [36] for details).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] Lindqvist E. Larsson T. J. Borell L. Experienced usability of assistive technology for cognitive support with respect to user goals NeuroRehabilitation 2015 36 1 135 149 2-s2.0-84922948433 10.3233/NRE-141201 25547777

      Not checked in the free run.

  • The quote only partly states this claim.

    Findingcitation

    When IAT failed to correspond with the participants' identity, needs, or expectations, their interest in using the device faded.

    “When IAT failed to correspond with the participants' identity and needs, their interest in using the device faded [28].”
    • Also stated in: § 3.3. Acceptance and Adherence to IAT Use · plain
      “When IAT does not correspond with the participants' expectations, their interest in using it faded [28].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [28] Karlsson E. Axelsson K. Zingmark K. Sävenstedt S. The challenge of coming to terms with the use of a new digital assistive device: a case study of two persons with mild dementia The Open Nursing Journal 2011 5 1 102 110 10.2174/18744346011050100102 22135718 PMC3227864

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Lack of experience with technology and older age affected time-use and increased the occurrence of errors significantly.

    “This affected time-use and increased the occurrence of errors significantly [24, 29].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [24] Granata C. Pino M. Legouverneur G. Vidal J.-S. Bidaud P. Rigaud A.-S. Robot services for elderly with cognitive impairment: testing usability of graphical user interfaces Technology and Health Care 2013 21 217 231 2-s2.0-84884362358 23792795 source

      Not checked in the free run.

    • cites [29] Kerkhof Y. J. Rabiee F. Willems C. G. Experiences of using a memory aid to structure and support daily activities in a small-scale group accommodation for people with dementia Dementia 2015 14 5 633 649 2-s2.0-84942933321 10.1177/1471301213504210 24339118 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Caregivers anticipated a reduction of the burden of care when IAT was implemented; however, stress increased when this was not the case.

    “The caregivers anticipated a reduction of the burden of care when IAT was implemented; however, stress increased when this was not the case [38].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Mitseva A. Peterson C. B. Karamberi C. 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 Current Gerontology and Geriatrics Research 2012 2012 19 401705 2-s2.0-84859723823 PMC3318209 22536230 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    While some informal caregivers were less anxious after accepting to use IAT, others reported a decrease in their quality of life.

    “While some informal caregivers were less anxious after accepting to use IAT, others reported a decrease in their quality of life [38].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Mitseva A. Peterson C. B. Karamberi C. 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 Current Gerontology and Geriatrics Research 2012 2012 19 401705 2-s2.0-84859723823 PMC3318209 22536230 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Participants ascribed lack of acceptance and use to their own lack of skills, fear of mistakes or being replaced, staff irritation, or fear of being replaced or due to an intrusive design.

    “The study participants explained that this lack of acceptance and use was to be ascribed to their own lack of skills, fear of mistakes or being replaced, staff irritation, or fear of being replaced or due to an intrusive design, e.g., a big watch on a frail arm [40].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] Nijhof N. van Gemert-Pijnen J. E. W. C. de Jong G. E. N. Ankoné J. W. Seydel E. R. 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 Technology and Disability 2012 24 103 115 2-s2.0-84862579642

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The majority of the IAT included in the studies could be categorized as 3rd generation IAT (n=16), while five studies related to 2nd generation IAT, and five studies included 1st generation IAT.

    “In relation to the typology of IAT evaluated, we found that the majority of the IAT included in the studies could be categorized as 3rd generation IAT (n=16), while five studies related to 2nd generation IAT, and five studies included 1st generation IAT.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Several barriers to robot-acceptance were identified, including older people's uneasiness with IAT, feeling of stigmatization, and ethical and societal issues associated with robot use.

    “More specifically, several barriers to robot-acceptance were identified, including older people's uneasiness with IAT, feeling of stigmatization, and ethical and societal issues associated with robot use [48].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [48] Wu Y.-H. Wrobel J. Cornuet M. Kerhervé H. Damnée S. Rrigaud A.-S. 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 Clinical Interventions in Aging 2014 9 801 811 10.2147/cia.s56435 2-s2.0-84900414639 24855349 PMC4020879

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Other issues affecting adherence were the need for further development of the technology and that more time was necessary for users to learn how to use IAT.

    “Other issues affecting adherence were the needs for further development of the technology [29] and that more time was necessary for the users to learn how to use IAT in order to make adherence successful [29, 34, 44, 46].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [29] Kerkhof Y. J. Rabiee F. Willems C. G. Experiences of using a memory aid to structure and support daily activities in a small-scale group accommodation for people with dementia Dementia 2015 14 5 633 649 2-s2.0-84942933321 10.1177/1471301213504210 24339118 source

      Not checked in the free run.

    • cites [34] Lim F. S. Wallace T. Luszcz M. A. Reynolds K. J. Usability of tablet computers by people with early-stage dementia Gerontology 2013 59 2 174 182 2-s2.0-84874771331 10.1159/000343986 23257664 source

      Not checked in the free run.

    • cites [44] Perilli V. Lancioni G. E. Laporta D. A computer-aided telephone system to enable five persons with Alzheimer's disease to make phone calls independently Research in Developmental Disabilities 2013 34 6 1991 1997 2-s2.0-84876301914 10.1016/j.ridd.2013.03.016 23584179 source

      Not checked in the free run.

    • cites [46] Thorpe J. R. Rønn-Andersen K. V. H. Bień P. Özkil A. G. Forchhammer B. H. Maier A. M. Pervasive assistive technology for people with dementia: a UCD case Healthcare Technology Letters 2016 3 4 297 302 10.1049/htl.2016.0057 2-s2.0-85032032497 28008366 PMC5168821 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The main facilitators identified were ease of use, familiarity with technology, improvement of care, low technical demands, and personalized fit of IAT to daily routines.

    “The main facilitators identified were ease of use, familiarity with technology, improvement of care, low technical demands, and personalized fit of IAT to daily routines.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Some studies indicated the need for transparent and easy-to-understand information feedback for increasing the perceived efficiency of the technology and the need for a personalized fit between the technology and preferences of the participants.

    “Some studies [46, 47] also indicated the need for transparent and easy-to-understand information feedback for increasing the perceived efficiency of the technology and the need for a personalized fit between the technology and preferences of the participants [36].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [46] Thorpe J. R. Rønn-Andersen K. V. H. Bień P. Özkil A. G. Forchhammer B. H. Maier A. M. Pervasive assistive technology for people with dementia: a UCD case Healthcare Technology Letters 2016 3 4 297 302 10.1049/htl.2016.0057 2-s2.0-85032032497 28008366 PMC5168821 source

      Not checked in the free run.

    • cites [47] Topo P. Saarikalle K. Begley E. Cahill S. Holthe T. Macijauskiene J. ‘I don't know about the past or the future, but today it's Friday’ - evaluation of a time aid for people with dementia Technology and Disability 2007 19 121 131 2-s2.0-34247474927

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [36] Lindqvist E. Larsson T. J. Borell L. Experienced usability of assistive technology for cognitive support with respect to user goals NeuroRehabilitation 2015 36 1 135 149 2-s2.0-84922948433 10.3233/NRE-141201 25547777 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Users had generally low interest to use the robot, as well as negative attitudes toward and negative images for this type of device.

    “When it comes to use of robots in health care, our results show that the users had generally low interest to use the robot, as well as negative attitudes toward and negative images for this type of devices [24, 26, 48].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [24] Granata C. Pino M. Legouverneur G. Vidal J.-S. Bidaud P. Rigaud A.-S. Robot services for elderly with cognitive impairment: testing usability of graphical user interfaces Technology and Health Care 2013 21 217 231 2-s2.0-84884362358 23792795 source

      Not checked in the free run.

    • cites [26] Hebesberger D. Koertner T. Gisinger C. Pripfl J. A long-term autonomous robot at a care hospital: a mixed methods study on social acceptance and experiences of staff and older adults International Journal of Social Robotics 2017 9 3 417 429 10.1007/s12369-016-0391-6 2-s2.0-85021651185 source

      Not checked in the free run.

    • cites [48] Wu Y.-H. Wrobel J. Cornuet M. Kerhervé H. Damnée S. Rrigaud A.-S. 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 Clinical Interventions in Aging 2014 9 801 811 10.2147/cia.s56435 2-s2.0-84900414639 24855349 PMC4020879 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The largest proportion of studies demonstrating acceptance and adherence of the IAT targeted 3rd generation IAT, while IAT belonging to the 2nd generation were less accepted followed by the 1st and 4th generation of IAT.

    “The largest proportion of studies demonstrating acceptance and adherence of the IAT targeted 3rd generation IAT, while IAT belonging to the 2nd generation were less accepted followed by the 1st and 4th generation of IAT (see Table 3).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Users did not perceive the robot as useful in their daily life, although they found it easy to use, amusing, and not threatening.

    “The users simply did not perceive it as useful in their daily life, although they found it easy to use, amusing, and not threatening.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    The review reflects the fast development of the technological field, as the older study (2014) evaluating robot use was conducted in a Living Lab setting, while the newest (2017) was performed as action research for three years in older people's own home.

    “Interestingly, our review reflects the fast development of this technological field, as the older study, published 2014 [48], evaluating the use of robot was conducted in a Living Lab settings, while the newest, published in 2017 [31], was performed as action research for three years in older people's own home.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [48] Wu Y.-H. Wrobel J. Cornuet M. Kerhervé H. Damnée S. Rrigaud A.-S. 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 Clinical Interventions in Aging 2014 9 801 811 10.2147/cia.s56435 2-s2.0-84900414639 24855349 PMC4020879

      Not checked in the free run.

    • cites [31] Khosla R. Nguyen K. Chu M.-T. Human robot engagement and acceptability in residential aged care International Journal of Human-Computer Interaction 2017 33 510 522 10.1080/10447318.2016.1275435 2-s2.0-85011277079

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    There is broad diversity among the studies included and among the journals they were published in.

    “We found a broad diversity among the studies included as well as among the journals they were published in.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    One author independently performed the literature search and then, in parallel with the first author, reviewed the titles for eligibility.

    “One of the authors (DR) independently performed the literature search and then, in parallel with the first author (BT), reviewed the titles for eligibility.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Two authors evaluated each paper separately for quality, and disagreements were solved by discussion until consensus.

    “In order to carry out an objective assessment of the study quality, two authors (BT and AMF) evaluated each paper separately. Disagreements between the authors (n=4 papers) were solved by means of discussions between the two until they reached consensus.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    A recent review shows that a wide range of IAT is already available for people with mild cognitive impairment and dementia, but that studies in this area remain contradictory.

    “A recent review focusing on usability and acceptability of technology among people with mild cognitive impairment and dementia shows that a wide range of IAT is already available for this target group, e.g., digital calendars and Global Positioning System (GPS) [15], but that studies in this area remain contradictory.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [15] Holthe T. Halvorsrud L. Karterud D. Hoel K.-A. Lund A. Usability and acceptability of technology for community-dwelling older adults with mild cognitive impairment and dementia: a systematic literature review Clinical Interventions in Aging 2018 13 863 886 10.2147/CIA.S154717 2-s2.0-85047820091 29765211 PMC5942395

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Positive experiences of technology are prerequisites for the acceptance of any new device in general, and this may apply especially in the case of older people.

    “According to the literature, positive experiences of technology are prerequisites for the acceptance of any new device in general, and this may apply especially in the case of older people [9–11].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [9] Alvseike H. Bronnick K. Feasibility of the iPad as a hub for smart house technology in the elderly; effects of cognition, self-efficacy, and technology experience Journal of Multidisciplinary Healthcare 2012 5 299 306 2-s2.0-84874782957 23226024 PMC3514061 source

      Not checked in the free run.

    • cites [10] Parker S. J. Jessel S. Richardson J. E. Reid M. C. Older adults are mobile too!Identifying the barriers and facilitators to older adults' use of mHealth for pain management BMC Geriatrics 2013 13 p. 43 2-s2.0-84877070644 PMC3673892 23647949 source

      Not checked in the free run.

    • cites [11] Kobayashi M. Hiyama A. Miura T. Asakawa C. Hirose M. Ifukube T. Elderly user evaluation of mobile touchscreen interactions Human-computer interaction–INTERACT 2011

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The quality of the included papers was evaluated using the Mixed Methods Appraisal Tool, revised version.

    “The quality of the included papers was evaluated using the Mixed Methods Appraisal Tool (MMAT), revised version [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Hong Q. N. Pluye P. Fàbregues S. The mixed methods appraisal tool (MMAT) version 2018 for information professionals and researchers Education for Information 2018 34 4 285 291 10.3233/EFI-180221

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Two authors separately screened titles of the remaining 2086 articles, and their results were cross-checked by a third author to finalize a list of eligible articles.

    “DR and BT separately performed a screening process based on the titles of the remaining 2086 articles. Their results were cross-checked by a third author (CC) in order to finalize a list of eligible articles to include.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Premisecitation

    Novel IAT in care could play a key role in supporting independent living of older people and could be more important for people with cognitive impairment as it may potentially reduce their dependence on others and promote autonomy and independence.

    “novel IAT in care could play a key role in supporting independent living of older people and could even be more important for the people with CI as it may potentially reduce their dependence on others and promote their autonomy and independence [12].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Greenhalgh T. Fahy N. Shaw S. The bright elusive butterfly of value in health technology development comment on "providing value to new health technology: the early contribution of entrepreneurs, investors, and regulatory agencies" International Journal of Health Policy and Management 2017 7 81 85 2-s2.0-85038818855 29325407 PMC5745872 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Cognitive impairments are increasingly prevalent in the ageing population.

    “Cognitive impairments (CI) are increasingly prevalent in the ageing population [2]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] Winblad B. Amouyel P. Andrieu S. Defeating Alzheimer's disease and other dementias: a priority for European science and society The Lancet Neurology 2016 15 5 455 532 10.1016/S1474-4422(16)00062-4 2-s2.0-84960841901 26987701

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    When end users do not perceive an immediate advantage, technology is not adopted at all or is soon abandoned after a short while.

    “This is in line with previous research which has demonstrated that technology is not adopted at all or is soon abandoned after a short while, when end users do not perceive an immediate advantage [51].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [51] Wade V. A. Eliott J. A. Hiller J. E. Clinician acceptance is the key factor for sustainable telehealth services Qualitative Health Research 2014 24 5 682 694 2-s2.0-84899502038 10.1177/1049732314528809 24685708

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The search strategy was prepared in cooperation with a university librarian.

    “The search strategy was prepared in cooperation with a university librarian.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Clients need to be motivated to use 4th generation IAT and to understand how they can benefit from them before they are willing to accept and adhere to its use.

    “The clients need to be motivated to use 4th generation IAT and to understand how they can actually benefit from them before they are willing to accept and adhere to its use.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The technology should be introduced at 'the right time' and the 'window' for implementation may be short in most cases.

    “As Holthe and colleagues [15] pointed out, the technology should be introduced at “the right time” and the “window” for implementation may be short in most cases.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Holthe and colleagues [15]

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The review stresses the need for personalization of technology around users' needs.

    “Coherently with this, our review stresses the need for personalization of technology around users' needs.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The need for adjustments to IAT has been previously underlined.

    “The need for adjustments has been previously underlined [53]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [53] Braley R. Fritz R. Van Son C. R. Schmitter-Edgecombe M. Prompting technology and persons with dementia: the significance of context and communication Gerontologist 2018 PMC6326250 29897450

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The 4th generation is radically new, based on new devices such as robots, with which users are not familiar anymore.

    “On the contrary, the 4th generation is radically new, as it is based on new devices such as robots, with which the users are not familiar anymore.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The findings indicate a need for more individually designed IAT.

    “Taken together, our findings indicate a need for more individually designed IAT.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Studies have suggested the need to create autoprompting systems that provide specific, personalized, and flexible prompts to users.

    “studies [54] have even suggested the need to create autoprompting systems that provide specific, personalized, and flexible prompts to the users.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] Bauer M. Fetherstonhaugh D. Haesler E. Beattie E. Hill K. D. Poulos C. J. The impact of nurse and care staff education on the functional ability and quality of life of people living with dementia in aged care: a systematic review Nurse Education Today 2018 67 27 45 10.1016/j.nedt.2018.04.019 2-s2.0-85050582691 29729501

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the general old population, the most important factors for acceptance of IAT are a perceived need for the technology and the expected benefits of its use.

    “A previous review by Peek et al. [14], targeting the general old population, provides partially overlapping results. It showed that the most important factors for acceptance of IAT were a perceived need for the technology and the expected benefits of its use.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Peek et al. [14] Peek S. T. M. Wouters E. J. M. van Hoof J. Luijkx K. G. Boeije H. R. Vrijhoef H. J. M. Factors influencing acceptance of technology for aging in place: a systematic review International Journal of Medical Informatics 2014 83 4 235 248 10.1016/j.ijmedinf.2014.01.004 2-s2.0-84896726350 24529817

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The results point to the importance of addressing adherence to IAT among people with CI in the mid- and long-term run.

    “Since most of the studies found showed that IAT was accepted by the users at the baseline assessment, our results point also to the importance of addressing adherence to IAT among people with CI in the mid- and long-term run.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Randomized controlled studies are difficult to perform in this population, e.g., due to drop-out; therefore data on technology acceptance and adherence in this context was extremely difficult to retrieve.

    “These studies are difficult to perform in this population, e.g., due to drop-out; therefore data on technology acceptance and adherence in this context was extremely difficult to retrieve.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    People with CI and their formal and informal caregivers need to be motivated to use IAT, i.e., understand how they can benefit personally before they are willing to accept and adhere to its use.

    “Most of all, people with CI and their formal and informal caregivers need to be motivated to use IAT, i.e., understand how they can benefit personally before they are willing to accept and adhere to its use.”
    Quote in the paperNot a substantial claim
52 of 52

  • The paper relies on this without support.

    The 30 included studies are representative of the broader literature on IAT for people with cognitive impairment and their caregivers.

    “We retrieved thirty studies, including in total 1655 participants from Europe, USA/Canada, Australia, and Asia, enrolled in their homes, care-residences, day-care centres, or Living Labs.”

  • The paper relies on this without support.

    Current knowledge on facilitators and barriers to IAT use among clients of health care and social services is insufficient.

    “More knowledge on facilitators and barriers to use of IAT among clients of health care and social services is crucial for the successful implementation of innovative programmes aiming to leverage innovative technologies for the independence of older people with CI.”

  • The paper relies on this without support.

    In care for people with CI, the time factor is critical.

    “The lack of prospective data is particularly relevant in the context of care for people with CI, in which the “time factor” is critical.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • This study supports the views of Lindeman, Kim, Thordardottir, Malmgren, Lethin, and others that technology-driven approaches should serve as a key means of supporting family caregivers in the new era.

    “This study further supports the views of Lindema, Kim, Thordardottir, Malmgren, Lethin, and others on the technologization of care, namely that technology-driven approaches should serve as a key means of supporting family caregivers in the new era (88, 89).”

    From Caring alone: older adult care burdens, practices, and structural imbalances among China's one-child generation (2025) · cites this paper as [89]

    The Conclusion (p. not available) says assistive technologies can be accepted and used by people with cognitive impairment and their caregivers, and may help with everyday activities. It does not recommend technology-driven approaches as a key means of supporting family caregivers generally; its findings are limited to this care context and emphasize the need for individualized design and further study of sustained use. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Through smart care systems, remote health monitoring, and wearable intelligent devices, technological development can improve the quality of older adult care services and reduce the burden on family caregivers.

    “Through smart care systems, remote health monitoring, and wearable intelligent devices, technological development can not only improve the quality of older adult care services but also reduce the burden on family caregivers (89).”

    From Caring alone: older adult care burdens, practices, and structural imbalances among China's one-child generation (2025) · cites this paper as [89]

    The Introduction describes smart sensor systems, remote monitoring and wearable devices for older people with cognitive impairment. The Results (§3.3; page unavailable) report that some caregivers felt less anxious or experienced relief and less worry, but others reported lower quality of life, and reduced care burden was an expectation rather than a consistent finding. The paper does not establish an improvement in the quality of older-adult care services generally. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Robot study described as home-based is cited as residential aged care

    Minor

    The discussion says study [31] took place in older people's own homes, whereas the cited study's title places it in residential aged care.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 7

  1. 2012, Journal of Multidisciplinary Healthcare, 5, 299
  2. 2011, Elderly user evaluation of mobile touchscreen interactions
  3. 2013, Gerontechnology, 11, 428
  4. 2013, Gerontechnology, 11, 469
  5. 2018, Gerontologist
  6. 2014, Technology and Disability, 26, 221
  7. 2018, Gerontologist

Cited by

Sorted by citations

Related

Authors
Thordardottir, B., Malmgren Fänge, A., Lethin, C., Rodriguez Gatta, D., & Chiatti, C.
Affiliations
  • OsloMet – Oslo Metropolitan University (NO)
  • Department of Health Sciences, Faculty of Medicine, Lund University, Lund 221 00, Sweden
  • Lund University (SE)
Corresponding author
Thordardottir, Björg
ORCID
Venue
BioMed Research International
Publisher
Wiley
Published
2019-03-06
Volume
2019
Pages
1-18
ISSN
  • 1110-7243 (ISSN-L)
  • 2314-6133
  • 2314-6141
DOI
10.1155/2019/9196729
PMC
PMC6431399
OpenAlex
W2918512129
Semantic Scholar
2244df0082c1613ad06d00ebe0f7f4dd9cb68603
Cited by
169
References
51
Citations by year
2026: 23 · 2025: 20 · 2024: 27 · 2023: 28 · 2022: 28 · 2021: 21 · 2020: 17 · 2019: 3 · 2018: 1
FWCI
5.49
Type
journal article
Language
en
Open access
Licence
Locations
  • BioMed Research International (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Lund University Publications (Lund University) (submittedVersion)
Funders
  • FORTE—Swedish Research Council for Health, Working Life and Welfare (2014-4913)
  • Faculty of Medicine at Lund University (2014-4913)
  • Faculty of Medicine, Lund University (2014-4913)
  • Oslo Metropolitan University (2014-4913)
Topics
  • Social Sciences › Demography › Technology Use by Older Adults
  • Health Sciences › Health Professions › Occupational Therapy › Assistive Technology in Communication and Mobility
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
cognitive impairment, assistive technology, technology acceptance, caregivers, Alzheimer's disease, dementia, older adults, home sensors, wearable devices, electronic reminders, surveillance systems, self-care, independence, barriers and facilitators, technology use
MeSH terms
Wearable Electronic Devices, Humans, Monitoring, Physiologic, Self-Help Devices, Caregivers, Cognitive Dysfunction

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-08.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-08.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review