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

The DOI matches its Crossref record; 51 of the 51 references it cites were found in a registry or an index; 1 of the 84 sources its claims cite were checked for support.

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

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.

Overview

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.

Figures

Figure 1 Flow diagram of the article selection process.
Figure 1 Flow diagram of the article selection process.CC BY · PubMed Central

Verification

Claims the paper makes

44 Not checked yet · 24 Own result · 14 Own interpretation · 10 No basis given · 4 Own method · 1 Partly supported · 1 Sources not found · accuracy not yet measured

Verify all 76 references — free account
  • It may state two separate claims as one. 40
  • Probably not a substantial claim. 21
  • The quote only partly states this claim. 1
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

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

1 of 1

Citations

Cites

Show all 51 references

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

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Metadata

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
Venue
BioMed Research International
Publisher
Wiley
Published
2019-03-06
Volume
2019
Pages
1-18
ISSN
  • 1110-7243 (ISSN-L)
  • 2314-6133
  • 2314-6141
OpenAlex
W2918512129
Cited by
169
References
51
Citations by year
2026: 23 · 2025: 20 · 2024: 27 · 2023: 28 · 2022: 28 · 2021: 21 · 2020: 17 · 2019: 3
FWCI
5.49
Type
journal article
Language
en
Open access
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
  • Health Sciences › Medicine › Geriatrics and Gerontology › 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

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