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Cited by 65Dementia and Cognitive Impairment ResearchTechnology Use by Older AdultsAssistive Technology in Communication and Mobility

Assistive technology and telecare to maintain independent living at home for people with dementia: the ATTILA RCT

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Gathercole, Rebecca, Bradley, Rosie, Harper, Emma, Davies, Lucy, Pank, Lynn, Lam, Natalie, Davies, Anna, Talbot, Emma +24 more·2021·Health Technology Assessment
DOI 10.3310/hta25190PMC PMC8020444
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Abstract

Background: Assistive technology and telecare have been promoted to manage the risks associated with independent living for people with dementia, but there is limited evidence of their effectiveness. Objectives: This trial aimed to establish whether or not assistive technology and telecare assessments and interventions extend the time that people with dementia can continue to live independently at home and whether or not they are cost-effective. Caregiver burden, the quality of life of caregivers and of people with dementia and whether or not assistive technology and telecare reduce safety risks were also investigated. Design: This was a pragmatic, randomised controlled trial. Blinding was not undertaken as it was not feasible to do so. All consenting participants were included in an intention-to-treat analysis. Setting: This trial was set in 12 councils in England with adult social services responsibilities. Participants: Participants were people with dementia living in the community who had an identified need that might benefit from assistive technology and telecare. Interventions: Participants were randomly assigned to receive either assistive technology and telecare recommended by a health or social care professional to meet their assessed needs (a full assistive technology and telecare package) or a pendant alarm, non-monitored smoke and carbon monoxide detectors and a key safe (a basic assistive technology and telecare package). Main outcome measures: The primary outcomes were time to admission to care and cost-effectiveness. Secondary outcomes assessed caregivers using the 10-item Center for Epidemiological Studies Depression Scale, the State–Trait Anxiety Inventory 6-item scale and the Zarit Burden Interview. Results: Of 495 participants, 248 were randomised to receive full assistive technology and telecare and 247 received the limited control. Comparing the assistive technology and telecare group with the control group, the hazard ratio for institutionalisation was 0.76 (95% confidence interval 0.58 to 1.01;p = 0.054). After adjusting for an imbalance in the baseline activities of daily living score between trial arms, the hazard ratio was 0.84 (95% confidence interval 0.63 to 1.12;p = 0.20). At 104 weeks, there were no significant differences between groups in health and social care resource use costs (intervention group – control group difference: mean –£909, 95% confidence interval –£5336 to £3345) or in societal costs (intervention group – control group difference: mean –£3545; 95% confidence interval –£13,914 to £6581). At 104 weeks, based on quality-adjusted life-years derived from the participant-rated EuroQol-5 Dimensions questionnaire, the intervention group had 0.105 (95% confidence interval –0.204 to –0.007) fewer quality-adjusted life-years than the control group. The number of quality-adjusted life-years derived from the proxy-rated EuroQol-5 Dimensions questionnaire did not differ between groups. Caregiver outcomes did not differ between groups over 24 weeks. Limitations: Compliance with the assigned trial arm was variable, as was the quality of assistive technology and telecare needs assessments. Attrition from assessments led to data loss additional to that attributable to care home admission and censoring events. Conclusions: A full package of assistive technology and telecare did not increase the length of time that participants with dementia remained in the community, and nor did it decrease caregiver burden, depression or anxiety, relative to a basic package of assistive technology and telecare. Use of the full assistive technology and telecare package did not increase participants’ health and social care or societal costs. Quality-adjusted life-years based on participants’ EuroQol-5 Dimensions questionnaire responses were reduced in the intervention group compared with the control group; groups did not differ in the number of quality-adjusted life-years based on the proxy-rated EuroQol-5 Dimensions questionnaire. Future work: Future work could examine whether or not improved assessment that is more personalised to an individual is beneficial. Trial registration: Current Controlled Trials ISRCTN86537017. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 19. See the NIHR Journals Library website for further project information.

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  • An RCT in 495 people with dementia of assistive technology and telecare recommended by a health or social care professional to meet assessed needs was not better than a basic package of safety-related devices in length of time that participants remained in the community, carer burden, depression or anxiety, health and social care or societal costs and quality-adjusted life-years.

    “An RCT in 495 people with dementia of assistive technology and telecare recommended by a health or social care professional to meet assessed needs was not better than a basic package of safety-related devices in length of time that participants remained in the community, carer burden, depression or anxiety, health and social care or societal costs and quality-adjusted life-years. (561)”

    From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [561]

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  1. Leroi I, Woolham J, Gathercole R, Howard R, Dunk B, Fox C, et al. Does telecare prolong community living in dementia? A study protocol for a pragmatic, randomised controlled trial. Trials 2013;14:349.
  2. Woolham J, Frisby B. Using Technology in Dementia Care. In Benson S, editor. Dementia Topics for the Millennium and Beyond. London: Hawker Publications; 2002. pp. 91-4.
  3. Gitlin LN, Winter L, Dennis MP. Assistive devices caregivers use and find helpful to manage problem behaviors of dementia. Gerontechnology 2010;9:408-14. https://doi.org/10.4017/ gt.2010.09.03.006.00 · DOI
  4. Miskelly FG. Assistive technology in elderly care. Age Ageing 2001;30:455-8. https://doi.org/ 10.1093/ageing/30.6.455 · DOI
  5. Lansley P, McCreadie C, Tinker A. Can adapting the homes of older people and providing assistive technology pay its way? Age and Ageing 2004;33:571-6. https://doi.org/10.1093/ ageing/afh190 · DOI
  6. Doughty K, Williams G. Practical solutions for the integration of community alarms, assistive technologies and telecare. Qual Ageing Older Adults 2001;2:31-47. https://doi.org/10.1108/ 14717794200100006 · DOI
  7. Bharucha AJ, Anand V, Forlizzi J, Dew MA, Reynolds CF, Stevens S, Wactlar H. Intelligent assistive technology applications to dementia care: current capabilities, limitations, and future challenges. Am J Geriatr Psychiatry 2009;17:88-104. https://doi.org/10.1097/JGP.0b013e318187dde5 · DOI
  8. Frisby B, Woolham J. Building a local infrastructure that supports the use of assistive technology in the care of people with dementia. Res Policy Plan 2002;20:11-24.
  9. Fisk MJ. Social Alarms to Telecare: Older People's Services in Transition. Bristol: The Policy Press; 2003. https://doi.org/10.2307/j.ctt1t8951n · DOI
  10. Woolham J, Gibson G, Clarke P. Assistive technology, telecare, and dementia: some implications of current policies and guidance. Res Policy Plan 2006;24:149-64.
  11. Poole T. Wanless Social Care Review: Telecare and Older People. London: The King's Fund; 2006.
  12. Bower P, Cartwright M, Hirani SP, Barlow J, Hendy J, Knapp M, et al. A comprehensive evaluation of the impact of telemonitoring in patients with long-term conditions and social care needs: protocol for the whole systems demonstrator cluster randomised trial. BMC Health Serv Res 2011;11:184. https://doi.org/10.1186/1472-6963-11-184 · DOI
  13. Cartwright M, Hirani SP, Rixon L, Beynon M, Doll H, Bower P, et al. Effect of telehealth on quality of life and psychological outcomes over 12 months (Whole Systems Demonstrator telehealth questionnaire study): nested study of patient reported outcomes in a pragmatic, cluster randomised controlled trial. BMJ 2013;346:f653. https://doi.org/10.1136/bmj.f653 · DOI · Paper page
  14. Steventon A, Bardsley M, Billings J, Dixon J, Doll H, Hirani S, et al. Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial. BMJ 2012;344:e3874. https://doi.org/10.1136/bmj.e3874 REFERENCES NIHR Journals Library www.journalslibrary.nihr.ac.uk · DOI · Paper page
  15. Hirani SP, Beynon M, Cartwright M, Rixon L, Doll H, Henderson C, et al. The effect of telecare on the quality of life and psychological well-being of elderly recipients of social care over a 12-month period: the Whole Systems Demonstrator cluster randomised trial. Age Ageing 2014;43:334-41. https://doi.org/10.1093/ageing/aft185 · DOI
  16. Steventon A, Bardsley M, Billings J, Dixon J, Doll H, Beynon M, et al. Effect of telecare on use of health and social care services: findings from the Whole Systems Demonstrator cluster randomised trial. Age Ageing 2013;42:501-8. https://doi.org/10.1093/ageing/aft008 · DOI
  17. Henderson C, Knapp M, Fernández JL, Beecham J, Hirani SP, Beynon M, et al. Cost-effectiveness of telecare for people with social care needs: the Whole Systems Demonstrator cluster randomised trial. Age Ageing 2014;43:794-800. https://doi.org/10.1093/ageing/afu067 · DOI · Paper page
  18. Brownsell S. Measuring the 'success' of telehealth interventions. J Assistive Technol 2009;3:12-20. https://doi.org/10.1108/17549450200900030 · DOI
  19. Van der Roest HG, Wenborn J, Pastink C, Dröes RM, Orrell M. Assistive technology for memory support in dementia. Cochrane Database Syst Rev 2017;6:CD009627. https://doi.org/ 10.1002/14651858.CD009627.pub2 · DOI
  20. Beecham J, Knapp M. Costing Psychiatric Interventions. In Thornicroft G, Brewin C, Wing J, editors. Measuring Mental Health Needs. 2nd edn. London: Gaskell/Royal College of Psychiatrists; 2001. pp. 200-24.
  21. Leggett AN, Zarit S, Taylor A, Galvin JE. Stress and burden among caregivers of patients with Lewy body dementia. Gerontologist 2011;51:76-85. https://doi.org/10.1093/geront/gnq055 · DOI
  22. Hirani SP, Rixon L, Beynon M, Cartwright M, Cleanthous S, Selva A, et al. Quantifying beliefs regarding telehealth: development of the Whole Systems Demonstrator Service User Technology Acceptability Questionnaire. J Telemed Telecare 2017;23:460-9. https://doi.org/10.1177/ 1357633X16649531 · DOI
  23. Fish J. Bristol Activities of Daily Living Scale. In Kreutzer JS, DeLuca J, Caplan B, editors. Encyclopedia of Clinical Neuropsychology. New York, NY: Springer; 2011. pp. 452-53. https://doi.org/ 10.1007/978-0-387-79948-3_1929 · DOI
  24. Courtney C, Farrell D, Gray R, Hills R, Lynch L, Sellwood E, et al. Long-term donepezil treatment in 565 patients with Alzheimer's disease (AD2000): randomised double-blind trial. Lancet 2004;363:2105-15. https://doi.org/10.1016/S0140-6736(04)16499-4 · DOI · Paper page
  25. International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use -Good Clinical Practice. Code of Federal Regulations & Guidelines Vol. 1. International Committee on Harmonization. Philadelphia, PA: Barnett International/PAREXEL; 1997.
  26. Forsyth K, Henderson C, Davis L, Singh Roy A, Dunk B, Curnow E, et al. Assessment of need and practice for assistive technology and telecare for people with dementia -The ATTILA (Assistive Technology and Telecare to maintain Independent Living At home for people with dementia) trial. Alzheimers Dement 2019;5:420-30. https://doi.org/10.1016/j.trci.2019.07.010 · DOI
  27. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M, Medical Research Council Guidance. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008;337:a1655. https://doi.org/10.1136/bmj.a1655 · DOI · Paper page
  28. Ritchie J, Lewis J. Qualitative Research Practice : A Guide for Social Science Students and Researchers. London: SAGE Publications Ltd; 2003.
  29. Ehrenhard M, Kijl B, Nieuwenhuis L. Market adoption barriers of multi-stakeholder technology: smart homes for the aging population. Technol Forecast Soc Change 2014;89:306-15. https://doi.org/10.1016/j.techfore.2014.08.002 · DOI
  30. Kijl B, Nieuwenhuis LJ, Huis in 't Veld RM, Hermens HJ, Vollenbroek-Hutten MM. Deployment of e-health services -a business model engineering strategy. J Telemed Telecare 2010;16:344-53. https://doi.org/10.1258/jtt.2010.006009 · DOI
  31. Siegel S. Nonparametric Statistics for the Behavioral Sciences. New York, NY: McGraw-Hill; 1956.
  32. Perneczky R, Wagenpfeil S, Komossa K, Grimmer T, Diehl J, Kurz A. Mapping scores onto stages: mini-mental state examination and clinical dementia rating. Am J Geriatr Psychiatry 2006;14:139-44. https://doi.org/10.1097/01.JGP.0000192478.82189.a8 · DOI · Paper page
  33. Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg 2018;126:1763-8. https://doi.org/10.1213/ANE.0000000000002864 · DOI · Paper page
  34. van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D, et al. Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health 2012;15:708-15. https://doi.org/10.1016/j.jval.2012.02.008 · DOI · Paper page
  35. Dolan P. Modeling valuations for EuroQol health states. Med Care 1997;35:1095-108. https://doi.org/10.1097/00005650-199711000-00002 · DOI
  36. Wimo A, Reed CC, Dodel R, Belger M, Jones RW, Happich M, et al. The GERAS Study: a prospective observational study of costs and resource use in community dwellers with Alzheimer's disease in three European countries -study design and baseline findings. J Alzheimers Dis 2013;36:385-99. https://doi.org/10.3233/JAD-122392 · DOI
  37. Koopmanschap MA, van Exel JN, van den Berg B, Brouwer WB. An overview of methods and applications to value informal care in economic evaluations of healthcare. PharmacoEconomics 2008;26:269-80. https://doi.org/10.2165/00019053-200826040-00001 · DOI
  38. Billingham LJ, Abrams KR. Simultaneous analysis of quality of life and survival data. Stat Methods Med Res 2002;11:25-48. https://doi.org/10.1191/0962280202sm269ra · DOI
  39. Gray A. Applied Methods of Cost-effectiveness Analysis in Health Care. Oxford: Oxford University Press; 2011.
  40. Bang H, Tsiatis AA. Estimating medical costs with censored data. Biometrika 2000;87:329-43. https://doi.org/10.1093/biomet/87.2.329 · DOI
  41. Basu A, Manning WG. Estimating lifetime or episode-of-illness costs under censoring. Health Econ 2010;19:1010-28. https://doi.org/10.1002/hec.1640 · DOI
  42. Rabe-Hesketh S, Skrondal A. Multilevel and Longitudinal Modeling Using Stata. 3rd edn. College Station, TX: Stata Press; 2011.
  43. Hoch JS, Briggs AH, Willan AR. Something old, something new, something borrowed, something blue: a framework for the marriage of health econometrics and cost-effectiveness analysis. Health Econ 2002;11:415-30. https://doi.org/10.1002/hec.678 · DOI
  44. Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the Economic Evaluation of Health Care Programmes. 4th edn. Oxford: Oxford University Press; 2015.
  45. Oremus M, Aguilar SC. A systematic review to assess the policy-making relevance of dementia cost-of-illness studies in the US and Canada. PharmacoEconomics 2011;29:141-56. https://doi.org/ 10.2165/11539450-000000000-00000 · DOI
  46. Glick H. Economic Evaluation in Clinical Trials. Oxford: Oxford University Press; 2007.
  47. Hounsome N, Orrell M, Edwards RT. EQ-5D as a quality of life measure in people with dementia and their carers: evidence and key issues. Value Health 2011;14:390-9. https://doi.org/10.1016/ j.jval.2010.08.002 · DOI
  48. Aguirre E, Kang S, Hoare Z, Tudor Edwards R, Orrell M. How does the EQ-5D perform when measuring quality of life in dementia against two other dementia-specific outcome measures? Qual Life Res 2016;25:45-9. https://doi.org/10.1007/s11136-015-1065-9 · DOI
  49. Brodaty H, Donkin M. Family caregivers of people with dementia. Dialogues Clin Neurosci 2009;11:217.
  50. Mahoney R, Regan C, Katona C, Livingston G. Anxiety and depression in family caregivers of people with Alzheimer disease: the LASER-AD study. Am J Geriatr Psychiatry 2005;13:795-801. https://doi.org/10.1097/00019442-200509000-00008 · DOI · Paper page
  51. Seeher K, Low LF, Reppermund S, Brodaty H. Predictors and outcomes for caregivers of people with mild cognitive impairment: a systematic literature review. Alzheimers Dement 2013;9:346-55. https://doi.org/10.1016/j.jalz.2012.01.012 · DOI
  52. Chen ML. The growing costs and burden of family caregiving of older adults: a review of paid sick leave and family leave policies. Gerontologist 2016;56:391-6. https://doi.org/10.1093/ geront/gnu093 · DOI
  53. Moore MJ, Zhu CW, Clipp EC. Informal costs of dementia care: estimates from the National Longitudinal Caregiver Study. J Gerontol B Psychol Sci Soc Sci 2001;56:S219-28. https://doi.org/ 10.1093/geronb/56.4.s219 · DOI
  54. Alzheimer's Association. 2017 Alzheimer's disease facts and figures. Alzheimer Dement 2017;13:325-73. https://doi.org/10.1016/j.jalz.2017.02.001 · DOI
  55. Wimo A, Winblad B, Jönsson L. The worldwide societal costs of dementia: estimates for 2009. Alzheimers Dement 2010;6:98-103. https://doi.org/10.1016/j.jalz.2010.01.010 · DOI
  56. Zarit SH, Todd PA, Zarit JM. Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 1986;26:260-6. https://doi.org/10.1093/geront/26.3.260 · DOI
  57. Schofield H, Murphy B, Herrman HE, Bloch S, Singh BS. Carers of people aged over 50 with physical impairment, memory loss and dementia: a comparative study. Ageing Soc 1998;18:355-69. https://doi.org/10.1017/S0144686X98006965 102. · DOI
  58. Ashworth M, Baker AH. 'Time and space': carers' views about respite care. Health Soc Care Community 2000;8:50-6. https://doi.org/10.1046/j.1365-2524.2000.00221.x 103. Brodaty H, Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry 2012;169:946-53. https://doi.org/ 10.1176/appi.ajp.2012.11101529 104. Cooke DD, McNally L, Mulligan KT, Harrison MJ, Newman SP. Psychosocial interventions for caregivers of people with dementia: a systematic review. Aging Ment Health 2001;5:120-35. https://doi.org/10.1080/713650019 105. · DOI
  59. Lindberg B, Nilsson C, Zotterman D, Söderberg S, Skär L. Using information and communication technology in home care for communication between patients, family members, and healthcare professionals: a systematic review. Int J Telemed Appl 2013;2013:461829. https://doi.org/10.1155/2013/461829 107. · DOI
  60. Schware R, Kenny C, Foster V, Wellenius B, Dokeniya A, Wheeler D, et al. Information and Communication Technologies: A World Bank Group Strategy. Washington, DC: World Bank Publications; 2002. 108. Lucero RJ, Fehlberg EA, Patel AGM, Bjarnardottir RI, Williams R, Lee K, et al. The effects of information and communication technologies on informal caregivers of persons living with dementia: a systematic review. Alzheimers Dement 2019;5:1-12. https://doi.org/10.1016/ j.trci.2018.11.003 109. · DOI
  61. Davies A, Rixon L, Newman S. Systematic review of the effects of telecare provided for a person with social care needs on outcomes for their informal carers. Health Soc Care Community 2013;21:582-97. https://doi.org/10.1111/hsc.12035 110. · DOI
  62. Neubauer S, Holle R, Menn P, Grossfeld-Schmitz M, Graesel E. Measurement of informal care time in a study of patients with dementia. Int Psychogeriatr 2008;20:1160-76. https://doi.org/ 10.1017/S1041610208007564 121. · DOI
  63. Joling KJ, van Marwijk HW, Veldhuijzen AE, van der Horst HE, Scheltens P, Smit F, van Hout HP. The two-year incidence of depression and anxiety disorders in spousal caregivers of persons with dementia: who is at the greatest risk? Am J Geriatr Psychiatry 2015;23:293-303. https://doi.org/ 10.1016/j.jagp.2014.05.005 122. · DOI · Paper page
  64. Sörensen S, Pinquart M, Duberstein P. How effective are interventions with caregivers? An updated meta-analysis. Gerontologist 2002;42:356-72. https://doi.org/10.1093/geront/42.3.356 128. · DOI
  65. Parker D, Mills S, Abbey J. Effectiveness of interventions that assist caregivers to support people with dementia living in the community: a systematic review. Int J Evid Based Healthc 2008;6:137-72. https://doi.org/10.1111/j.1744-1609.2008.00090.x 129. Thompson CA, Spilsbury K, Hall J, Birks Y, Barnes C, Adamson J. Systematic review of information and support interventions for caregivers of people with dementia. BMC Geriatr 2007;7:18. https://doi.org/10.1186/1471-2318-7-18 130. · DOI · Paper page
  66. Kaizik C, Caga J, Camino J, O'Connor CM, McKinnon C, Oyebode JR, et al. Factors underpinning caregiver burden in frontotemporal dementia differ in spouses and their children. J Alzheimers Dis 2017;56:1109-17. https://doi.org/10.3233/JAD-160852 134. · DOI
  67. Hammersley M, Atkinson P. Ethnography: Principles in Practice. Abingdon: Routledge; 2007. https://doi.org/10.4324/9780203944769 136. · DOI
  68. Wenborn J, Hynes S, Moniz-Cook E, Mountain G, Poland F, King M, et al. Community occupational therapy for people with dementia and family carers (COTiD-UK) versus treatment as usual (Valuing Active Life in Dementia [VALID] programme): study protocol for a randomised controlled trial. Trials 2016;17:65. https://doi.org/10.1186/s13063-015-1150-y 137. · DOI
  69. Lewis SJ, Russell AJ. Being embedded: a way forward for ethnographic research. Ethnography 2011;12:398-416. https://doi.org/10.1177/1466138110393786 138. · DOI
  70. Greenhalgh T, Wherton J, Sugarhood P, Hinder S, Procter R, Stones R. What matters to older people with assisted living needs? A phenomenological analysis of the use and non-use of telehealth and telecare. Soc Sci Med 2013;93:86-94. https://doi.org/10.1016/j.socscimed.2013.05.036 147. · DOI
  71. Mort M, Roberts C, Pols J, Domenech M, Moser I, EFORTT investigators. Ethical implications of home telecare for older people: a framework derived from a multisited participative study. Health Expect 2015;18:438-49. https://doi.org/10.1111/hex.12109 148. · DOI · Paper page
  72. Samus QM, Black BS, Bovenkamp D, Buckley M, Callahan C, Davis K, et al. Home is where the future is: the BrightFocus Foundation consensus panel on dementia care. Alzheimers Dement 2018;14:104-14. https://doi.org/10.1016/j.jalz.2017.10.006 150. von Kutzleben M, Schmid W, Halek M, Holle B, Bartholomeyczik S. Community-dwelling persons with dementia: what do they need? What do they demand? What do they do? A systematic review on the subjective experiences of persons with dementia. Aging Ment Health 2012;16:378-90. https://doi.org/10.1080/13607863.2011.614594 151. Department of Health and Social Care. Prime Minister's Challenge on Dementia 2020: Implementation Plan. London: Department of Health and Social Care; 2016. 152. Aminzadeh F, Dalziel WB, Molnar FJ, Garcia LJ. Symbolic meaning of relocation to a residential care facility for persons with dementia. Aging Ment Health 2009;13:487-96. https://doi.org/10.1080/13607860802607314 153. · DOI
  73. Tchalla AE, Lachal F, Cardinaud N, Saulnier I, Rialle V, Preux PM, Dantoine T. Preventing and managing indoor falls with home-based technologies in mild and moderate Alzheimer's disease patients: pilot study in a community dwelling. Dementia and geriatric cognitive disorders 2013;36:251-61. https://doi.org/10.1159/000351863 154. · DOI
  74. Brims L, Oliver K. Effectiveness of assistive technology in improving the safety of people with dementia: a systematic review and meta-analysis. Aging and Mental Health 2019;23:942-51. https://doi.org/10.1080/13607863.2018.1455805 155. Alzheimer's Disease International. Dementia Statistics. URL: www.alz.co.uk/research/statistics (accessed July 2019). 156. Raina P, Santaguida P, Ismaila A, Patterson C, Cowan D, Levine M, et al. Effectiveness of cholinesterase inhibitors and memantine for treating dementia: evidence review for a clinical practice guideline. Ann Intern Med 2008;148:379-97. https://doi.org/10.7326/0003-4819-148- 5-200803040-00009 157. · DOI · Paper page
  75. Holthe T, Jentoft R, Arntzen C, Thorsen K. Benefits and burdens: family caregivers' experiences of assistive technology (AT) in everyday life with persons with young-onset dementia (YOD). Disabil Rehabil Assist Technol 2018;13:754-62. https://doi.org/10.1080/ 17483107.2017.1373151 158. · DOI
  76. Nauha L, Keränen NS, Kangas M, Jämsä T, Reponen J. Assistive technologies at home for people with a memory disorder. Dementia 2018;17:909-23. https://doi.org/10.1177/ 1471301216674816 159. · DOI
  77. Liddle J, Smith SJ. Intelligent assistive technology for people living with dementia is a rapidly growing and changing area requiring clinical consideration. Aust Occup Ther J 2017;64:510-11. https://doi.org/10.1111/1440-1630.12434 160. · DOI
  78. Megges H, Freiesleben SD, Rösch C, Knoll N, Wessel L, Peters O. User experience and clinical effectiveness with two wearable global positioning system devices in home dementia care. Alzheimers Dement 2018;4:636-44. https://doi.org/10.1016/j.trci.2018.10.002 161. · DOI
  79. Gibson G, Newton L, Pritchard G, Finch T, Brittain K, Robinson L. The provision of assistive technology products and services for people with dementia in the United Kingdom. Dementia 2016;15:681-701. https://doi.org/10.1177/1471301214532643 REFERENCES NIHR Journals Library www.journalslibrary.nihr.ac.uk 162. Momanyi K. Enhancing Quality in Social Care Through Economic Analysis. PhD thesis. Aberdeen: University of Aberdeen; 2018. 163. Allen C, Beecham J. Costing Services: Ideals and Reality. In Netten A, Beecham J, editors. Costing Community Care: Theory and Practice. Avebury: Ashgate; 1993. 164. Beecham J. Unit Costs -Not Exactly Child's Play. London: Department of Health and Social Care, Personal Social Services Research Unit and Dartington Social Care Research Unit; 2000. 165. Curtis L. Unit Costs of Health and Social Care 2013. Canterbury: Personal Social Services Research Unit, University of Kent; 2013. 166. Curtis L. Unit Costs of Health and Social Care 2014. Canterbury: Personal Social Services Research Unit, University of Kent; 2014. 167. Banks L, Barnes, M. Evaluation of the East Sussex Carers' Breaks Demonstrator Site. Brighton: University of Brighton, 2011. 168. Federation of (Ophthalmic and Dispensing) Opticians (FODO). GOS Sight Test Fees. 2018. URL: www.fodo.com/resource-categories/nhs-sight-test-fees (accessed August 2019). 169. Department of Health and Social Care. General Ophthalmic Services: NHS Sight Test Fee, Increases to NHS Optical Voucher Values, Payments for Continuing Education and Training and Pre-registration Supervisors Grant. London: Department of Health and Social Care; 2016. 170. Department of Health and Social Care. General Ophthalmic Services -Increases to NHS Sight Test Fee, Continuing Education and Training Payment and Pre-registration Supervisors Grant. London: Department of Health and Social Care; 2015. 171. Romeo R, Knapp M, Banerjee S, Morris J, Baldwin R, Tarrier N, et al. Treatment and prevention of depression after surgery for hip fracture in older people: cost-effectiveness analysis. J Affect Disord 2011;128:211-19. https://doi.org/10.1016/j.jad.2010.07.026 172. Office for National Statistics (ONS). Consumer Prices Index including owner occupiers' housing costs (CPIH). 2019. URL: www.ons.gov.uk/economy/inflationandpriceindices/timeseries/l522/mm23 (accessed 10 May 2019). 173. Iliffe S, Wilcock J, Drennan V, Goodman C, Griffin M, Knapp M, et al. Changing practice in dementia care in the community: developing and testing evidence-based interventions, from timely diagnosis to end of life (EVIDEM). Programme Grants Appl Res 2015;3(3). https://doi.org/ 10.3310/pgfar03030 174. NHS Digital. Prescription Cost Analysis England 2017. Leeds: NHS Digital; 2018. 175. Automobile Association. Mileage Calculator. URL: www.theaa.com/driving/mileage-calculator.jsp (accessed 11 October 2018). · DOI

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Authors
Gathercole, R., Bradley, R., Harper, E., Davies, L., Pank, L., Lam, N., Davies, A., Talbot, E., Hooper, E., Winson, R., Scutt, B., Montano, V. O., Nunn, S., Lavelle, G., Lariviere, M., Hirani, S., Brini, S., Bateman, A., Bentham, P., Burns, A., Dunk, B., Forsyth, K., Fox, C., Henderson, C., Knapp, M., Leroi, I., Newman, S., O’Brien, J., Poland, F., Woolham, J., Gray, R., & Howard, R.
Affiliations
  • King's College London (GB)
  • University of Oxford (GB)
  • City, University of London (GB)
  • Norfolk and Suffolk NHS Foundation Trust (GB)
  • University of Manchester (GB)
  • Cambridgeshire and Peterborough NHS Foundation Trust (GB)
  • Hertfordshire Community NHS Trust (GB)
  • Cambridgeshire Community Services NHS Trust (GB)
  • University of Sheffield (GB)
  • University of Essex (GB)
  • Birmingham and Solihull Mental Health NHS Foundation Trust (GB)
  • South London and Maudsley NHS Foundation Trust (GB)
  • Queen Margaret University (GB)
  • University of East Anglia (GB)
  • London School of Economics and Political Science (GB)
  • Trinity College Dublin (IE)
  • Department of Psychiatry, University of Cambridge, Cambridge, UK
  • University College London (GB)
Corresponding author
Gathercole, Rebecca
ORCID
Venue
Health Technology Assessment
Publisher
National Institute for Health and Care Research
Published
2021-03
Volume
25
Issue
19
Pages
1-156
ISSN
  • 1366-5278 (ISSN-L)
  • 2046-4924
DOI
10.3310/hta25190
PMC
PMC8020444
OpenAlex
W3138123109
Cited by
65
References
23
Citations by year
2026: 10 · 2025: 25 · 2024: 10 · 2023: 12 · 2022: 5 · 2021: 2 · 2017: 1
FWCI
5.20
Type
journal article
Language
en
Open access
Licence
Locations
  • Health Technology Assessment (publishedVersion, cc-by)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, other-oa)
  • Bristol Research (University of Bristol) (publishedVersion, cc-by)
  • London School of Economics and Political Science Research Online (London School of Economics and Political Science) (acceptedVersion)
  • City Research Online (City University London) (acceptedVersion)
  • Open Access at Essex (University of Essex) (acceptedVersion)
  • London School of Economics and Political Science Theses Online (London School of Economics and Political Science) (submittedVersion, cc-by)
  • UEA Digital Repository (University of East Anglia) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • UCL Discovery (University College London) (submittedVersion)
  • Queen Margaret University Publications Repository (Queen Margaret University) (submittedVersion, cc-by)
  • Explore Bristol Research (submittedVersion, cc-by)
Funders
Health Technology Assessment programme (10/50/02)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Demography › Technology Use by Older Adults
  • Health Sciences › Health Professions › Occupational Therapy › Assistive Technology in Communication and Mobility
Keywords
dementia, assistive technology, telecare, independent living at home, cost-effectiveness, caregiver burden, caregiver depression, caregiver anxiety, quality of life, fall risk, safety risk, quality-adjusted life years, community-dwelling older adults, adult social care, home safety assessment
MeSH terms
Activities of Daily Living, Adult, Dementia, Humans, Quality of Life, Self-Help Devices, Independent Living

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