Best Practice Guidance
Human Interaction with Technology in Dementia

Recommendations

Evaluating the effectiveness of specific contemporary technology

The rapid growth of the technological landscape and related new services have the potential to improve the effectiveness and cost-effectiveness of health and social services and facilitate social participation and engagement in activities. But which technology is effective and how is this evaluated best? This section provides recommendations to evaluate the effectiveness of technology in daily life, meaningful activities and healthcare services as well as of technologies aimed to promote the Social Health of people with dementia. Examples of useful technologies in some of these areas are provided.
Social Health Domain 2: Manage ones own life and promote independence

Instruments are needed to measure self-management of people with mild cognitive impairment or mild dementia, in order to investigate the effectiveness of technolog-ical interventions

Guidance

Researchers interested in Social health in dementia need to develop instruments to measure the self-management aspect of Social health. Self-management is clearly defined as one of the three domains of Social health besides the capacity to fulfil one’s potential and social participation. Whilst several instruments have been proposed for the measurement of self-management, all have limitations e.g. not measuring the construct as understood in the context of Social health (managing one’s own life), being too burdensome for participants, or ceiling effects on scale of total scores. Instruments which measure the construct of self-management, as understood in this context, without burdening participants and with sufficient discriminatory power for use in intervention studies are needed in order to effectively evaluate interventions aiming to improve Social health in dementia.

Explanation and Examples:

A review of existing instruments which may be used to measure self-management found no options specifically designed to measure the construct as understood in the context of Social health in dementia (to manage one’s own life). In the FindMyApps pilot study, the Self-Management Activities Scale (SMAS) was used, but proved too burdensome to administer. In the FindMyApps definitive randomized controlled trial, another option was used to measure self-management, the Adult Social Care Outcomes Toolkit (ASCOT), which was less burdensome but also less well-aligned to the construct. The usefulness of the ASCOT proved to be further limited by ceiling effects when used in the population participating in this intervention study (people with MCI or mild dementia). Research should be undertaken to confirm consensus amongst people with dementia, their caregivers and researchers in the field on the operational definition of self-management within the context of Social health; to compose statements and scales which investigate the components of the operational definition; and to test the psychometric properties (reliability, validity, responsiveness), feasibility and discriminatory power (precision with which between- and within-subjects variation can be detected) of the resulting instrument in a population of people with MCI/mild dementia, in both an observational and interventional study setting.

Type of evidence

David Neal (DISTINCT ESR 6)

Systematic review of measuring instruments, results of a randomized controlled trial.

References

van Leeuwen KM, Bosmans JE, Jansen APD, Rand SE, Towers AM, Smith N, et al. Dutch translation and cross-cultural validation of the adult social care outcomes toolkit (ASCOT). Health Qual Life Outcomes. 2015;12:13(1).

Mangiaracina F, Meiland F, Kerkhof Y, Orrell M, Graff M, Dröes R-M. Self-management and social participation in community-dwelling people with mild dementia: a review of measuring instruments. Int Psychogeriatrics. 2019 6;1–19.

Neal D., Ettema T., Zwan M., Dijkstra K., Finnema E., Graff M., Muller M., Dröes R. M. FindMyApps compared with usual tablet use to promote social health of community-dwelling people with mild dementia and their informal caregivers: a randomised controlled trial, eClinicalMedicine. 2023. 63. https://doi.org/10.1016/j.eclinm.2023.102169

Useful links

Find My Apps website:
https://findmyapps.io/