Best Practice Guidance
Human Interaction with Technology in Dementia

themes: Design

Practical, cognitive & social factors to improve usability of technology for people with dementia

Technologies are increasingly vital in today’s activities in homes and communities. Nevertheless, little attention has been given to the consequences of the increasing complexity and reliance on them, for example, at home, in shops, traffic situations, meaningful activities and health care services. The users’ ability to manage products and services has been largely neglected or taken for granted. People with dementia often do not use the available technology because it does not match their needs and capacities. This section provides recommendations to improve the usability of technology used in daily life, for meaningful activities, in healthcare and in the context of promoting the Social Health of people with dementia.
Technology for meaningful activities

Creating a suitable user experience and design


When developing new digital applications, ensure you generate an optimal user experience and focus on sophisticated design including clear signposting and, an easy and intuitive navigation.

Explanation and example

People using the iCST app valued the sophisticated, mature design and the clear navigation but noted the need for clearer buttons. The design should have a highly professional look and feel and be clearly orientated to adults not children.

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Health care technologies

Consult with end users when deciding on a mode of delivery for a digital intervention


Researchers and developers of digital psychosocial interventions for people with dementia and family carers should consult end users on the mode of delivery of their interventions to ensure its usability.

Explanation and Examples

Consensus exists that consultations with people with dementia and family carers should be carried out when developing digital complex interventions for these populations. However, with different platforms that are available to researchers and developers, it is especially important to ensure that the mode of delivery of these technologies (e.g., smartphone application, website, text messages etc.) is appropriate and useful for people who are going to use the intervention. Qualitative consultations in the form of interviews and focus groups with end users can be especially useful for this. We conducted focus groups with 17 people with dementia and family carers to establish their needs and wishes regarding the digital adaptation of an existing face-to-face intervention. Contrary to our expectations, we discovered that participants preferred a website intervention if they were going to use the intervention for a limited amount of time, for example less than four weeks. Smartphone applications were preferred if they were going to be used for a longer period. Consultations with end users are recommended to establish not just the intervention content but also its mode of delivery.

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Social Health Domain 1: Fulfill ones potential and obligations

The development of web-based advance care planning support tools should in-volve end-users and should be based on scientific evidence


End-users should be involved in the development of web-based advance care planning support tools to ensure their usability and usefulness for end-users. Furthermore, the content of web-based advance care planning tools should be substantiated by scientific evidence.

Explanation and Examples:

More and more web-based advance care planning support tools are publicly available on the internet. We conducted a systematic review of web-based interactive advance care planning support tools. We found numerous interactive web-based advance care planning support tools, varying in terms of their characteristics, functionalities, readability, quality of content, and level of evidence. Most tools were not co-developed with end users; were of low or medium quality; and, with a few exceptions, had not been evaluated in research. Tools should be evaluated through usability and effectiveness testing and should be substantiated with the most recent scientific literature.

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Social Health Domain 2: Manage ones own life and promote independence

Privacy policies of health apps and websites should be (re-)written and (re-)designed to promote cognitive accessibility


Policy-makers and developers of apps and websites, particularly those for people with cognitive impairment or dementia, should review and improve the cognitive accessibility of privacy policies associated with apps and websites. Privacy information should be available in the official language of each country in which the app or website is available. Navigation to information should be promoted by simple, attention-focusing user interface design. Length and linguistic complexity of information in the privacy policy should be limited, or the information should be summarized.

Explanation and Examples

Cognitive accessibility conceptualizes the extent to which digital services are simple, consistent, clear, multimodal, error-tolerant, and attention-focusing to use, taking into account all users.

Online data privacy is an important legal and ethical issue, and an important concern of many (potential) app-users, which may impact on their adoption of digital tools and services. The European General Data Protection Regulation (GDPR) protects people’s right to access information about how their data is processed, so that they can make informed choices, but there are concerns that many privacy policies are too long, too complex and sometimes not even available. This may reduce trust in digital tools, presenting a barrier to adoption.

A cross-sectional study found that, in the Netherlands, Sweden and the UK:

  • Most health and wellness apps sampled outside the UK did not have a privacy policy available in the official language of the user’s country
  • Almost no privacy policies met reading level benchmarks, meaning the language was too complex for the average native speaker to understand.
  • The time that it would take the average adult native speaker to read each privacy policy was 10 minutes (websites) to 12 minutes (apps).

Recommendations to improve the cognitive accessibility of online privacy information have been made. An example of a privacy policy designed largely in line with these recommendations is the privacy policy of the FindMyApps project, which can be found on the project website:

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