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BackgroundMany older adults choose to live independently in their homes for as long as possible, despite psychosocial and medical conditions that compromise their independence in daily living and safety. Faced with unprecedented challenges in allocating resources, home care administrators are increasingly open to using monitoring technologies known as ambient assisted living (AAL) to better support care recipients. To be effective, these technologies should be able to report clinically relevant changes to support decision making at an individual level. ObjectiveThe aim of this study is to examine the concurrent validity of AAL monitoring reports and information gathered by care professionals using triangulation. MethodsThis longitudinal single-case study spans over 490 days of monitoring a 90-year-old woman with Alzheimer disease receiving support from local health care services. A clinical nurse in charge of her health and social care was interviewed 3 times during the project. Linear mixed models for repeated measures were used to analyze each daily activity (ie, sleep, outing activities, periods of low mobility, cooking-related activities, hygiene-related activities). Significant changes observed in data from monitoring reports were compared with information gathered by the care professional to explore concurrent validity. ResultsOver time, the monitoring reports showed evolving trends in the care recipient’s daily activities. Significant activity changes occurred over time regarding sleep, outings, cooking, mobility, and hygiene-related activities. Although the nurse observed some trends, the monitoring reports highlighted information that the nurse had not yet identified. Most trends detected in the monitoring reports were consistent with the clinical information gathered by the nurse. In addition, the AAL system detected changes in daily trends following an intervention specific to meal preparation. ConclusionsOverall, trends identified by AAL monitoring are consistent with clinical reports. They help answer the nurse’s questions and help the nurse develop interventions to maintain the care recipient at home. These findings suggest the vast potential of AAL technologies to support health care services and aging in place by providing valid and clinically relevant information over time regarding activities of daily living. Such data are essential when other sources yield incomplete information for decision making.

Intergenerational initiatives have the potential to bring generations together and can have a wide range of benefits for the health of older adults as well as for the development of young people. This paper presents a five-phase participatory action research protocol for the co-design and pilot implementation of a toolkit supporting intergenerational practice across community organizations in the province of Quebec (Canada), as well as the initial impacts of the project. This participatory action research was initiated in response to a need expressed by community organizations for support in selecting, implementing, and evaluating evidence-based intergenerational initiatives. To date, the funding secured for this project has allowed our research team to establish several partnerships with field actors involved in intergenerational practice and conduct the first three phases of the project in collaboration with these partners. While demanding in terms of time and resources, this collaborative work is fruitful and will ensure the creation of a toolkit that meets the needs of knowledge users. This article a) describes the origins of the project; b) outlines a step-by-step process for developing and implementing a participatory action research project with community organizations; and c) discusses the initial impacts of the participatory action research process.

Background: Aphasia is an acquired language disorder that occurs secondary to brain injury, such as stroke. It causes communication difficulties that have a significant impact on quality of life and social relationships. Although the efficacy of speech-language therapy has been clearly demonstrated in this population, long-term services are currently limited due to logistical and financial constraints. In this context, the potential contribution of technology, such as smart tablets, is worth exploring, especially to improve vocabulary that is relevant in daily life. Aims: The main aim was to investigate the efficacy of a self-administered treatment using a smart tablet to improve naming of functional words in post-stroke anomia. Methods & Procedures: Four adults with post-stroke aphasia took part in the study. An ABA design with multiple baselines was used to compare naming performances for four equivalent lists: (1) trained with functional words chosen with the participant; (2) trained with words randomly chosen from a picture database; (3) exposed but not trained; and (4) not exposed (control). Outcomes & Results: For all participants, the treatment self-administered at home (four times/week for 4 weeks) resulted in a significant improvement for both sets of trained words that was maintained 2 months after the end of treatment. Moreover, in two participants, evidence of generalization to conversation was found. Conclusions & Implications: This study confirms the efficacy of using smart tablets to improve naming in post-stroke aphasia. Although more studies are needed, the use of new technologies is unquestionably a promising approach to improve communication skills in people with aphasia, especially by targeting vocabulary that is relevant to them in their daily lives.

Following a traumatic brain injury (TBI), meal preparation may become challenging as it involves multiple cognitive abilities and sub-tasks. To support this population, the Cognitive Orthosis for coOKing (COOK) was developed in partnership with an alternative residential resource for people with severe TBI. However, little is known about the usability of this technology to support people with TBI living in their own homes. A usability study was conducted using a mixed-methods single-case design with a 35-year-old man with severe TBI living alone at home. The number of assistances provided, time taken and the percentage of unnecessary actions during a meal preparation task were documented nine times to explore the usability of COOK. Interviews were also conducted with the participant to document his satisfaction with COOK. Potential benefits were explored via the number of meals prepared per week. The usability of COOK was shown to be promising as the technology helped the participant prepare complex meals, while also reducing the number of assistances needed and the percentage of unnecessary actions. However, several technical issues and contextual factors influenced the efficiency and the participant's satisfaction with COOK. Despite improving his self-confidence, COOK did not help the participant prepare more meals over time. This study showed that COOK was easy to use and promising, despite technical and configuration issues. Results suggest the importance of further technological developments to improve COOK's usability and fit with the needs of people with TBI living in their own homes. Cognitive Orthosis for coOKing (COOK) is a promising technology to support people with TBI when preparing meals within their homes, though usability issues need to be corrected. Factors such as current meal-preparation related habits, expectations and availability of technical support were found to influence the usability of COOK. Various questions to consider in future studies involving an assistive technology for cognition to support meal preparation were identified. [ABSTRACT FROM AUTHOR]

INTRODUCTION: In a 5‐year follow‐up study, we investigated the enduring effects of cognitive training on older adults with mild cognitive impairment (MCI). METHODS: A randomized controlled single‐blind trial involved 145 older adults with MCI, assigned to cognitive training (MEMO+), an active control psychosocial intervention, or a no‐contact condition. Five‐year effects were measured on immediate and delayed memory recall, the Montreal Cognitive Assessment screening test (MoCA), self‐reported strategy use, and daily living difficulties. RESULTS: At follow‐up, participants who received cognitive training showed a smaller decline in delayed memory and maintained MoCA scores, contrasting with greater declines in the control groups. Cognitive training participants outperformed controls in both delayed memory and MoCA scores at the 5‐year time point. No significant group differences were observed in self‐reported strategy use or difficulties in daily living. DISCUSSION: Cognitive training provides long‐term benefits by mitigating memory decline and slowing clinical symptom progression in older adults with MCI. Highlights: Cognitive training reduced the 5‐year memory decline of persons with MCI.Cognitive training also reduced decline on the Montreal Cognitive Assessment (MoCA).No intervention effect was found on strategy use or activities of daily living. [ABSTRACT FROM AUTHOR]

Community organizations play a key role in reaching out to diverse populations of older adults to address their unmet social participation needs, including in times of crisis (e.g., pandemic) and beyond. It is important to learn from their experiences (challenges, strategies used) to improve preparedness for future crises and strengthen the post-pandemic adaptation of these organizations. This study documented the experiences of community organizations providing social participation services for older adults during the first eighteen months of the pandemic. A descriptive qualitative study was conducted, with data collected at two time points, August 2020 (T1) and August 2021 (T2). Fifteen of the twenty-three participants completed interviews at both time points. From T1 to T2, community organizations faced challenges in adapting services to meet the evolving needs of a heterogeneous population while managing the challenges posed by the digital divide, managing organizational challenges, and adapting to changing public health measures and their social implications. Their strategies evolved from an urgent response to basic needs (T1) to diversifying the solutions used (both technological and non-technological) to promote older adults’ active engagement in services (T2). From T1 to T2, they also strengthened communication bridges and partnerships. Having advocated for older adults’ rights during the pandemic, they emphasized, particularly at T2, the importance of empowering them (e.g., through intergenerational initiatives). These findings underscore the need to use effective mechanisms to support cross-sectoral collaboration in order to identify, implement, and sustain the promising initiatives that emerged during the pandemic, particularly in sectors at risk of experiencing inequities in accessing services [ABSTRACT FROM AUTHOR]

To describe the use of mobile devices after acquired brain injury (ABI), from the perspectives of injured individuals and significant others, and to examine factors associated with mobile device use for cognition. Cross-sectional study with 50 adults with moderate/severe traumatic brain injury or stroke (42% women; mean of 50.7 years old, 4.6 years post-ABI), and 24 significant others. Participants completed questionnaires on mobile technology, cognitive functioning and the impact of technology. Of 45/50 adults with ABI who owned a smartphone/tablet, 31% reported difficulties in using their device post-injury, 44% had received support, and 46% were interested in further training. Significant others reported motor/visual impairments and the fear of becoming dependent on technology as barriers for mobile device use, and 65% mentioned that their injured relative needed additional support. Mobile device use for cognition was common (64%), predicted in a regression model by lower subjective memory and more positive perception of the psychosocial impacts of technology, and also associated in univariate analyses with younger age, lower executive functioning, and greater use of memory strategies. Using mobile devices for cognition is common post-ABI but remains challenging for a significant proportion. Developing training approaches may help supporting technology use. Using mobile electronic devices (smartphones and tablets) is common after acquired brain injury (ABI) but is challenging for a significant proportion of individuals. After the ABI, close to 50% of individuals receive support in using their mobile device, mostly from family members and friends, but rarely from rehabilitation clinicians or technology specialists. In a sample of 50 adults with ABI, more frequent use of mobile devices to support cognition was associated with poorer subjective memory and executive functioning, greater use of memory strategies, more positive perception of the psychosocial impacts of technology, and younger age. [ABSTRACT FROM AUTHOR]

Cognitive interventions are helpful in the non-pharmacological management of Primary progressive aphasia (PPA) and other neurodegenerative disorders of cognition, by helping patients to compensate for their cognitive deficits and improve their functional independence. In this study, we examined the effectiveness of cognitive rehabilitation based on the use of mobile device technology in PPA. The aim of this research study was to determine if BL, a patient with semantic variant PPA (svPPA) and severe anomia, was able to learn using specific smartphone functions and an application to reduce her word finding difficulties. She was trained during the intervention sessions on a list of target pictures to measure changes in picture naming performance. Errorless learning was applied during learning. BL quickly learned to use smartphone functions and the application over the course of the intervention. She significantly improved her anomia for trained pictures, and to a lesser extent for untrained semantically related pictures. Picture naming performance was maintained six months after the intervention, and she continued to use her smartphone regularly to communicate with family members and friends. This study confirms that smartphone use can be learned in PPA, which can help reduce the symptoms of anomia and improve communication skills. [ABSTRACT FROM AUTHOR]

Objective: To identify facilitators and barriers to older adults' participation in telehealth interventions for primary prevention and health promotion. Methods: Relevant articles were searched using keywords in Embase and MEDLINE. Study characteristics, type of telehealth interventions and technology involved, as well as facilitators and barriers to their use, were extracted from selected articles. The Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model was used to organise data. Results: A total of 24 articles (pertaining to 20 studies) were included. Nine facilitators and 11 barriers influencing the participation in telehealth interventions for primary prevention and health promotion among older adults were identified. The most recurrent facilitators were related to the individual's performance expectancy and effort expectancy, as well as the presence of a social dimension associated with the intervention (i.e. having a good relationship with the other participants in the program). The two most prevalent barriers were also related to effort expectancy and performance expectancy, followed by barriers related to the inherent characteristics of the technology and older adults' health condition. Experience, age and gender were also found to moderate technology use and acceptance. Conclusions: This rapid review highlights the importance of adopting a holistic perspective when designing telehealth interventions aimed at preventive and health promotion purposes among older adults. [ABSTRACT FROM AUTHOR]

Introduction: Individuals with traumatic brain injury (TBI) frequently need assistance to manage complex everyday activities. However, little is known about the types of cognitive assistance that can be used to facilitate optimal independence. A conversion mixed method study using video analysis was conducted to describe assistance provided by trained occupational therapists during three everyday tasks carried out in the participants' homes and surrounding environments. Methods: Forty‐five people with moderate and severe TBI were tested by three occupational therapists using the Instrumental Activities of Daily Living Profile, an observation‐based assessment that documents independence in complex everyday activities and the minimal assistance required to attain task goals. Using video analysis, difficulties experienced by the people with TBI during a meal preparation and grocery shopping task, and the cognitive assistance provided by the occupational therapists in response to these difficulties, were documented. Statistical analyses were also completed to identify the main difficulties and types of cognitive assistance provided during the evaluation, for the whole group and depending on their level of independence. Results: Nine types of cognitive assistance were used by occupational therapists, including implicit (stimulating thought processes), and more explicit assistance (cueing), to facilitate task performance. When needed, motivational assistance, which consisted of encouraging participants to think for themselves, was also used. Stimulating thought processes was mostly used to support goal formulation and planning, whereas cueing was used in numerous instances. Participants with lower levels of independence received more assistance of almost all types to support them. Conclusion: Using these findings, training could be developed for caregivers and occupational therapists to support them in providing minimal and personalised cognitive assistance. Further research is needed to examine the extent to which all types of cognitive assistance are effective in helping various cognitive profiles of people with TBI attain optimal independence. [ABSTRACT FROM AUTHOR]

This study examined the effects on attitudes and lifestyle behavior of "Jog your Mind," a multi-factorial community-based program promoting cognitive vitality among seniors with no known cognitive impairment. A quasi-experimental study was conducted. Twenty-three community organizations were assigned either to the experimental group (offering the program) or to the control group (creating a waiting list). They recruited 294 community-dwelling seniors. The aims of the study were to verify the effects of the program on attitudes and behaviors related to cognitive vitality and to explore its effects on cognitive vitality. Data was collected at baseline and after the program. Regression analyses revealed that, following their participation in the program, experimental group participants reported: (i) in terms of attitudes, having a greater feeling of control concerning their cognitive capacities, (ii) in terms of behaviors, using significantly more memory strategies and practicing more physical activity and stimulating activities than control group participants. However, the program had no significant effects on measures of cognitive vitality. This study supports the fact that a multi-factorial community-based program can have significant effects on seniors' attitudes and lifestyle behaviors related to cognitive vitality but at short term, no effects on cognitive vitality it-self were found.

This study aimed to investigate the feasibility of implementing an assistive technology for meal preparation called COOK within a supported community residence for a person with an acquired brain injury. Using a mixed-methods approach, a multiple baseline single-case experimental design and a descriptive qualitative study were conducted. The participant was a 47-year-old woman with cognitive impairments following a severe stroke. She received 21 sessions of training on using COOK within a shared kitchen space. During meal preparation, independence and safety were evaluated using three target behaviours: required assistance, task performance errors, and appropriate responses to safety issues, which were compared with an untrained control task, making a budget. Benefits, barriers, and facilitators were assessed via three individual interviews with the client and three focus groups with the care team. Both quantitative and qualitative analyses showed that COOK significantly increased independence and safety during meal preparation but not in the control task. Stakeholders suggested that the availability of a training toolkit to a greater number of therapists at the residence and installation of COOK within the client's apartment would help with successful adoption of this technology. COOK is a promising assistive technology for individuals with cognitive deficits who live in supported community residences. COOK is a promising assistive technology for cognition to increase independence and safety in meal preparation for clients with ABI within their supported living contexts. Receiving training from an expert and the availability of technical support are imperative to the successful adoption of COOK. [ABSTRACT FROM AUTHOR]

Background: Jog Your Mind is a community-based program aiming to enable seniors to maintain their cognitive abilities. It includes stimulating activities, information on aging, mnemonic strategies, and promotion of a healthy lifestyle and is offered over 10 weekly sessions to seniors with no known cognitive impairment. Purpose: This article describes the development and content of the program, as well as the results of the process evaluation. Methods: A coconstruction framework guided the development and evaluation of the program. The development involved experts, practitioners, and partners. The program was implemented by 13 community organizations (n = 143 seniors). Program implementation, response of the participants, and group leaders' and managers' opinions of the program were documented. Results: The program was implemented in variable contexts, socioeconomic levels, type and size of settings, group leaders' background, and participants' profiles. Seniors' satisfaction and participation rates were high. Opinions from group leaders and managers were positive and suggestions for improvement were minor. Discussion: Jog Your Mind was considered as satisfactory and beneficial by participants and feasible by community organization practitioners. Translation to Health Education Practice: Using a systematic, coconstruction framework involving stakeholders can lead to relevant and practical interventions that are well received by practitioners and the target population.