The use of assistive technology in persons living with dementia : a systematic review of practice

Abstract

Background: Assistive technology (AT) refers to equipment or devices used to support overall function and ability in the premise of activity and participation in everyday life for older adults and persons with disabilities. In order to regulate the increase of ageing population in Europe and the western world, advocating for active ageing has become the way forward for policymakers. As a result, the main objective of this study was to review systematically the empirical support for the use of assistive technology with persons living with dementia as an intervention to improve independence, safety, communication and wellbeing at home and in long term care. Studies included those with current technology being used by persons living with dementia as supportive means of practice with the main focus being directed towards the persons living with dementia rather than the caregiver’s well-being. Furthermore, the study also sought to investigate the technology that directly affect the following domains: behavioural and psychological symptoms of dementia (BPSD), depression, cognitive function, pharmacological intervention, physical well-being, activities of daily living (ADL) and overall quality of life. Methodology: A systematic search through multiple databases, including MEDLINE, PsycINFO, CINAHL, IEEEXplore and Cochrane Central Register of Controlled Trials (CENTRAL), was conducted. Only peer-reviewed studies published after the year 2000 were included. The search focused on Assistive Technology (AT) practices and research with persons living with dementia. The reporting quality and vetting of the chosen random controlled trials (RCTs) and cross over study (COS) articles were appraised using the Cochrane RoB_2.0 bias tool and CASP Randomised-Controlled-Trial-Checklist. To minimise bias, four individuals reviewed the papers separately. Met-analysis was carried out with a fixed-effect model to calculate the pooled effects of BPSD, depression, cognition, pharmacological interventions, Activities of Daily Living (ADLs), quality of life and health and physical wellbeing. Furthermore, as part of the meta-analysis, the Hughes g correction was also applied to the BPSD, depression, cognitive function, pharmacological interventions, physical well-being, ADL, and overall quality of life. Results were reported following the (PRISMA) guidelines. Results: Eight studies met the eligibility criteria, which included 821 participants in all. The selected studies varied in content – from robot pets to hearing aids and exergaming. Overall, these interventions positively affected minimising depression (p=0.004), pharmacological interventions (p=<0.00001), improving physical well-being (p=0.005) and quality of life (p=0.03). Conclusion: The current study revealed that assistive technology interventions could be an effective tool to improve the health and quality of life in persons living with dementia. The results promoted exergaming as an alternative approach to pharmacological interventions. In addition, assistive technologies were found to improve balance, enhance socialisation and introduce a healthier routine for persons living with dementia in the community and long-term care settings.