Dementia and AT (Assistive Technology): Personal Review

Note: The following personal review was edited by Kiyoshi Yasuda as my studying note. Therefore, the English grammar and expression style have not been checked by natives. Most of article cited in this review were published until 2016. The cited parts are longer than those of normal reviews. I appreciate the authors which I cited. The table of contents (detailed version) is attached at the end of this files.

I uploaded this review here for interested readers to overview the literature on this theme. If you are interested in the articles cited in this review, be sure to refer to the original article. When you cannot find the articles, please try to find it on search engines such as Google Scholar.  

   I have written an English book “Rehabilitation for MCI and dementia: Using assistive Technology to support daily activities” in 2022. If you are interested in my studies, see the book for details. 

       Preface     

    Chapter 

          1  Memory and its memory impairments　　　　　　 　　　　　　         　

2  Dementia and assistive Technologies 

3  Low Tech Interventions by Non-electronic Tools (Memory Aids)

4  Low Tech Interventions : Assistance by Electronic Devices 

5  Various Non-pharmacological Approaches　　　　　　　　　　　　　　              6  Reminiscence Therapy and ICT　　　　　　　　　　　　　　　　　　　　 　　         7  Music Therapy and ICT

8   Therapy for Communication and ICT 　　　　　　　　　　　　　          

9   Daily Assistance by High Tech Interventions　 　　　　　　　      　　

10  Daily Assistance by Virtual Agents and Robots　　　    　　　       

        11  Assisting Dog for People with Dementia 

It is estimated that approximately 100 million people will have dementia by the year 2050. More than 50% of people with dementia live at home. Although most people live with a spouse or other family members, the people with dementia who live alone is rapidly

increasing.

   Dementia usually starts with a progressive decline in memory function. Dementia symptoms vary greatly from forgetfulness to incontinence, wandering, etc. At an advanced stage, people with dementia are no longer able to take care of themselves and require assistance to perform even simple daily activities. Because dementia inevitably increases with aging and there is no complete cure, specifically for the degenerative type of dementia, i.e., Alzheimer’s or Pick’s disease.

   The most promising way to provide relief is to assist them in their daily lives. Memory loss is the main symptom of dementia. These memory disorders manifest as deficits in information storage, inability to retrieve information, and failure to make effective use of the information. For example, a person who is no longer able to retrieve location information for the toilet or home develops incontinence or wandering.

   The first thing that we should do for such individuals is provide them with the necessary information where and when needed. Assistive technologies (ATs) can facilitate provision of information. AT is a compensatory rehabilitation approach to maintain independence, manage potential risks, and reduce stress on caregivers in their daily lives. Because people with dementia often demonstrate various memory impairments and behavioral psychological symptoms of dementia (BPSD), various types of ATs are required.

   ATs help people through both low- and high-tech interventions. Low-tech interventions can be classified into daily tools (e. g., diary, memo-pad, and calendar) or commercially available electronic devices (e.g., timer, tape recorder, and telephone). Although low-tech interventions or memory aids involve relatively simple equipment, they are practical, easily applicable, indispensable, and can be continuously used.

   People with dementia face a great number of problems. However, the number of reports on memory aids is still quite limited, especially for home-living mild and moderate dementia. As a speech and language therapist, over the last 30 years, I have been involved in the evaluation and rehabilitation of people with dementia or memory impairments.

   I have developed various memory aids (e.g., bracelet-type note pads and special diaries for dementia) and many interventions using electronic devices (e.g., IC recorder and DVD) or information communication techno logy (ICT) systems. Automatic playback of voice instructions and music using an IC recorder has been 3 shown to successfully relieve BPSD, including wandering and agitation. Introduction of these memory aids and interventions will contribute to enrichment of the AT field, especially for people with mild/moderate dementia living at home.

   Majority of older adults wish to live at home for as long as possible. High -tech interventions are also promising in enabling continued independent living. High-tech devices include computers, robots, safety monitoring, and conversation system, and aim to maintain communication and social contact as well as independent living. I have also collaborated with many engineers to develop various high-tech intervention systems to support daily lives and communication for people with dementia.

   Conversation mediated by remote videophone considerably enhances psychological stability and reduces BPSD in some cases. In addition, we have invented a toilet-assistance system, a wandering-prevention system, a virtual-agent conversation system, and robots designed to search for lost items.

   Furthermore, I have proposed the concept of an assistant dog to wear ICT devices and help people with dementia. In this personal review, I shall introduce low-tech, high-tech, and ICT interventions for people with dementia.

   Based on my empirical experience, this personal review will introduce various practical and promising studies, regardless of whether or not the studies are based on randomized controlled trials (RCTs).

   I hope that through reading this review, readers will be able to find clues to develop smarter and more effective ATs. To date, many engineers have proposed various high-tech intervention systems. However, from a clinical point of view, they are often difficult to adapt to daily situations. Through this review, engineers will come to know many practical cases of high-tech interventions for people with dementia and will be encouraged to develop interventions quickly and with efficient perspectives.

   Furthermore, this review may inspire professionals in other fields, such as animal trainers, dressing/interior designers, and social entrepreneurs, who rarely participate in assisting dementia, to take interest, which will lead to a wider interdisciplinary development of ATs. People with dementia show decline in abilities with disease progression.

   Therefore, AT must be strengthened, modified, and changed to maintain the quality of life at each stage of the disease. The continuation of collective efforts to improve ATs will enable people with dementia to make full use of their remaining capacities.