Dr Laura Meade Dr Vanessa Cooper
A call to action
This week is Dementia Action Week and Alzheimer’s Society UK is calling for improvements to the care system for people with dementia and their carers.1 The effects of dementia have widespread impacts on patients and their families. While there is currently no cure for dementia, quality of life may be enhanced by interventions that improve symptoms (such as problems with memory and depression), provide a means of staying safe while maintaining independence, increase self-confidence, help the individual to remain active and facilitate social connection. 2,3
Recent years have seen an explosion in the development of digital innovations. From wearables such as Fitbit to digital therapeutics that diagnose, treat and prevent,4 harnessing this technology to support people with dementia and their carers may provide a well-timed opportunity to enhance care within the home and delay the need for institutionalized care.
Leveraging digital innovations
Digital therapeutics (DTx) are evidence-based interventions that prevent, manage or treat a medical condition using software programmes.5 This technology can help to prevent illness, alleviate symptoms, improve treatment outcomes, enhance mental health and reduce healthcare costs in people with chronic diseases.6 This technology is well suited to conditions such as dementia. Indeed, it has been predicted that the future of dementia care will include digital technology.4
Recent studies have found that digital innovations for people with dementia and their carers show promise. One study found that using a tablet device as a nonpharmacological tool was feasible, safe and had potential utility to manage agitation in people with dementia.7 Participants were given a tablet device once they started to demonstrate restlessness or agitation and were able to engage with apps such as YouTube, puzzles and games.7 In a caregiver population, a systematic review identified internet-based interventions that aimed to provide support and address the needs of carers (such as peer support and provision of information) can have positive results on psychological wellbeing.8 While these technologies have the potential to reduce burden and stress, their success is reliant on adoption and ongoing engagement.
How to support engagement in digital innovations
Involving people with dementia in the design and development of digital innovations can help ensure that the product is useful, meets the needs of those they are intended for, are simple to use and have high acceptability.9 For people with dementia, being involved in co-design projects can also be empowering, facilitate social connection, build self-esteem and lead to ongoing engagement with community endeavours.10
Using frameworks that seek to understand behavior in the development of digital innovations could also support user engagement. According to the COM-B framework, behavior (e.g., engagement with a digital intervention) is determined by factors impacting a person’s capability, opportunity and motivation.11
A recent review identified factors that influence the adoption of health technology in people with dementia and their carers.9 Viewing these results within the COM-B framework may provide helpful insight for the development of digital innovations to support people with dementia.
- Alzheimer’s Society, Dementia Action Week. Available at https://www.alzheimers.org.uk/get-involved/dementia-action-week. Accessed 14 April 2021.
- Csipke, E., Shafayat, A., Sprange, K., Bradshaw, K. et al. Promoting Independence in Dementia (PRIDE): A Feasibility Randomized Controlled Trial Clinical Interventions in Aging 2021:16 363–37
- Hurt, C., Bhattacharyya, S., Burns, A., Camus,V. Liperoti, R. et al. Patient and caregiver perspectives of quality of life in dementia. An investigation of the relationship to behavioural and psychological symptoms in dementia. Dement Geriatr Cogn Disord 2008;26(2):138-46.
- Astell AJ, Bouranis N, Hoey J, Lindauer A, Mihailidis A, Nugent C, Robillard JM; Technology and Dementia Professional Interest Area …. Technology and Dementia: The Future is Now. Dement Geriatr Cogn Disord. 2019;47(3):131-139. doi: 10.1159/000497800. Epub 2019 Jun 27. PMID: 31247624; PMCID: PMC6643496.
- Digital Therapeutics Alliance. Available at: https://dtxalliance.org/. Accessed April 13 2021.
- Sverdlov O, van Dam J, Hannesdottir K, Thornton-Wells T. Digital therapeutics: An integral component of digital innovation in drug development. Clin Pharmacol Ther. 2018;104:72–80.
- Vahia IV, Kamat R, Vang C, Posada C, Ross L, Oreck S, Bhatt A, Depp C, Jeste DV, Sewell DD. Use of Tablet Devices in the Management of Agitation Among Inpatients with Dementia: An Open-Label Study. Am J Geriatr Psychiatry. 2017 Aug;25(8):860-864. doi: 10.1016/j.jagp.2016.07.011. Epub 2016 Aug 4. PMID: 27746070.
- Hopwood J, Walker N, McDonagh L, Rait G, Walters K, Iliffe S, Ross J, Davies N
Internet-Based Interventions Aimed at Supporting Family Caregivers of People With Dementia: Systematic Review, J Med Internet Res 2018;20(6):e216 doi: 10.2196/jmir.9548
- Guisado-Fernandez, Giunti, G., Mackey, L et al. Factors influencing Smart Health Technologies adoption for People with Dementia and their Informal Caregivers: A Scoping Review and Design Framework. JMIR Aging 2019; 2(1). Doi 10.2196/12192
- Dening, T., Gosling, J., Craven, M., Niedderer, M. Guidelines for designing with and for people with dementia https://designingfordementia.eu/wp-content/uploads/2020/02/Design-Guidelines-v3.pdf.Accessed on May 13, 2021
- Michie, S., van Stralen, M. M., & West, R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement Science, 20116,42. doi:10.1186/1748-5908-6-42