JMIR Publications

ABSTRACT

Background:

Cognitive training and assessment technologies offer the promise of dementia risk reduction and more timely diagnosis of dementia respectively. Cognitive training technologies may help to reduce the lifetime risk of dementia by helping to build cognitive reserve whereas digital cognitive assessment offers the opportunity of a more convenient approach to early detection or screening.

Objective:

To investigate barriers and facilitators to the widespread adoption of cognitive training games and assessment technologies and to understand end-user perceptions of their potential benefits, shortcomings, and perceived risks.

Methods:

Four linked workshops were conducted with the same group, each focusing on a specific topic: meaningful improvement, learning and motivation, trust in digital diagnosis and barriers to technology adoption. Participants in the workshops included local Involvement Team members acting as facilitators as well as those recruited via Join Dementia Research through a purposive selection and volunteer sampling method. The group activities were recorded, and transcripts were analyzed using thematic analysis with a combination of a priori and data-driven themes. Using a mixed-methods approach, we investigate the relationships between the categories of Capability, Motivation and Opportunity along with data-driven themes by measuring the phi correlation between coded excerpts and ensured the reliability of our coding scheme by using independent reviewers and assessing inter-rater reliability.

Results:

In addition to discussions around Capability, Motivation and Opportunity, several important themes emerged during the workshops; family and friends, cognition and mood, work and hobbies and technology. Group participants mentioned the importance of functional and objective measures of cognitive change, the social aspect of activities as a motivating factor and the opportunities and potential shortcomings of digital healthcare provision. Our quantitative results indicated at least moderate agreement on all but one of the coding schemes, and good independence of our coding categories. Correlations were observed between several coding themes between categories, including moderate a moderate correlation between Capability and Cognition (0.468, p<0.001).

Conclusions:

The implications for researchers and technology developers include assessing how cognitive training and screening pathways would integrate into existing healthcare systems, but further work needs to be undertaken to address barriers to adoption and the potential real-world impact of cognitive training and screening technologies.