JMIR Publications

ABSTRACT

Background:

Mild cognitive impairment (MCI) may affect up to 20% of people over 65. Global incidence of MCI is increasing, and technology is being explored for early intervention. Theories of technology adoption (TA) predict that useful and easy-to-use solutions will have higher rates of adoption, however these models do not specifically consider older people with cognitive impairments, or the unique human-computer interaction (HCI) challenges posed by MCI. There are gaps in understanding the combined impacts of aging and cognitive impairment on factors affecting TA for older people with MCI, and it is not clear how MCI impacts HCI and device and interaction modality preferences for this population.

Objective:

This study collates opinions from older people with MCI about technology solutions proposed for them, to understand if solutions are useful, easy to use and what changes are suggested. It also identifies which devices and interaction modalities are preferred, and other factors which may affect usage and adoption.

Methods:

This scoping review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A consistent search was performed across nine electronic databases (ACM Digital Library, EBSCOhost CINAHL Plus with Full Text, EBSCOhost Computers and Applied Sciences Complete, Google Scholar, JMIR, IEEE Xplore, EBSCOhost Medline, Scopus, Web of Science Core Collection) for articles published between 1 January 2014 and 1 May 2024. Extracted data was analyzed using inductive, thematic analysis.

Results:

We identified 4271 articles and after removal of duplicates and screening, 83 articles remained for data extraction. Inductive, thematic analysis of feedback from older people with MCI about technology solutions proposed for them identified five themes (i) purpose and need, (ii) solution design and ease of use, (iii) self-impression, (iv) lifestyle, and (v) interaction modality. Solutions are perceived as useful, even though gaps in functional support exist, however, they are not perceived as entirely easy to use, due to issues related to usability and user experience. Devices which are light, portable, common and have large screens are preferred, as is multimodal interaction, in particular speech, visual/text and touch.

Conclusions:

Using technology can create feelings which positively or negatively affects a user's comfort, confidence and overall well-being. Older people with MCI value independence and autonomy, and solution designs should support these. Usefulness, ease of use, security, privacy, cost, physical comfort and convenience are important considerations for use of technology. Reliable technology creates trust, confidence and feelings of empowerment. This review recommends future work to (i) improve usability and user experience, (ii) enhance personalization, (iii) better understand interaction preferences and effectiveness, (iv) enable options for multimodal interaction, and (v) more seamlessly integrate solutions into users’ lifestyles.