Authors (including presenting author) :
Cheung KY(1), Hui KY(1), Ma HY(1), Lui NF(1), Lam CF(1), Choi CM(2)
Affiliation :
1 Department of Occupational Therapy, Queen Elizabeth Hospital
2 Department of Family Medicine and General Outpatient Clinic, Queen Elizabeth Hospital
Introduction :
Smartphone usage is integral to daily life, facilitating social interactions, transportation, and healthcare management through applications like HAGO. However, the adoption of smartphone applications among the elderly in Hong Kong is limited due to cognitive challenges associated with aging. Various technological tasks necessitate different cognitive abilities, highlighting the need for tailored cognitive interventions to overcome these barriers. This study presents an innovative smartphone cognitive program designed to enhance technology engagement and community living skills among patients with early dementia and Mild Cognitive Impairment (MCI).
Objectives :
The study aims to (1) develop a smartphone cognitive program for patients with early dementia and MCI, and (2) evaluate its effectiveness in facilitating mobile technology engagement and enhancing community living skills.
Methodology :
Smartphone tasks require distinct cognitive abilities, including memory for procedures, visuospatial skills for locating information, and executive function for organizing actions. The program comprised four sessions addressing these cognitive challenges, covering the importance and utility of smartphones, privacy and security, memory strategies, and practical tips for common applications. Home assignments featuring HA Go N-back cognitive training for visuo-spatial, memory, and executive function skills were provided after each session. This study was conducted at the Occupational Therapy Unit of the Enhancement of Public Primary Care Services at Yau Ma Tei Jockey Club Clinic from September 2023 to February 2024, targeting individuals referred for cognitive assessment and training. Inclusion criteria included a score of 6 or higher on the Abbreviated Mental Test and above the 7th percentile on the Hong Kong version of the Montreal Cognitive Assessment (HK-MoCA), with access to smartphones. Self-reported questionnaires gathered data on participants' experiences, including confidence score in smartphone use and perceived changes in usage. The HK-MoCA assessed cognitive performance and identified limitations affecting smartphone use.
Result & Outcome :
Thirty participants aged 60-89 were recruited within the period, all having used smartphones for over three years. Among the participants, ninety-six percent reported daily use, primarily for calls. Their baseline HK-MoCA results showed fair delayed recall (65% scored ≤2 out of 5) and visuospatial and executive function performance (57.7% scored ≤2 out of 5). After the program, self-reported questionnaires revealed that 79.2% of participants reported improvements in self-efficacy regarding smartphone use, with notable increases in the variety of application usage. For example, HAGO usage rose from 11.5% pre-program to 100% post-program. Other applications related to Instrumental Activities of Daily Living (IADL) also demonstrated significant growth, including calendar planning (from 7.7% to 76.9%), photo/album usage (from 15.4% to 88.5%), access to community resources (news and weather) (from 11.5% to 53.8%), and leisure/learning applications (from 15.4% to 73.1%).
Conclusion: The smartphone cognitive program effectively addresses cognitive barriers, improving both efficacy and proficiency in smartphone usage among MCI patients. User feedback indicated increased confidence in technology use and a greater sense of independence, ultimately enhancing community living skills and overall quality of life. This program is recommended for integration into regular MCI self-management groups, with further research needed to evaluate long-term outcomes and scalability.
