Arlene Astell

Using a touch screen computer to support relationships between people with dementia and caregivers

Progressive and irreversible cognitive impairments affect the ability of people with dementia to communicate and interact with caregivers. This places a burden on caregivers to initiate and manage interactions to the extent that they may avoid all but essential communication. CIRCA is an interactive, multimedia touch screen system that contains a wide range of stimuli to prompt reminiscing. The intention is that people with dementia and caregivers will explore CIRCA together, using the recollections sparked by the media as the basis for conversations. This paper reports an evaluation of the utility of CIRCA looking particularly at whether CIRCA can meet the needs of both people with dementia and caregivers to engage in mutually satisfying interactions. The findings confirm that people with dementia can use the touch screen system and that the contents prompt them to reminisce. The system also supports caregivers to interact with people with dementia as more equal participants in the conversation. The results suggest that interacting with the touch screen system is engaging and enjoyable for people with dementia and caregivers alike and provides a supportive interaction environment that positively benefits their relationships.

Molecular connexions between dementia and diabetes.

Recent evidence suggests that the molecular defects associated with the development of diabetes also contribute to an increased risk of all types of dementia, including Alzheimers disease, vascular dementia and Picks disease. Indeed, the presence of type II diabetes mellitus results in a two to three fold higher risk of developing dementia [Fontbonne et al., 2001. Changes in cognitive abilities over a 4-year period are unfavourably affected in elderly diabetic subjects: results of the Epidemiology of Vascular Aging Study. Diabetes Care 24, 366-370; Gregg et al., 2000. Is diabetes associated with cognitive impairment and cognitive decline among older women? Study of Osteoporotic Fractures Research Group. Archives of Internal Medicine 160, 174-180; Peila et al., 2002. Type 2 diabetes, APOE gene, and the risk for dementia and related pathologies: The Honolulu-Asia Aging Study. Diabetes 51, 1256-1262]. There are currently 250 million people worldwide (>2 million in the UK) diagnosed with diabetes, and this number is predicted to double within the next 20 years, therefore the associated risk translates into a potential explosion in the appearance of dementia in the population. This review primarily focuses on the proposed molecular links between insulin action, Diabetes and Alzheimers disease, while discussing the potential for therapeutic intervention to alleviate these disorders. In particular, we will review the regulation of glycogen synthase kinase-3 (GSK-3) and its neuronal substrates.

A cognitive prosthesis and communication support for people with dementia

Abstract Computers may have the potential to augment human cognitive processes in ways that could be beneficial for people with dementia. This possibility is being investigated by a multidisciplinary team. Previous work on improving the performance of augmentative communication systems for non-speaking people has shown the value of conversation modelling and prompting in this setting. The impairment of short-term memory with dementia causes serious difficulties in communication. A conversation support and prompting system is being developed based on an interactive multimedia reminiscence presentation. Reminiscence has been chosen as a basis for the conversations because long-term memories can remain relatively intact with dementia, even where short-term memory is ineffective. Initial trials of the system involving people with dementia and their carers have shown that such a system can maintain the interest and active participation of a person with dementia, and increase carers’ enjoyment of the interaction. Further work will focus on directing the impact of multimedia towards increasing the quantity and quality of the communication taking place.

A Communication Support System for Older People with Dementia

CIRCA lets those with short-term memory loss draw on reminiscences to converse with relatives and caregivers. The system, which software engineers, psychologists,and designers developed with caregiver input, features a touch screen that displays photos, music, video, text, and other materials to help those with dementia access long-term memory. This paper presents a communication support system for older people with dementia.

Effects of age, dysphoria, and emotion-focusing on autobiographical memory specificity in children.

Overgeneral autobiographical memory (OGM) is strongly associated with depression in adults and appears to reflect a stable cognitive bias. However, it is not known whether this bias exists in children or what factors contribute to its development. We examined the roles of age, dysphoria, and a new variable, emotion‐focusing (EF), on the production of specific autobiographical memory (AM) in children, using the standard Autobiographical Memory Test (AMT; Williams & Broadbent, 1986). Results show that older children are more specific than younger children, irrespective of cue valence. Dysphoria was linked to less specific retrieval of positive memories in children. A three‐way interaction between age, valence, and dysphoria was also found, such that older dysphoric children demonstrated a difficulty in retrieving specific negative memories. In addition, emotion‐focusing was associated with specific AM recall, especially to negative cues. Results are discussed with reference to the development of depressogenic biases.

Technology and personhood in dementia care

Modern dementia care is increasingly turning to technology to address a wide range of issues. Such developments are argued to improve quality of life, as, for example, technological interventions that reduce risks and increase safety can enable people with dementia to stay in their own homes for longer. However, all interventions in dementia care must strike a balance between doing what is perceived to be for the best and preserving the personhood of people with dementia. Technological interventions run a particularly high risk of crossing the line into doing things to people with dementia, rather than with them. Doing things for people with dementia is also problematic if it takes away their ability to do things for themselves. These issues are examined with reference to electronic tagging, assistive or ‘smart’ technology and interventions to address the psychosocial needs of people with dementia.

Ambient Assisted Living Technologies for Aging Well: A Scoping Review

Abstract Ambient assisted living (AAL) technology is of considerable interest in supporting the independence and quality of life of older adults. As such, it is a core focus of the emerging field of gerontechnology, which considers how technological innovation can aid health and well-being in older age. For this scoping review, a comprehensive search of databases and key journals was conducted from January to April of 2013 in order to identify AAL technologies that have the potential to help deal with some of the challenges associated with aging. In particular, we focused on technologies that could potentially be used by people living with some degree of cognitive impairment, ranging from normal cognitive aging to mild cognitive impairment up to earlier stages of dementia. Options currently available and those still under development were both included in our search. Fifty-nine technologies were identified and are outlined here, along with a discussion of history of AAL from a gerontological perspective and related theoretical considerations.

Technology and Fun for a Happy Old Age

The past 20 years have seen a rise in the development and production of technologies to support older people. These have typically focused on issues related to safety and security and to reduce the risk of hospitalization (e.g. fall detection devices). Despite their undoubted importance, it could be argued that these aspects of aging have received more attention than is warranted and as a consequence have unduly influenced the direction of technology development for the aging population. While much less attention has been paid to technology to support people to live well and experience the things that make life worth living, the evidence that is available suggests that technology can provide people with meaningful and engaging activities that are stimulating, enjoyable and fun. This chapter provides a brief examination of this evidence for the aging population in general and then considers the application of technology for that sector of the aging population who are living with dementia. The context is provided by positive psychology, an approach to human behaviour that seeks to promote the good things in life.

Stimulating people with dementia to reminisce using personal and generic photographs

Reminiscing is a positive pastime for people with dementia but little is known about selecting materials to prompt reminiscing, particularly whether personal items are more useful than generic ones. This paper reports two small studies, the first using personal stimuli (family photographs) and the second generic photographs of annual events to examine their relative effectiveness as reminiscence prompts for people with dementia. Story telling and the types of information people with dementia produced in response to the photographs are examined. In response to family photographs, people with dementia told very few stories and produced quite limited information. When shown generic photographs, people with dementia produced quite detailed and emotional stories of personal significance. The findings suggest that personal items perform as a memory test for labels and descriptions of family events whereas generic items spark off different recollections in different people, thereby encouraging the sharing of stories and social reminiscing.

The effects of rumination and distraction on over-general autobiographical memory retrieval during social problem solving.

OBJECTIVES We examined the effects of rumination and distraction on over-general autobiographical memory (AM) retrieval during social problem solving (SPS), as well as SPS performance in terms of means and effectiveness. DESIGN AND METHODS After undergoing a rumination or distraction manipulation, dysphoric and non-dysphoric participants performed a SPS task and reported the memories retrieved during SPS. RESULTS The dysphoric ruminators performed significantly less effectively on the SPS task than the other groups. However, the dysphoric ruminators did not differ from the dysphoric distracters on the numbers of categoric memories retrieved during SPS although they retrieved significantly more categoric memories than the non-dysphoric distracters and non-dysphoric ruminators. For all groups, the effectiveness score was significantly negatively correlated with categoric memories retrieved during SPS. CONCLUSION The results demonstrated that in a dysphoric sample, rumination impaired SPS performance but did not influence categoric AM retrieval during SPS. The results suggested that in a dysphoric sample, rumination might affect SPS performance by affecting processes like initiation and motivation rather than AM retrieval during SPS.