Thomas, Neil

Abstract Background Individuals with mild cognitive impairment (MCI) experience challenges in maintaining independence in their instrumental activities of daily living (IADLs). The memory support system (MSS) is a paper‐based planner intervention to train individuals with MCI to complete personal goals and IADLs independently. As more individuals use electronic calendar systems, the MSS will need to adapt. This project aimed to develop and test an electronic prototype of the MSS (eMSS). Method Drawing on the MSS, an eMSS prototype intended for phone/tablet use was developed in Axure, allowing participants to interact with the planner and its sections (calendar, notes, to do list). The prototype was evaluated with MSS trainers and individuals with MCI and their partners using a computer or tablet over a virtual platform. Participants were asked to go through fictional ‘planning’ scenarios which were assessed using cognitive task analysis (CTA). The scenarios were designed to evaluate overall ease of use, and specifics such as navigation between pages/sections and developing schedules and task lists. During sessions, participants were encouraged to 'think aloud,' providing insight into their eMSS experience. Result To date, CTA has been conducted with 6 MSS trainers, and 2 patient/partner dyads that completed the MSS training program. Early results provide insight on strengths, challenges and opportunities to optimize the eMSS. Participants could identify and use key features (e.g., menus) and found the symbols and language consistent. However, participants didn’t notice some features (e.g., interactive arrows to navigate across dates) and requested more ‘cueing’ or ‘interactive prompts.’ Participants would prefer to see all information entered on individual pages (which is possible with the MSS) to support better situation awareness. Conclusion To respond to the everyday planning needs of individuals with MCI in a digital age, an eMSS was developed, drawing on a clinically trialed hardcopy version (MSS). Positive feedback from MSS trainers and patients with MCI and their partners suggests promise for the overall design. Improvements for the next iteration include designing cues to help users know actions have been completed or when to attend to important information, as well as providing more fulsome information on pages to support awareness of daily tasks.

Background: Mild cognitive impairment (MCI) is a precursor to dementia, with a prevalence of over 15% among community dwellers, with significant economic and social implications. Despite preserved autonomy in daily living, individuals with MCI face challenges in handling everyday technology and memory-related tasks, necessitating digital interventions, such as digital planning-based technologies to support cognitive functioning. Objective: The aim of this study is to identify and summarize available research literature on available digital planning-based technologies to support memory-related functioning in older adults with MCI. Specifically, this study seeks to (1) document the types and functions of these technologies, (2) report their effectiveness, and (3) identify gaps in the current evidence. Methods: A comprehensive literature search of four databases (Medline, Embase, APA PsycINFO, and CINAHL) was conducted in accordance with Arksey and O’Malley’s scoping review methodological framework from inception to February 6, 2024, without restrictions. Inclusion criteria focused on peer-reviewed studies involving adults aged 50 or older with diagnosed cognitive impairment, specifically using digital planning-based technologies for memory support. Results: From 1854 sources, 8 studies were included. Five categories of digital planning-based technologies were identified: (1) reminders and alarms, (2) electronic calendars, (3) digital memory notebooks, (4) digital visual mapping, and (5) smart-home integration. Several studies reported improved task performance, memory recall, and executive function, with digital memory notebooks and visual mapping software showing greatest impact on functional independence. While interventions were generally well-received, usability challenges and low adherence were common, often linked to technological familiarity and motivation. Conclusions: Digital planning-based technologies show promise in supporting memory-related functioning in older adults with MCI. While studies report positive outcomes, more research is needed to refine these tools, evaluate long-term effects, and ensure integration into daily life. Expanding the evidence base will be key to improving accessibility and effectiveness for this population.

Background/Objectives: Mild Cognitive Impairment (MCI), a condition between normal aging and dementia, is characterized by cognitive changes that do not significantly affect instrumental activities of daily living. The Memory Support System (MSS), an evidence-based behavioral intervention developed by the Mayo Clinic, has been shown to aid those living with MCI and their support partners in coping with cognitive challenges. However, the MSS has not been offered clinically within the Canadian context. Therefore, we conducted a study assessing the feasibility of the MSS from the perspectives of individuals living with MCI and their support partners. Methods: Participants from an institutional registry of research participants, patients, and support partners at a memory clinic, as well as members of a local Dementia Society, were approached to complete an online or paper version of a survey assessing feasibility dimensions. Responses were compared between and within groups for differences in mean scores and associations between linked binary choice response questions. Results: A total of 77 responses were received; 39 surveys were completed by participants with MCI, and 38 by support partners. Respondents found the MSS to be acceptable and practical. On average, participants thought it would be more difficult to train in using the MSS than support partners. Both groups expressed interest in the intervention. On average, participants with MCI and support partners preferred virtual MSS training to in-person and indicated more interest in participating in training over six weeks as compared to two weeks. Conclusions: Flexibility in duration and format when offering the MSS are important considerations when offering the intervention as part of a clinical program. Future research should evaluate cost-effectiveness (e.g., financial, staff resources, etc.) of the MSS approach if it were to be institutionalized in the Ontario healthcare system.