Background:Major neurocognitive disorders (MNCDs) frequently lead to difficulties in performing activities. Several studies have shown that people living with an MNCD benefit from the use of learning optimization methods from cognitive rehabilitation, such as error-free learning, motor encoding, spaced retrieval, and fading, which promote the safe pursuit of their meaningful activities. However, while the principles of learning optimization methods are relatively straightforward, the personalized application of these methods to the specific situations encountered can be more difficult. Objective:The aim of this study was to describe the codevelopment process, including the validation of a web application called "Aide-Mémoire-Interactif (AMI)," a tool to help in personalizing learning optimization methods. Methods:To design the web application, participatory action research based on a codevelopment and validation process was carried out. The various stages leading to the codevelopment of the AMI web application were grouped into 3 phases: (1) assessment of caregivers' needs (identification of situations frequently encountered by people living with an MNCD); (2) production of the first version of the AMI web application; and (3) validation of the AMI application. Individual interviews and workshops were conducted with 20 participants (caregivers, health and social service professionals, and community organization workers) to obtain a diversity of viewpoints and application contexts of use. Results:The AMI web application was developed through an iterative, participatory process involving caregivers and professionals. Participants identified daily situations requiring the use of learning optimization methods and provided feedback that guided successive refinements to the content, answer choices, navigation, and personalization features. The logical architecture was built according to the rationale underlying learning optimization methods. The final version enables users to generate tailored strategies for specific situations, access educational capsules, and save personalized strategies. Participants reported improved clarity, usability, and relevance. Conclusions:This participatory action research enabled the codevelopment and validation of the AMI web application to support the operationalization of learning optimization methods for people living with an MNCD by personalizing them to the situations encountered daily as well as to the underlying cognitive difficulties. By involving caregivers, professionals, and users, this process contributed to the development of a web application that meets user needs and their appreciation.

Smart assistive technologies are increasingly being used to support independent living. Occupational therapists perceive such technologies as useful to helping their clients become more independent in their everyday activities, particularly individuals having sustained a traumatic brain injury. However, adapting and configuring these technologies to meet each person's individual needs remain challenging. In this study, occupational therapists and computer scientists collaborate to develop a recommendation system designed to assist in configuring a smart assistive technology that helps people having sustained a traumatic brain injury cook safely. The relevance of the recommendations made by this case-based recommendation system was first evaluated by comparing the recommended assistant options with the selections of an expert occupational therapist. Then, we questioned the final users, i.e. occupational therapists, about the usefulness of such a system. This first prototype demonstrated promising results, with about 80% correct recommendations for selection (with an average percentage ranging from 77.0% to 86.2% depending on the threshold set for recommended functionalities, using a database of 16 cases). Additionally, the system was found to be robust against an unbalanced database and has been estimated as useful and relevant by end-users, who remain the final decisionmakers. The latter also expressed concerns and suggested improvements, which were incorporated early in the development process to enhance acceptance and facilitate the tool's integration into clinical practice. As a result, the tools and methods used by the multidisciplinary team led to the successful development of a generic human-centered recommendation system that can be used to personalize smart assistive technologies to each unique person's needs.

Background Aging is associated with various challenges, especially concerning mobility. Transportation planning e-tools are currently available to provide older adults with real-time travel information and help them choose trip options. However, many older adults find them challenging to use, as they are not tailored to their specific needs, such as lack of accessibility to the different means of transportation. It is necessary to identify knowledge gaps about design based on older adults’ experience using transportation planning e-tools. Objective This study aims to identify knowledge gaps regarding the user experience design and its evaluation for older adults using transportation planning e-tools. Methods A scoping review of the scientific literature was conducted, based on Arksey and O’Malley’s guidelines. The search covers sources published in English from January 2002 to October 2022 through 7 scientific databases, including MEDLINE, AgeLine, CINAHL, SCOPUS, ProQuest, IEEE Explore, and TRID (Transportation Research International Documentation), and was updated in October 2023. Data selection and extraction were performed by the first author and were co-validated by 2 co-authors. The identified sources were analyzed based on source characteristics (authors, year of publication, title of the article, source of article, country, and context of the studies), the purpose of the studies (objectives and study orientation), and the mapping of the methodology and evaluation of user experience (design approach, setting, type of data collection and analysis, type of usability evaluation, and sample size). Both descriptive-analytical methods and thematic analysis were used to analyze the categorized data. Results Overall, 1905 sources were identified through databases, and 40 sources were selected for full-text analysis. Data analysis revealed in recent years that there has been significant growth in e-tools designed for older adults, but only 2 studies were related to the field of transportation. In total, 12 studies aimed to evaluate user experience, and 22 studies focused on a user-centered design approach. Most of these studies (n=31) were carried out in a laboratory setting, using summative usability evaluation (user-based testing). The System Usability Scale (SUS) was the most prevalent tool (15 studies) to measure user efficiency and satisfaction. However, no studies have been found that specifically aim to improve the mobility experience of older adults using an age-friendly transportation planning e-tool in a real-life context. Conclusions There is a lack of studies assessing older adults’ experience when using transportation planning e-tools in real-life situations. To bridge this gap, a participatory approach is necessary to better consider the needs of older adults in a real-life context and create age-friendly design guidelines for the development of transportation planning e-tools. This will not only enhance their user experience in trip planning but also promote their social engagement by improving their mobility.

Smart homes for ambient assisted living (SHAAL) can provide cognitive assistance and telemonitoring to foster independent living at home. However, building a personalized SHAAL is a complex and time-consuming co-construction process involving IT specialists, healthcare specialists, caregivers, and the elderly person herself. Not surprisingly, it is very difficult to access and integrate all these expertise at the same time in the same place. That is why we are developing a do-it-yourself (DIY) approach aiming at enabling a non-expert to build her own SHAAL. To get there, four phases need to be supported: design, installation, tests, operation, and maintenance. This paper focusses on the design phase. It presents an innovative prototype platform that leverages Augmented Reality (AR) and Artificial Intelligence (AI) to guide a non-expert through a user-friendly “do-it-yourself” (DIY) process to design in situ a SHAAL. This platform captures each category of expertise using templates and models. Thanks to ontologies and case-based reasoning, AR makes available this expertise and assists a user while she is designing in-situ her SHAAL. Two preliminary experiments involving expert and non-expert users showed promising results.

Exploring the intersection of mobility challenges faced by older adults reveals the nuanced issues accompanying advancing age. Existing trip planning tools often fall short in addressing the unique preferences and needs of older adults. This paper delves into an initiative committed to developing an Age-Friendly trip planner platform for smart cities tailored to meet the distinctive mobility requirements of the aging population. The paper introduces the Mobilaînés project (a user-centric solution addressing the unique needs of older adults in Transportation Planning), highlights the key co-creation phase elements of the project, presents the proposed architecture, and shares insights from usability tests. By embracing smart city principles, this initiative strives to redefine the urban mobility landscape for older adults, offering an innovative solution to their specific challenges.

BackgroundTelemonitoring of activities of daily living (ADLs) offers significant potential for gaining a deeper insight into the home care needs of older adults experiencing cognitive decline, particularly those living alone. In 2016, our team and a health care institution in Montreal, Quebec, Canada, sought to test this technology to enhance the support provided by home care clinical teams for older adults residing alone and facing cognitive deficits. The Support for Seniors’ Autonomy program (SAPA [Soutien à l’autonomie des personnes âgées]) project was initiated within this context, embracing an innovative research approach that combines action research and design science. ObjectiveThis paper presents the research protocol for the SAPA project, with the aim of facilitating the replication of similar initiatives in the future. The primary objectives of the SAPA project were to (1) codevelop an ADL telemonitoring system aligned with the requirements of key stakeholders, (2) deploy the system in a real clinical environment to identify specific use cases, and (3) identify factors conducive to its sustained use in a real-world setting. Given the context of the SAPA project, the adoption of an action design research (ADR) approach was deemed crucial. ADR is a framework for crafting practical solutions to intricate problems encountered in a specific organizational context. MethodsThis project consisted of 2 cycles of development (alpha and beta) that involved cyclical repetitions of stages 2 and 3 to develop a telemonitoring system for ADLs. Stakeholders, such as health care managers, clinicians, older adults, and their families, were included in each codevelopment cycle. Qualitative and quantitative data were collected throughout this project. ResultsThe first iterative cycle, the alpha cycle, took place from early 2016 to mid 2018. The first prototype of an ADL telemonitoring system was deployed in the homes of 4 individuals receiving home care services through a public health institution. The prototype was used to collect data about care recipients’ ADL routines. Clinicians used the data to support their home care intervention plan, and the results are presented here. The prototype was successfully deployed and perceived as useful, although obstacles were encountered. Similarly, a second codevelopment cycle (beta cycle) took place in 3 public health institutions from late 2018 to late 2022. The telemonitoring system was installed in 31 care recipients’ homes, and detailed results will be presented in future papers. ConclusionsTo our knowledge, this is the first reported ADR project in ADL telemonitoring research that includes 2 iterative cycles of codevelopment and deployment embedded in the real-world clinical settings of a public health system. We discuss the artifacts, generalization of learning, and dissemination generated by this protocol in the hope of providing a concrete and replicable example of research partnerships in the field of digital health in cognitive aging. International Registered Report Identifier (IRRID)RR1-10.2196/52284

Objectives This study aimed to investigate the feasibility of implementing an assistive technology for meal preparation called COOK within a supported community residence for a person with an acquired brain injury. Methods Using a mixed-methods approach, a multiple baseline single-case experimental design and a descriptive qualitative study were conducted. The participant was a 47-year-old woman with cognitive impairments following a severe stroke. She received 21 sessions of training on using COOK within a shared kitchen space. During meal preparation, independence and safety were evaluated using three target behaviours: required assistance, task performance errors, and appropriate responses to safety issues, which were compared with an untrained control task, making a budget. Benefits, barriers, and facilitators were assessed via three individual interviews with the client and three focus groups with the care team. Results Both quantitative and qualitative analyses showed that COOK significantly increased independence and safety during meal preparation but not in the control task. Stakeholders suggested that the availability of a training toolkit to a greater number of therapists at the residence and installation of COOK within the client's apartment would help with successful adoption of this technology. Conclusion COOK is a promising assistive technology for individuals with cognitive deficits who live in supported community residences.Implication For Rehabilitation COOK is a promising assistive technology for cognition to increase independence and safety in meal preparation for clients with ABI within their supported living contexts. Receiving training from an expert and the availability of technical support are imperative to the successful adoption of COOK.

Remote monitoring uses smart home features to promote aging in place by preventing emergencies and increasing the quality of life of older adults. However, traditional reports, data, and graphs produced by remote monitoring technologies are not well suited to older adults’ needs. Thus, the complexity for older adults to use and interpret reports can lead to usability and adoption issues. The goals of this study were 1) to incorporate ludic-based design principles into an application that provides older adults with an alternative way to interact with information about their Activities of Daily Living (ADL), and 2) involve older adults in creating new ludic interfaces that address usability and reduce adoption issues. This ambient assistive technology offers older adults the opportunity, through its interface, to promote curiosity and exploration, the pursuit of non-external goals, and openness about the user’s routine and lifestyle. By using an iterative, Human-Centered, co-design approach in 4 workshops with older adults (N = 7), we combine older adults’ needs with ludic elements to propose a new user experience.

This work presents a real-time system for tracking multiple object in the context of meal preparation when using the Cognitive Orthosis for CoOKing (COOK). This system is called SafeCOOK. It aims to provide more capabilities to detect some dangerous situations that the current system does not consider. For example, it can locate a utensil or other kitchen object that has been left on the cooking surface of the stove while a meal is being prepared. This system uses a hybrid method based on YOLO and KCF to detect, track and drop cooking utensils as they enter and leave the cooking area, and is capable of monitoring an entire cooktop in real-time with a single camera. The software has been implemented on an embedded platform in the smart stove and has been added to it. The system produces good segmentation and tracking results at a frame rate of 1 to 4 frames per second, as demonstrated in extensive experiments using video sequences under different conditions.

Telemonitoring of activities of daily living (ADLs) offers significant potential for gaining a deeper insight into the home care needs of older adults experiencing cognitive decline, particularly those living alone. In 2016, our team and a health care institution in Montreal, Quebec, Canada, sought to test this technology to enhance the support provided by home care clinical teams for older adults residing alone and facing cognitive deficits. The Support for Seniors' Autonomy program (SAPA [Soutien à l'autonomie des personnes âgées]) project was initiated within this context, embracing an innovative research approach that combines action research and design science.

To promote the aging in place of elderly people with cognitive impairment, it is desirable to make their homes more intelligent. With Ambient Assisted Living (AAL) systems, it is possible to define intelligent environments that can take into account the needs of these people. This article presents the results of the experimentation of a Nighttime Assistance System (NAS) for elderly people with Alzheimer’s disease. The NAS uses AAL technologies to non-intrusively monitor the Activities of Daily Living (ADL) of an elderly person living alone, to contextualize and adapt the help that will be offered to them. For this experiment, we collected data for five weeks on a person’s activities. This work describes how this experimentation was carried out with an emphasis on user needs. It also shows the different patterns of activity observed, with particular emphasis on nocturnal ambulation. Finally, it describes the contextual model set up to support the person in the event of an episode of nocturnal wandering.

Résumé Cette étude visait à documenter comment un programme de familiarisation à l’utilisation du transport en commun influence l’expérience de mobilité des aînés. Ce programme a été co-construit avec des partenaires clés afin d’y inclure l’usage d’outils de planification technologiques et un accompagnement personnalisé tenant compte des incapacités des participants. Une étude de cas multiples (n = 7) a été menée selon une approche mixte convergente, combinant des méthodes qualitatives (p. ex., entrevues) et quantitatives (p. ex., cartes à puces). Les participants qui ont bénéficié davantage de la formation ont rapporté une meilleure connaissance du transport en commun et une plus grande confiance à utiliser l’autobus. Ils ont aussi effectué plus de sorties. Nos résultats suggèrent d’intégrer une destination « signifiante » et l’apprentissage d’outils de planification non technologiques à la formation pour en assurer la compatibilité avec les besoins et le niveau de littératie numérique des aînés. De futures études aideront à favoriser cette option de transport en amont de la perte du permis de conduire.

This study aimed to document how a public transport familiarization program influences the mobility experience of older adults. This program was co-constructed with key partners to include the use of technological planning tools and personalized support taking into account the disabilities of the participants. A multiple case study (n = 7) was carried out using a mixed convergent approach, combining qualitative (e.g., interviews) and quantitative (e.g., smart cards) methods. Participants who benefited more from the training reported better knowledge and confidence in using the bus, while more trips were made. Our results confirm the relevance of integrating a "meaningful" destination and the learning of non-technological planning tools into training so that it is adapted to the needs and digital literacy level of older adults. Future studies will help to promote this option of transport before losing a driving license.

INTRODUCTION:Following a traumatic brain injury (TBI), meal preparation may become challenging as it involves multiple cognitive abilities and sub-tasks. To support this population, the Cognitive Orthosis for coOKing (COOK) was developed in partnership with an alternative residential resource for people with severe TBI. However, little is known about the usability of this technology to support people with TBI living in their own homes. METHODS:A usability study was conducted using a mixed-methods single-case design with a 35-year-old man with severe TBI living alone at home. The number of assistances provided, time taken and the percentage of unnecessary actions during a meal preparation task were documented nine times to explore the usability of COOK. Interviews were also conducted with the participant to document his satisfaction with COOK. Potential benefits were explored via the number of meals prepared per week. RESULTS:The usability of COOK was shown to be promising as the technology helped the participant prepare complex meals, while also reducing the number of assistances needed and the percentage of unnecessary actions. However, several technical issues and contextual factors influenced the efficiency and the participant's satisfaction with COOK. Despite improving his self-confidence, COOK did not help the participant prepare more meals over time. CONCLUSION:This study showed that COOK was easy to use and promising, despite technical and configuration issues. Results suggest the importance of further technological developments to improve COOK's usability and fit with the needs of people with TBI living in their own homes.

Objectives Background Social isolation is probably one of the most affected health outcomes in the elderly people, particularly those living alone, due to the COVID-19 pandemic. Therefore, we try to identify it by detecting changes in the elderly such as malnutrition and lack of mobility. Material and methods The system consists of two types of sensors installed at various locations in the user's home: Passive infrared (PIR) sensors and reed switch sensors. It was implemented for 15 days in the home of a 26 -year-old student living alone, as a first step to later be deployed in the home of elderly people. Results Our study showed strong similarities between the activities detected by the algorithm and the real activity pattern of the interviewed individual. In addition, the system was able to identify two daily patterns (weekday and weekend) of the person as he is a student and is present in class during the week. Conclusion A system composed of low-cost, unobtrusive, non-intrusive and miniaturized sensors is able to detect meal-taking activity and mobility. These results are an intermediate step in assessing the potential risk of social isolation in older people living alone based on these ADLs.(c) 2023 AGBM. Published by Elsevier Masson SAS. All rights reserved.

Technology-driven cognitive assistance is often either excessive or insufficient, and then not necessarily helpful, because of the inadaptability to the needs and abilities of people with cognitive impairments. Cognitive assistance is usually a dialogue (an interaction) where the caregiver provides assistive cues to which the assisted person replies with behaviours. This research proposes an ontology-based cognitive assistance model for ambient assisted living (AAL) systems. It aims to characterize the situations where assistance is needed and to provide an adaptive dialogue between the AAL system and individuals to help them cope with problematic situations in a minimally assisted manner, in so far as that is possible. The theory of speech acts is extended to translate cognitive assistance into adaptive assistive messages. The model enables AAL systems to identify when to assist according to the sensor observations and to deliver progressive minimal guidance messages with stops, or adjustments and replays, depending on the behaviours of people living with cognitive impairments, such as traumatic brain injury. Such user-centered assistance considers both the abilities, and the assistance needs of individuals, to give the right level of assistance that just nudges them towards carrying out tasks “on their own”. The model builds on cognitive assistance as used within clinical practice in the field of TBI and extends it to enable AAL systems to deliver assistance acts in due course through various actuators during the person’s everyday life activities. The model is formalized in an ontology to enable reasoning capability, extension, and reuse in different AAL systems. The illustration using a real-life scenario shows its usability and applicability in the provision of cognitive assistance through graded guidance message spreading.

Background Multiple mobility-related challenges frequently appear with aging. As a result, many older adults have difficulty getting around, to go, for example, to doctors’ appointments or leisure activities. Although various means of transportation are currently available, older adults do not necessarily use them, partly because they do not know which ones are adapted to their needs and preferences. To foster older adults’ autonomy and freedom in their decision-making about transportation, it is crucial to help them make informed decisions about the means that suit them best. Objective Our aim is to develop Mobilainés, a one-stop platform transportation planning service combining different transport modes and services to help older adults move around in their community where, when, and how they wish. More specifically, we aim to (1) define older adults’ mobility needs and preferences in order to conceptualize a one-stop platform; (2) cocreate a prototype of the one-stop platform; and (3) test the prototype with users in a real-life context. Methods This ongoing study uses a “Living Lab” co-design approach. This approach differs from traditional research on aging by facilitating intersectoral knowledge sharing and innovative solutions by and with older adults themselves. A steering committee of 8 stakeholders from the public, scientific, and private sectors, as well as older citizens, will meet quarterly throughout the study. The design comprises three phases, each with several iterative subphases. Phase 1 is exploration: through co-design workshops and literature reviews, members of the intersectoral committee will define older adults’ mobility needs and preferences to support the conceptualization of the one-stop platform. Phase 2 is experimentation: 4 personas will be produced that reflect the different needs and preferences of typical older adult end users of the platform; for development of a prototype, scenarios and mockups (static designs of the web application) will be created through co-design sessions with older adults (N=12) embodying these personas. Phase 3 is evaluation: we will test the usability of the prototype and document changes in mobility, such as the ability to move around satisfactorily and to participate in meaningful activities, by and with older adults (N=30) who use the prototype. The steering committee will identify ways to support the adoption, implementation, and scaling up of Mobilainés to ensure its sustainability. Qualitative and quantitative data will be triangulated according to each subphase objective. Results The first phase began in September 2019. The study is scheduled for completion by mid-2023. Conclusions This innovative transportation planning service will merge existing transportation options in one place. By meeting a wide variety of older adults’ needs and preferences, Mobilainés will help them feel comfortable and safe when moving around, which should increase their participation in meaningful activities and reduce the risk of social isolation. International Registered Report Identifier (IRRID) DERR1-10.2196/33894