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There is currently a need to identify feasible and effective interventions to help older individuals suffering from memory loss maintain functional independence and quality of life. To improve upon paper and pencil memory notebook interventions, the Digital Memory Notebook (DMN) application (app) was developed iteratively with persons with cognitive impairment. In this paper we detail a manual-based intervention for training use of the DMN app. A series of three case studies are described to illustrate the clinical process of the DMN intervention, the key components of the intervention and participants' perceptions of the intervention. The Reliable Change Index was applied to pre/post intervention scores that examined everyday memory lapses, daily functioning, coping self-efficacy, satisfaction with life, and quality of life with standardized measures. Following the intervention, two of three participants self-reported a clinically significant reduction in everyday memory lapses and improved everyday functioning. One participant reported clinically significant change in quality of life. All participants demonstrated clinically significant changes in their ability to cope with problems and build self-efficacy. Furthermore, all participants scored in the normative range post-intervention on the measure of satisfaction with life. Clinical observations and participant feedback were used for refinement of the DMN intervention (ClinicalTrials.gov NCT03453554). [ABSTRACT FROM AUTHOR]

Purpose: Memory impairment can necessitate use of external memory aids to preserve functional independence. As external aids can be difficult to learn and remember to use, technology may improve the efficacy of current rehabilitation strategies. We detail the iterative development of a digital application of a paper-and-pencil memory notebook. Methods: Twenty participants (aged 54+) of varying levels of cognitive ability were recruited for four iterations of usability testing (five participants per iteration). Each participant completed a series of tasks using the digital memory notebook (DMN), followed by questionnaires that assessed satisfaction (Questionnaire for User Interface Satisfaction) and usability ratings (Post-Study System Usability Questionnaire) for the application. Results and Conclusions: Between Iterations 2 and 5, participants demonstrated marked reductions in time to complete several types of tasks (e.g., add event, navigate interface) using the DMN. Participants in Iteration 5 also rated all subscales of both the usability and satisfaction questionnaires very highly. Faster task completion times were correlated with more favourable system ratings. However, neither task performance times nor system ratings were correlated with cognitive abilities, scheduling tool use or comfort with technology. Both the questionnaire and performance-based data indicate the final iteration of the DMN was easy to use. Furthermore, the application was user-friendly despite individual differences in cognitive ability, familiarity with scheduling tools and comfort with technology. Future work will demonstrate whether the DMN will support everyday retrospective and prospective memory lapses and increase the functional independence and quality of life for persons with cognitive impairment. Building on practice standards and user-centred design, the digital memory notebook (DMN) application is an "all-in-one" memory aid and organizational tool with an intuitive interface designed to help improve everyday functioning. The DMN's today page, to do list and calendar functions can support everyday prospective and retrospective memory abilities. The DMN's notes, journaling and motivational functions can support longer-term goal planning and mood management. The DMN's alarm functions can support learning to use the DMN and serve as reminders to support prospective memory and aid in activity completion. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the current study was to use a newly developed digital tablet-based variant of the TMT to isolate component cognitive processes underlying TMT performance.Method: Similar to the paper-based trail making test, this digital variant consists of two conditions, Part A and Part B. However, this digital version automatically collects additional data to create component subtest scores to isolate cognitive abilities. Specifically, in addition to the total time to completion and number of errors, the digital Trail Making Test (dTMT) records several unique components including the number of pauses, pause duration, lifts, lift duration, time inside each circle, and time between circles. Participants were community-dwelling older adults who completed a neuropsychological evaluation including measures of processing speed, inhibitory control, visual working memory/sequencing, and set-switching. The abilities underlying TMT performance were assessed through regression analyses of component scores from the dTMT with traditional neuropsychological measures.Results: Results revealed significant correlations between paper and digital variants of Part A (rs = .541,p < .001) and paper and digital versions of Part B (rs = .799,p < .001). Regression analyses with traditional neuropsychological measures revealed that Part A components were best predicted by speeded processing, while inhibitory control and visual/spatial sequencing were predictors of specific components of Part B. Exploratory analyses revealed that specific dTMT-B components were associated with a performance-based medication management task.Conclusions: Taken together, these results elucidate specific cognitive abilities underlying TMT performance, as well as the utility of isolating digital components. [ABSTRACT FROM AUTHOR]