Examining Technology Perspectives of Older Adults With Mild Cognitive Impairment: Scoping Review

Mild cognitive impairment (MCI) affects up to 20% of people older than the age of 65 years. The global incidence of MCI is increasing, and technology is being explored for early intervention. Theories of technology adoption predict that useful and easy-to-use solutions will have higher rates of adoption; however, these models do not specifically consider older adults with cognitive impairments or the unique human-computer interaction challenges posed by MCI. There are gaps in understanding the combined impacts of aging and cognitive impairment on factors affecting technology adoption for older adults with MCI, and it is not clear how MCI impacts human-computer interaction and device and interaction modality preferences in this population.

This study aimed to collate perspectives from older adults with MCI about technology solutions proposed for them, to understand whether solutions are perceived as useful, easy to use, and what changes are suggested. It also identifies which devices and interaction modalities are preferred, and other factors that may affect usage and adoption.

This scoping review was completed according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. A consistent search was performed across 9 electronic databases (ACM Digital Library, EBSCOhost CINAHL Plus with Full Text, EBSCOhost Computers and Applied Sciences Complete, Google Scholar, JMIR Publications, IEEE Xplore, EBSCOhost MEDLINE, Scopus, and Web of Science Core Collection) for studies published between January 1, 2014, and May 1, 2024. Extracted data were analyzed using inductive thematic analysis.

We identified 4271 studies, and after the removal of duplicates and screening, 83 studies were included for data extraction. Inductive thematic analysis of feedback from older adults with MCI about technology solutions proposed for them identified five themes: (1) purpose and need, (2) solution design and ease of use, (3) self-impression, (4) lifestyle, and (5) interaction modality. Solutions were perceived as useful, even though gaps in functional support exist; however, they were not perceived as entirely easy to use due to issues related to usability and user experience. Devices that are lightweight, portable, familiar, and have large screens are preferred, as is multimodal interaction-particularly speech, visual or text, and touch.

Using technology can create feelings that positively or negatively affect a user's comfort, confidence, and overall well-being. Older adults with MCI value independence and autonomy, and solution designs should support these. Usefulness, ease of use, security, privacy, cost, physical comfort, and convenience are important considerations for technology use. Reliable technology creates trust, confidence, and feelings of empowerment. This review recommends future work to (1) improve usability and user experience, (2) enhance personalization, (3) better understand interaction preferences and effectiveness, (4) enable options for multimodal interaction, and (5) more seamlessly integrate solutions into users' lifestyles.