Thinkability: A new app for cognitive stimulation for people with dementia

Abstract

Given that the prevalence of dementia is set to increase in the coming years, there will be an increased need for sustainable, affordable and scalable solutions to support people with dementia. Thinkability offers such a solution: the app is easy to access from home; it only requires a single download with a one-off payment, and it includes a wide range of activities, which can be updated in real time. Furthermore, the Thinkability app is well placed to reach underserved communities of people with dementia, for example those who live more rurally or those who are uncomfortable with attending groups; this may help to reduce inequalities in terms of care and support received. The development process, over the course of multiple stages and small-scale studies, has demonstrated that an agile approach towards technology development where all relevant stakeholders are involved can be effective in creating suitable technology for people with dementia and carers. However, within our studies, we found that agile development requires a quick turn-around meaning that when a prototype is developed, it should be evaluated by users as soon as possible. Given the practicalities of conducting research, which require sufficient time for study preparation, this is not always possible. Therefore, to add more value to development, it is recommended to involve one or two people with dementia as co-researchers throughout the development process in order to receive consistent feedback. Furthermore, the development process can be supported by using appropriate frameworks to better understand the process and determine the necessary research activities. These recommendations are useful in creating an intervention which is fit for purpose and has better potential to be successfully implemented into practice. In terms of the evaluation, feedback from people with dementia and carers indicated that Thinkability could be useful and had good usability. The majority of the participants found Thinkability to be enjoyable; however, for people who had milder dementia, the activities were found to be less challenging and therefore, less mentally stimulating. Adding more relevant content in the form of activities and levels, which are tailored to individual needs and interests, would help make Thinkability more engaging. This is also recommended for future touch-screen interventions for people with dementia to ensure an appropriate level of personalization. Preliminary results are in accordance with previous iCST research and show improvements in the QoL of carers in a small sample. Furthermore, Thinkability has been deemed to be an enjoyable app appropriate for mental stimulation and engagement. These findings contribute to the existing but limited body of research surrounding computerized cognitive stimulation and will therefore be relevant for multiple stakeholders looking to develop or participate in such interventions. However, large-scale studies investigating the formal effectiveness of such interventions are still lacking. Therefore, it is recommended to conduct a fully powered RCT to determine the cost-effectiveness of Thinkability. If individual benefits on cognition and quality of life can be established, these could lead to reduced excess disability, longer residence at home and perhaps even decrease admissions to care and/or nursing homes, thus affecting overall costs of care. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Source: chapter)