Creating a digital memory notebook application for individuals with mild cognitive impairment to support everyday functioning

Abstract

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.

Implications for rehabilitation

• 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.

Keywords:

• Memory
• older adults
• iterative design
• usability testing
• rehabilitation
• compensation

Acknowledgements

We thank the WSU Cognitive Aging and Dementia Lab and the CASAS Lab. We would also like to thank Thao Vo for her help with project administration.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported in part by the Office of the Assistant Secretary of Defence for Health Affairs, through the Peer Reviewed Alzheimer’s Research Program, Quality of Life Research Award, Funding Opportunity Number: W81XWH-15-PRARP-QUAL under Award No. AZ150096. Opinions, interpretations, conclusions and recommendations are those of the authors and are not necessarily endorsed by the Department of Defence. This work was also supported in part by the National Institute on Aging under Award No. R25AG046114, the US Department of Education under Award No. P200A150115, and the National Science Foundation under Grant No. 121407.