Examination of a cut-off score to express the meaningful activity of people with dementia using iPad application (ADOC)

Abstract

Purpose: To determine a quantifiable measure to identify patients with dementia who can choose an illustration of meaningful activity using an iPad application, Aid for Decision-making in Occupation Choice (ADOC). Method: We recruited 116 patients from 5 institutions in Japan. Occupational therapists interviewed patients with dementia to determine meaningful activities using ADOC. The most meaningful activity was confirmed by their primary caregivers. The cut-off was estimated from Mini-Mental State Examination (MMSE). Results: Receiver operating characteristic analysis indicated that an MMSE score of 8 was the cut-off for choosing meaningful activities using ADOC. Sensitivity and specificity was 91.0% and 74.1%, respectively, and the area under the curve value was 0.89. Conclusion: ADOC can provide individualized information regarding meaningful activities for patients with moderate dementia.

Implications for Rehabilitation

• As dementia progresses, difficulty in expressing needs or desires regarding meaningful activity may increase.

• The iPad application (Aid for Decision-making in Occupation Choice; ADOC) can be useful to promote shared decision-making through a systematic goal-setting process involving a choice of 95 illustrations describing daily activities.

• Mini-Mental State Examination (MMSE) score greater than 8 points is required to use the ADOC to choose most meaningful activities.

• ADOC provides individual information regarding meaningful activities for patients with moderate dementia.

Keywords:

• ADOC
• cut-off
• dementia
• meaningful activity
• occupational therapy

Acknowledgements

The authors thank all the occupational therapists (Seshita Y, Yamaguchi M, Ashikaga T, Akimoto T, Uezu S, Matsuo R, and Kawano S), patients, and caregivers who volunteered to participate in this study.

Declaration of interest

This study was supported in part by a Grant-in-Aid for Scientific Research (C) (project no. 24531257 to K. Tomori and project no. 23590610 to R. Nagatani) from the Japan Society for the Promotion of Science. The authors declare no conflicts of interests. The authors alone are responsible for the content and writing of this article.