Authors (including presenting author) :
Ho SWS1, Hui KY1, Ma HY1, Leung WT1, Ma WL1, Chan SL2, Li YC2
Affiliation :
1 Department of Occupational Therapy, Queen Elizabeth Hospital 2 Department of Family Medicine and General Outpatient Clinic, Queen Elizabeth Hospital
Introduction :
In Hong Kong, there is an increasing popularity and acceptance for the elderly to use smartphone. With the demographic changes and technology advancement, mobile health is advocated as a new strategy to improve healthcare management. Recently, a new mobile cognitive app under HAGo (Cogn-App) has been launched. It adopts N-Back task to train working memory and requires patient to execute inhibitory control, cognitive flexibility, problem solving, decision making and selective attention. To further extend the effectiveness of department cognitive training, Cogn-App has been incorporated as home program enhancement.
Objectives :
This pilot study aimed to review the experience and satisfaction level in using Cogn-App among the elderly at primary care setting.
Methodology :
This study was conducted in Occupational Therapy Unit of Enhancement of Public Primary Care Services at Yau Ma Tei Jockey Club Clinic for patients referred for cognitive assessment and training during September to December 2020. Individuals aged ≥ 60 years old with electronic device available and participated in department cognitive training were eligible. Cogn-App was firstly introduced to patients and their carers with pamphlet distributed to encourage download on a voluntary basis. Therapist would then prescribe a series of N-Back training weekly on top of department cognitive training. The level of difficulty and frequency of training varied according to participant’s ability and availability. In each subsequent session, N-Back training results were reviewed. Questionnaires were distributed to evaluate satisfaction level. Compliance rate was also included for analysis.
Result & Outcome :
24 patients were recruited, in which, 80% downloaded the app. Among those participated in Cogn-App, all participants expressed overall satisfaction towards Cogn-App. 70% of participants agreed or strongly agreed that the app increased daily training opportunity and was user friendly. Although 50% of participants agreed or strongly agreed that the app helped improve cognition, most participants attained at least 2 levels upgraded in Cogn-App. 12 patients completed department training with Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) conducted premorbid. 80% of patients with compliance rate ≥ 70%, scored above 16th percentile in HK-MoCA and patients with advance age often required carer support additionally. Meanwhile, for patients with < 50% compliance rate, 80% scored below 16th percentile in HK-MoCA. Apart from cognitive incompetence to comprehend the instruction of N-Back training, common problems participants encountered included visual deficiency, hardware and software inadequacy and technical issue in registration and log in. To the best of our knowledge, this was the first study evaluating community dwelling older patients’ satisfaction towards Cogn-App. The elderly expressed a strong satisfaction and acceptance to new technology. The study also provided preliminary insight to Occupational Therapist for a more effective Cogn-App prescription. Patients with higher cognitive function and stronger carer support might benefit the most. Introducing smart technology application into home cognitive training allows therapist to provide continuous home program and monitor remotely without restriction from pandemic condition or geographical problem, which may be one major trend in healthcare service development in the future.
