Usability Evaluation after a 6-month Tablet-based Dementia Training Program by People with Alzheimer’s Disease, Relatives, and Dementia Trainers

Non-pharmacological interventions, like tablet-based cognitive trainings, already present an important alternative treatment of dementia. For tablet-based cognitive trainings to be effective, regular practice seems to be required, highlighting the need for such trainings to be applicable not only in well-prepared laboratory settings, but also for continuous use at home. In order to raise the acceptance as well as the user-friendliness of such trainings to consequently increase training intensity, usability research is essential. Therefore, the aim of this study was to explore the experiences of people with Alzheimer’s disease (PwAD), relatives, and dementia trainers regarding the usability of a tablet-based dementia training practiced in the home setting.A qualitative study was performed within the ongoing randomized controlled trial of the project multimodAAL. In total 15 individual interviews (each 5 per target group) were conducted with people with mild AD, their relatives and dementia trainers, who were already assigned to the intervention group for at least 6 months, practicing a dementia training program, including physical and cognitive exercises on a tablet-PC at home. The interviews lasted 91.9 minutes on average. A qualitative content analysis was performed to analyze the data.Participants were predominantly female (73.3 %). PwAD and relatives stated that they had no previous experience with this type of computer-based cognitive training and had experienced the training as positive and enriching. Some relatives saw the joint performance as a meaningful activity with their loved ones. Participants confirmed that the different types of physical exercises (e.g., coordination, strength), presented in a video format were well feasible for PwAD. In this regard, some PwAD reported feeling a bit unchallenged. Relatives and dementia trainers recommended for the exercise videos to be more motivating and fun (e.g., direct motivational address by the gymnast in the video like in a tv show, colorful sportswear). Regarding cognitive exercises, participants appreciated the variety (e.g., quiz, puzzle, calculating) as well as the sequence of the different exercises within a training session. Dementia trainers and relatives perceived that exercises related to topics about past/biography (e.g., previous occupation, hobbies) and to religious/seasonal traditions (e.g., Christmas) were particularly appreciated among PwAD. In view of beneficial factors to complete a training session with its physical and cognitive exercises successfully, relatives and dementia trainers underlined that PwAD needed support in terms of (technical) guidance, motivation/feedback/praise, as well as hints/tips/thought-provoking impulses. Dementia trainers and relatives suggested that this could be achieved by a supporting person (e.g., dementia trainer) or an expansion of the program by written and verbal support (e.g., hint button, voice assistant). Furthermore, participants emphasized the need of a tablet pen for comfortable handling, as well as a high sensitivity of the tablet-PC's touch screen.The results show that the already applied tablet-based dementia training is well received and accepted by participants. However, there is still potential for enhancement regarding motivational and feedback strategies as well as user-friendliness by the addition of a comprehensive application for guiding through the physical and cognitive exercises to enable more independent practice sessions.