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Abstract Background and Objectives Prospective memory (PM), the ability to remember to execute an intention in the future, is critical for performing everyday tasks contributing to health, financial, and social outcomes. PM declines with greater age and in the presence of a cognitive impairment. Toward the goal of developing technology-based support for older adults experiencing cognitive challenges, this study aimed to assess the attitudes of older adults with subjective cognitive complaints (SCCs) toward technology to support PM and their preferences regarding device type and the type of activity being supported. Research Design and Methods In an online survey, 188 older adults with SCCs and 190 older adults without SCCs indicated their attitudes toward 3 technologies to support PM (mobile apps, smartwatches, voice-activated assistants) and toward 6 PM-related activity areas (relationships and social activities, healthcare activities, transportation, shopping, housework and laundry, managing finances). Results, Discussion, and Implications Results showed that attitudes toward technology to support PM among older adults with SCCs were relatively positive overall and (1) differed based on the type of device and the type of activity the technology is meant to support, (2) were more positive than attitudes of older adults without SCCs, and (3) were associated with individual difference factors such as general attitudes toward technology, technology proficiency, frequency of memory failures, health, and age. Results indicate older adults with SCCs might prefer using mobile apps relative to other devices and technology to support healthcare relative to supporting other activities. Further, older adults with SCCs showed privacy concerns for voice-activated assistants and technology to manage finances. Older adults with SCCs are a promising population to target using technology-based solutions, and the type of device and type of activity being supported are important to consider while developing technology solutions to enhance independence and well-being.

Prospective memory (PM), the ability to remember to execute an intention in the future, is critical for the performance of everyday tasks important for independence and quality of life. PM failures are more frequent with increased age and can be even greater for older adults with a cognitive impairment such as subjective cognitive decline (SCD). Technology holds promise for providing everyday PM support for older adults with SCD, but little is known regarding their attitudes and preferences toward technology-based PM support. The present work utilized an online survey and focus groups to examine these attitudes. 188 older adults with SCD and 190 older adults without SCD completed an online survey on a variety of technologies to support PM in different areas of activities. A separate sample of 24 older adults with SCD participated in online focus groups and were probed about their perception of the use of technology devices for supporting PM. Results show that the attitudes of older adults with SCD 1) differed based on the type of device and the type of activity the technology is meant to support, 2) were more positive than attitudes of older adults without SCD, and 3) were associated with a variety of individual difference factors. Results indicate that older adults with SCD may be a promising population to target using technology-based solutions, and the type of device and type of activity being supported are important to consider in the development of technology solutions to enhance independence and well-being.

Abstract Smartwatches have potential to provide support for prospective memory, the ability to remember and carry out an intention in the future, crucial for maintaining health, independence, and social connections. Little is known about how older adults, particularly those with cognitive impairment, might interact with smartwatches. This study aimed to understand 1) the types of challenges older adults with and without cognitive impairment experience when using a smartwatch, and 2) the potential for smartwatches to serve as reminder aids for this population. Participants were twenty-seven older adults (age 60+) with normal cognitive functioning or cognitive impairment due to mild cognitive impairment, traumatic brain injury, or stroke. Participants were asked to use a smartwatch’s reminder notifications to remember to complete a daily survey for 10 days and completed demographic, neuropsychological, technology acceptance, and usability measures. Half were first asked to use their usual memory strategies without the smartwatch to remember to complete the daily survey for 10 days. Participants gave relatively low usability ratings for the smartwatches overall and reported a variety of challenges. The smartwatches did not appear to significantly help or hurt participants’ abilities to remember to complete the daily survey. Perceived usefulness of the smartwatches was significantly associated with subjective memory, suggesting that perceived memory challenges may play an important role in the adoption of smartwatches. Results suggest that the smartwatches used in this study may not be the best fit for supporting prospective memory and can inform the development of future efficacy tests and interventions involving smartwatches.

We examined age differences in metacognitive monitoring of emotionally-valenced stimuli. If older adults (OAs) are more focused on emotionally meaningful goals in late life (Carstensen, 2006), then they should demonstrate attentional and memory biases for positive stimuli over neutral and negative stimuli and, arguably, these cognitive biases should be reflected in their metacognitive judgments of learning. Judgments of learning (JOLs) for memory of positive, negative, and neutral words were collected. Younger adults (YAs) aged 18-23 years and OAs aged 65-90 years (N = 85) studied words in each valence category and made immediate JOLs, followed by a two-alternative forced choice (2AFC) recognition memory task. Analyses of JOLs revealed evidence for a positivity effect (Mather & Carstensen, 2005) in metacognitive confidence for OAs and an emotional salience effect in YAs (Tauber & Dunlosky, 2012; Zimmerman & Kelley, 2010). Predictably, YAs recognized more words than OAs, but valence did not affect number of words recognized and valence did not moderate age differences in recognition memory (p = .055). Memory monitoring as measured by resolution accuracy was equivalent in YAs and OAs (Hertzog & Dunlosky, 2011). Positive affect was higher and negative affect was lower in OAs relative to YAs (Gallant, Spaniol, & Yang, 2019), lending additional evidence to an orientation toward the positive in older adulthood. These results are novel in that they demonstrate an age-related positivity effect that extends beyond the domains of memory and emotion to the domain of metacognitive aging. Discussion will focus on theoretical, methodological, and applied implications.

Abstract Technology holds tremendous promise for supporting older adults' performance of important everyday activities. However, truly inclusive design of technology-based solutions must account for diversity with respect to cognitive status. This talk will focus on empirical studies conducted under the umbrella of the Enhancing Neurocognitive Health, Abilities, Networks, & Community Engagement (ENHANCE) Center with an emphasis on designing inclusive prospective memory solutions for older adults with cognitive impairments. Initial usability studies will be discussed examining the usability and efficacy of novel technology solutions, including the use of smartwatches and digital assistants, to support prospective memory, the ability to remember and carry out an intention in the future, which is crucial for maintaining health, independence, and social connections.

As the necessity of digital technology and the number of devices needed to participate in everyday life increases, understanding age differences in the use of familiar and emerging technologies is crucial for implementing technology-based solutions to enhance independence and wellbeing. We conducted an online survey to understand the types of technology categories used across age groups to support everyday life. Forty younger adults (aged 18-35 years), 40 middle-aged adults (35-64 years), and 40 older adults (65+ years) reported technology use across 13 categories (e.g., smart phones, robots) within the past year. Age-related differences in technology use varied across technology categories. For example, nearly every participant in each age group reported using a computer, a navigation device, a smartphone, and a TV, devices commonly used for everyday activities. Several technologies, including virtual reality and wearable devices, were reported most frequently by middle-aged adults. The use of tablets was reported least frequently by younger adults, voice-activated assistants were reported most frequently by older adults, and gaming consoles were reported less frequently with each increasing age group. Robots were less commonly used, and this pattern was similar for all age groups. These data challenge the idea that older adults are overall less likely to adopt and use technology compared to younger age groups. Understanding technology use at the level of an individual may be more important than at the level of age group for tailoring technology interventions that support everyday activities.

Prospective memory (PM), the ability to remember to execute an intention in the future, is critical for the performance of everyday tasks important for independence and quality of life. PM failures are associated with negative health, financial, and social outcomes, and are more frequent with increased age and can be even greater for older adults with a cognitive impairment such as subjective cognitive decline (SCD). Technology holds promise for providing everyday PM support for older adults with cognitive impairment, but little is known regarding their attitudes and preferences toward technology-based PM support. The present work utilized an online survey and focus groups to examine the attitudes of older adults with SCD toward technologies to support PM. 188 older adults with SCD and 190 older adults without SCD completed an online survey and answered questions about a variety of technologies to support PM in different activity areas. A separate sample of 24 older adults with SCD participated in online focus groups and were probed about their perception of the use of technology devices for supporting PM, benefits they feel they might derive from these devices, and potential costs or barriers to using them. Results show that the attitudes of older adults with SCD 1) differed based on the type of device and the type of activity the technology is meant to support, 2) were more positive than those of older adults without SCD, and 3) were associated with individual difference factors such as attitudes toward technology in general, technology proficiency, frequency of memory failures, health, and age. Results suggest that older adults with SCD might prefer using mobile apps relative to other devices and technology to support healthcare relative to other activities. Older adults with SCD also showed privacy concerns related to voice-activated assistants and using technology to manage finances. Results indicate that older adults with SCD may be a promising population to target using technology-based solutions, and the type of device and type of activity being supported are important to consider in the development of technology solutions to enhance independence and well-being.

Abstract Cognitive impairments (CIs) result in difficulties with a wide range of daily activities. Older adults are especially at risk for CIs, and as the older adult population increases, so does the importance of understanding and supporting the needs of those with CIs. The Enhancing Neurocognitive Health, Abilities, Networks, and Community Engagement (ENHANCE) Center was established with a focus on developing technology-based support for socialization, transportation, and prospective memory needs of older adults with CIs due to mild cognitive impairment (MCI), traumatic brain injury (TBI), and stroke. The extent to which relevant literature in these domains existed was unknown. We conducted a scoping review to identify existing research meeting the following criteria: participants aged 50+ years classified as having a CI due to MCI, TBI, or stroke; and a focus on technology-based support for socialization, transportation, and/or prospective memory needs. Using PRISMA guidelines, we searched three electronic databases, and reviewers screened citations for inclusion and completed data charting. Following screening, only 11 studies met our inclusion criteria. Qualitative and quantitative data are reported for each study. In addition to few studies available, it was common for studies to include 20 or fewer participants. Most assessed technology interactions at one time and few studies examined longitudinal use and benefits. While each paper examined one aspect of user-centered design, no technologies were reported that underwent all stages of the user-centered design process, from needs assessment to iterative design and usability testing, to efficacy trial. Such gaps highlight the important role ENHANCE can play.

Prospective memory, the ability to remember and carry out an intention in the future, is crucial for maintaining health, independence, and social connections. Wearable technologies, such as smartwatches, have the potential to serve as effective prospective memory aids, but little is known about how older adults, particularly those with cognitive impairment, might interact with such devices. This study aimed to 1) understand the types of challenges older adults with a diverse range of cognitive abilities experience when using a smartwatch, and 2) gain an initial understanding of the potential for smartwatches to serve as a prospective memory aid for this population. Participants included 27 older adults (age 60+) with normal cognitive functioning and those with cognitive impairment due to mild cognitive impairment (MCI), traumatic brain injury (TBI), or post-stroke cognitive impairment (PSCI). Participants were asked to wear a smartwatch and use its reminder notifications to remember to complete a daily automated telephone survey for 10 days. Half of the participants were first asked to use their usual memory strategies without the smartwatch to remember to complete the same daily survey for 10 days. Participants completed an initial interview consisting of demographic, neuropsychological, and technology acceptance measures, and a final interview consisting of usability measures. Participants gave relatively low usability ratings for the smartwatches overall and reported a variety of challenges. The smartwatches did not appear to significantly help or hurt participants’ abilities to remember to complete the daily survey. Participants’ perceptions of their memory were significantly associated with their perceived usefulness of the smartwatches, suggesting that perceived memory challenges may play an important role in the adoption of smartwatches. Results suggest that the smartwatches used in the present study may not be the best fit for providing prospective memory support and can inform the development of future efficacy tests and interventions involving smartwatches.

Abstract Prospective memory, the ability to remember to execute an intention in the future, is crucial for the performance of many everyday tasks important for independent living. Prospective memory abilities decline with age, and older adults living with mild cognitive impairment (MCI), cognitive impairment due to traumatic brain injury (TBI), and cognitive impairment due to stroke are especially susceptible to prospective memory failures. The goal of the Digital Reminders for Everyday Activity Memory (DREAM) project is first to establish proof of concept for an adaptive cognitive aid to support the prospective memory of older adults with various cognitive impairments, and then establish proof of product in studies examining the use of a working prototype within the lab and within participants' homes. Data will be presented from initial work verifying product requirements through engagement with stakeholders, including subject matter experts, older adults with cognitive impairments, and their care partners.