Exploring how technology influences out‐of‐home participation for persons living with dementia or mild cognitive impairment: a scoping review
Bibliographic record
Abstract
BACKGROUND: Aging-in-place presents unique challenges for persons living with dementia or mild cognitive impairment (PLWD/MCI). Cognitive deficits and unaccommodating environments often reduce PLWD/MCI's access to and participation in places outside the home (e.g., public, commercial, transportation), even though out-of-home (OoH) participation is vital to maintaining health, wellbeing, and social citizenship. Technology is increasingly embedded in everyday environments, but its role in supporting OoH participation for PLWD/MCI has not been systematically reviewed. Using the Canadian Model of Occupational Participation, this scoping review synthesizes personal (i.e., meaning, purpose, history, relationships) and contextual (micro, meso, macro-system) factors that shape how PLWD/MCI use technology to access and sustain OoH participation. METHOD: This review applied the Joanna Briggs Institute methodology and guidance. MEDLINE, Scopus, CINAHL, PsycINFO, AgeLine, Embase, and ACM Digital Library were searched for articles addressing: 1) the design/development or use of technological products/services (e.g., "navigation tool," "wayfinding"), 2) out-of-home accessibility or participation (e.g., "neighbourhood," "community"), and 3) PLWD/MCI (e.g., "dementia," "Alzheimer disease"). After deduplication, 35280 articles were screened by title/abstract, 691 articles were full-text screened, and 78 articles were included for data extraction. RESULT: Preliminary analysis results underscore the interplay between personal goals/values, history, relationships, socio-environmental and structural contexts. For PLWD/MCI, OoH participation is not only functional but also meaningful, connoting freedom, belonging, identity, and social roles. Technologies can enable or disable this participation, and alter these meanings (e.g., GPS tracker may sustain freedom but imply dependence). PLWD/MCI with meaningful OoH motivations, past digital literacy, and supportive social networks are best positioned to sustain OoH participation. At the macro level, low public awareness and inadequate digital accessibility policies often create structural barriers (e.g., replacing in-person staff with digital payment machines). CONCLUSION: Technologies embedded into OoH experiences of PLWD/MCI can enable or disable their meaningful and sustained participation, depending on interrelated personal and contextual factors. Assumptions of cognitive normativity and digital literacy in the design of OoH environments and technologies should be redressed by more dementia-inclusive policies and attitudes that regard access to OoH places as central to health, social participation, and citizenship.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.045 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.013 | 0.016 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".