C-TOC Literature Review

HCI Universal Usability

References

[Moffat 10] - Karyn's thesis

K.A. Moffatt, "Addressing Age-Related Pen-Based Target Acquisition Difficulties," Ph.D thesis, 2010.

[Zhai 04] - from Karyn Moffatt's thesis

S. Zhai, J. Kong, and X. Ren, "Speed-accuracy trade-off in Fitts’ law tasks — On the equivalency of actual and nominal pointing precision," International Journal of Human-Computer Studies, vol. 61, 2004, pp. 823-856.''

• comment: documents user performance differences between five wordings of speed/accuracy task instructions for a Fitt's-like task.

CPSC 544 Topic Presentation & Paper: Universal Usability - Healthy Older Adults (10/13/09)

• 544_Presentation_Universal_Usability_Health.pdf: CPSC 544 Research Topic Presentation

• 544_A1_brehmer.pdf: CPSC 544 Research Topic Paper

References

The following references were presented during a research area presentation on universal usability: healthy older adults Oct. 13, 2009.

[Abeele 06]

Abeele V, Van Rompaey V. Introducing Human-Centered Research to Game Design : Designing Game Concepts for and with Senior Citizens. In: CHI'06 extended abstracts on Human factors in computing systems. ACM; 2006:1474. Available at: http://portal.acm.org/citation.cfm?id=1125451.1125721.

• Abstract: UCD for non-traditional player groups such as senior citizens result in inspiring and creative game concepts based on the passions of elderly individuals.

• passion model: core activity + connect, cultivate, contribute - model of passions in elderly life
• focus on more than gameplay - cultivating personal growth, contributing to society, connecting people (ensure meaningful play)
• co-design of game concepts for passions and desires of seniors
• UCD in games - non-traditional player group - assessing playability in social games - incorporating ethnography and participatory design
• PD: brainstorm around a conceptual story and passions - co-designed into paper prototype + concept
• less important: playing cards, puzzles, TV
• passions: people, event planning, visiting/travel, dinner, walking, cultivating knowledge, attending guest lectures, reading non-fiction, attending workshops, watching grandchildren, organising and visiting isolated/non-mobile people

[Dix 04]

Dix, A., Finlay, J., Abowd, G. D., & Beale, R. Human-Computer Interaction (3 ed.). Peason Education Limited, Essex, UK (2004). 390-391.

• Abstract: Chapter on designing for diversity, section on designing for different age groups. Some high-level design guidelines and practices for designing for older users.

• no evidence of technophobia among older users
• more leisure time, disposable income, more independence in recent years (improved elder health)
• familiarity an issue - terminology may have different meanings
• make use of redundancy, accessibility
• clear, simple, forgiving or errors, sympathetic and relevant training

[Eisma 03]

Eisma R, Dickinson A, Goodman J, et al. Mutual inspiration in the development of new technology for older people. In: Proceedings of Include.Vol 7. Citeseer; 2003. Available at: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.107.5588&rep=rep1&type=pdf.

• Abstract: Presents design guidelines for working with older users and concept of mutual inspiration. Discusses value of hand-on activities.

• early involvement, common ground, encourage discussion, focus group atmosphere, hands-on activities / workshops - build confidence, social support
• more general than participatory design
• address the worries and fears of older users, but do not patronise

[Eisma 04]

Eisma R, Dickinson A, Goodman J, et al. Early user involvement in the development of information technology-related products for older people. Universal Access in the Information Society. 2004;3(2):131-140. Available at: http://www.springerlink.com/openurl.asp?genre=article&id=doi:10.1007/s10209-004-0092-z.

• Abstract: Methodology for early user involvement; generation of seminars regarding older users for industry.

• communicating with industry - lack of interest - reluctant to consider older users, treated them as homogenous group - no subdivision of the demographic
• HCI/UCD does not address problems for eliciting requirements for ICT for older users; HCI methods focus on req's for specific products / projects, but not when product has not yet been developed
• contacting older users possible through charity orgs, educational establishments, community orgs, sheltered housing, church groups, social clubs, day centres - maintain and extend relationship - personal visits and newsletters
• use carefully worded questionnaires, standardised UCD process
• allow for a focus-group atmosphere (aids in individuals' lack of confidence)
• social workshops - incorporate games, chatting, group interviews

[Harley 09]

Harley DA, Kurniawan SH, Fitzpatrick G, Vetere F. Age Matters : Bridging the Generation Gap through Technology-Mediated Interaction. In: Proceedings of the 27th international conference extended abstracts on Human factors in computing systems. ACM; 2009:4799–4802. Available at: http://portal.acm.org/citation.cfm?id=1520744.

• Abstract: Workshop dedicated to exploring the opportunities and obstacles faced for the design of intergenerational communication. Poses questions as a means to define the current state-of-the-art and what design/accessibility/social issues factor into design for internet/mobile/pervasive technology.

• Q: problems facing elderly people (non-health related)
• A: social isolation, social support + companionship, loss of loved ones and peers due due death / loss of mobility, families growing distant, economic migration, existing intergenerational communication tools (familiarity issues)
• considering intergenerational context for design
• social isolation, social support + companionship, greater social networks - protective influence against mortality
• decline in mobility - families distant due to economic migration
• fastest growing user group online

[Kurniawan 06]

Kurniawan SH. An exploratory study of how older women use mobile phones. UbiComp 2006: Ubiquitous Computing. 2006:105–122. Available at: http://www.springerlink.com/index/R7G4V0145304J187.pdf.

• Abstract: Guidleines established by group of senior users HCI experts. Senior-targeted websites reviewed using heuristic evaluation and new guidelines. A review of new guidelines with senior web-users.

• older users using the web more: socialisation, new skill acquisition, special interests, news, personal finances, online companionship, shopping, communicating, assisting the homebound or otherwise disabled
• categories of guidelines: vision, psychomotor, attention, memory and learning, intelligence and expertise
• 38 guidelines under 11 headings: target design, graphics, navigation, browser features, layout of control, links, user cognitive design, colour and background text design, search engine feedback,
• user evaluation of guidelines + website rating
• conclusions: guidelines too general, not specific enough, but nevertheless implications for web developers

[Massimi 07]

Massimi M, Baecker RM, Wu M. Using participatory activities with seniors to critique, build, and evaluate mobile phones. Proceedings of the 9th international ACM SIGACCESS conference on Computers and accessibility - Assets '07. 2007;6185:155. Available at: http://portal.acm.org/citation.cfm?doid=1296843.1296871.

• Abstract: Presentation paper. Presents list of considerations for design of mobile phones for older users. Also presents considerations for participatory design for ICT with seniors.

• participants want a variety of functions and applications - hardware often frustrating
• by 2050, 21% of population > 60
• "senior-friendly" - decreased sensorimotor skills, reduction in complexity and functionality (oversimplified - appropriate for dementia)
• discourage hasty, single-function, re-purposed solutions
• applications: way-finding, memory aids, keyboard/mouse alternatives
• implications for legibility - macular degeneration a reality
• guided participatory activities - software design (needs analysis, requirements engineering, paper prototypes), needs analysis (mobile phone critiques, scenario-based design)
• critical comments on form factor, interaction styles, aesthetics, undesirable features
• personal organiser and memory aid - develop own phone software / main-menu redesign
• results: function areas: calendar, address book, notebook, how-to-use-this-phone, reminder alarm, games, emergency
• results: hardware: large buttons, screen/text size + brightness, grip, selection mechanism, jog wheel, weight, hearing aid compatibility
• user tests / deployment: placing / receiving calls, notes, calendar, contacts, photographs, voice recorder
• participatory design considerations: provide alternative activities, subgroups to level out individual differences and deficits, minimise cross-talk, participation as an institutional affair, activity structure, speed up / slow down as necessary, blend individual + group sessions
• design considerations: eliminate side/rear buttons, avoid soft keys - form appropriate mental models, home state button, human support networks, several input modalities, avoid modifiers, personal data structures, no slide-out, naming conventions,
• discussion: design for "us" rather than for "me" or "them" - less homogenous
• limitations: may not generalise well, not guidelines but considerations - need more testing, seniors are better critics, hardware design, accessible software, lack of creativity during design (learning rather than creating)
• conclusion: support memory to promote autonomous living

[Zajicek 04]

Zajicek M. Successful and available: interface design exemplars for older users. Interacting with Computers. 2004;16(3):411-430. Available at: http://linkinghub.elsevier.com/retrieve/pii/S0953543804000402.

• Abstract: Discusses usefulness of a pattern language in interaction design for older users, with an example in the domain of voice input/output web kiosk. Generalizes to all interfaces used by older users.

• web voice kiosk case study
• pattern language for message types
• web applications - 1st source of info: bus schedules, council collections, doctor/hospital appts.
• diversity among older users - variability w/ age - dynamic diversity
• older people ineffective when contributing to new technologies - unaware or possibilities
• design patterns for older users - pattern language - message types: confirmatory / default / explanation
• case study / limitations of guidelines - voice output web browser - mixed mode text + speech - evaluate usefulness of spoken instructions (voice help) - confirmatory messages to build confidence / conceptual models; what is optimal message length?
• guidelines:
  • keep messages as short as possible
  • reduce choice whenever possible
  • use mnemonic letters to indicate key press menu selections
  • insert confirmatory statements whenever possible
• web accessibility exemplifies dilemma inherent in use of guidelines
• task artefact theory + claims / patterns - claims preserve info surrounding a guideline essential elements of good interface in terms of task to be completed, artefact/system or claim based on experiment or theory - encapsulate design knowledge into patterns - describing an element of design + how/why it is used - used together to enhance effectiveness; memory-supporting patterns
• features specially designed to make interaction easier for older people will be useful for everybody - greater universal usability - user sensitive inclusive design
• types of messages: menu choice, confirmatory, default input, context-sensitive help, talk-through, explanation, error recovery, partitioned input

Additional References (not presented)

The following references were not presented during the topic presentation, but included in the initial research survey.

[Davis 08]

Davis H, Vetere F, Francis P, Gibbs M, Howard S. “I Wish We Could Get Together�: Exploring Intergenerational Play Across a Distance via a 'Magic Box'. Journal of Intergenerational Relationships. 2008;6(2):191-210. Available at: http://www.informaworld.com/openurl?genre=article&doi=10.1080/15350770801955321&magic=crossref||D404A21C5BB053405B1A640AFFD44AE3.

[Ellis 00]

Ellis RD, Kurniawan SH. Increasing the Usability of Online Information for Older Users: A Case Study in Participatory Design. Computer Law. 2000;16(3):180-186.

[Goodman 04]

Goodman J, Dickinson A, Syme A. Gathering Requirements for Mobile Devices using Focus Groups with Older People. In: Designing a More Inclusive World, Proceedings of the 2nd Cambridge Workshop on Universal Access and Assistive Technology (CWUAAT), Springer. Citeseer; 2004:1-10. Available at: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.130.7025&rep=rep1&type=pdf.

[Kurniawan 05]

Kurniawan SH, Zaphiris P. Research-derived web design guidelines for older people. In: Proceedings of the 7th international ACM SIGACCESS conference on Computers and accessibility. ACM; 2005:135. Available at: http://portal.acm.org/citation.cfm?id=1090810.

[Rosson 02]

Rosson M, Carroll J, Seals C, Lewis T. Community design of community simulations. In: Proceedings of the 4th conference on Designing interactive systems: processes, practices, methods, and techniques. ACM; 2002:75–83. Available at: http://portal.acm.org/citation.cfm?id=778726.

Utopia Conference [Brewster 02]

Brewster, S., & Zajicek, M. A new research agenda for older adults. Worksop held at HCI2002, South Bank University (2002). http://www.dcs.gla.ac.uk/~stephen/workshops/utopia/index.shtml (accessed Oct 2009).

• Abstract: A workshop to establish research questions and consideration when designing ICT for older adults.
• motivation: increased life expectancy in developed nations: 2021 - 78 M / 83 F, 2050 - 79 M / 84 F
• topics: social inclusion, lifestyle, user group, modelling, system design paradigm, unifying strands in interfaces / applications, age-related impairments, design guidelines, differences from universal design

Contains a link to all papers submitted:

• 1. Dickinson A, Eisma R, Syme A, Gregor P. Utopia: Usable Technology For Older People: Inclusive and Appropriate. A New Research Agenda for Older Adults, BCS HCI, London. 2002:38-39. Available at: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Utopia:+Usable+Technology+For+Older+People:+Inclusive+and+Appropriate#0.

• 2. Dong H, Keates S, Clarkson P. Accommodating older users' functional capabilities. Group. 2002;2:10-12. Available at: http://publications.eng.cam.ac.uk/8393/.

• 3. Goodman J, Brewster SA, Gray P. Memory aids for older people. In: Proceedings.Vol 2.; 2002:32–33. Available at: http://www.dcs.gla.ac.uk/~joy/research/2002_pos_paper/position_paper_hci02.pdf.

• 4. Hanson VL. Making the Web Usable By Seniors. :10-12.

• 5. Jensen BR, Laursen B, Sandfeld J. The effect of aging on performance and muscle activity during computer use . :8-9.

• 6. Keates S, Clarkson PJ, Robinson P. Providing Access to E-Information for Older Adults. Group. 2002:19-20. Available at: http://publications.eng.cam.ac.uk/10449/.

• 7. King A, Kurniawan SH, Evans DG, Blenkhorn P. The Design and Evaluation of A Joystick-Operated Screen Magnifier. Group. 2002:10-12.

• 8. Coleman R, Cassim J, Hamlyn H. It's CHI Jim, but not as we know it! Design.:34-35.

• 9. Lines L, Hone KS. Research methods for older adults. Research Agenda for Older Adults, BCS HCI, London. 2002;(September):10-12. Available at: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Research+Methods+for+Older+Adults#8.

• 10. Monk AF, Baxter G. Would you trust a computer to run your home? Dependability issues in smart homes for older adults. Brewster, S. and Zaijicek, M. A New Research Agenda for Older Adults. British HCI, London, UK. 2002:21-22. Available at: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Would+You+Trust+a+Computer+to+Run+your+Home?+Dependibility+Issues+in+Smart+Homes+for+Older+Adults#0.

• 11. Morrissey W. What's Stopping Silver Surfers? The Triumphs & Challenges of Older Adults Surfing the Web. Group. 2002:14-15.

• 12. Reed D. Towards dependability of technology assessment in the delivery of care to the elderly: a case study. Brewster, S. and Zaijicek, M. A New Research Agenda for Older Adults. British HCI, London, UK. 2002:23-24. Available at: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Towards+Dependibility+of+Technology+Assessment+in+the+Delivery+of+Care+to+the+Elderly#0.

• 13. Wales RJ. It's a Person Issue Before a Technology Issue. Group. 2002:10-12.

• 14. Whitney G. The Navigation of Older People with a Range of Disabilities in Complex Pedestrian Environments. :6-7.

• 15. Wilmes B, Vogel M. Web-/kiosk-based health information on falls delivered to older people in tower hamlets. Methodology.:10-13.

• 16. Zajicek M, Lee A. Voice XML for Older Adults' Web Access. Group.:10-12.

• 17. Zaphiris P. Quantitative Models for Older Adults’ Hierarchical Structure Browsing. Group. 2002:10-12.

CPSC 544 - Human Computer Interaction - Universal Usability

Topic Paper References

Research papers discussed and presented during the CPSC 544 lectures.

[Shneiderman 00] - Universal Usability (General)

Shneiderman B. Universal usability. Communications of the ACM. 2000;43(5). Available at: http://portal.acm.org/citation.cfm?id=332833.332843&dl=GUIDE&dl=ACM&idx=332833&part=periodical&WantType=periodical&title=Communications of the ACM.

• Comment: This article's contribution to the field is far-reaching and addresses many forms of usability concerns. In the past 10 years, we have seen the rise of broadband internet access, the One-Laptop-Per-Child initiative (i.e. the XO-1 laptop), and the creation of many diverse online communities cited in the article. In addition, we cannot forget the rise of Web 2.0 and social networking, which have undoubtedly adhered to principles of universal usability. However, with the technical divide shrinking, a set of universal usability problems still persist today, such as concerns regarding net neutrality.

[Ho-Ching 03] - Auditory Impairments

Ho-Ching FW, Mankoff J, Landay JA. Can you see what i hear?: the design and evaluation of a peripheral sound display for the deaf. In: Proceedings of the SIGCHI conference on Human factors in computing systems. ACM New York, NY, USA; 2003:161–168. Available at: http://portal.acm.org/citation.cfm?id=642641.

• Comment: I expect that efficient wireless microphone arrays, especially those requiring little calibration, could eventually fall within a reasonable cost range, thus enabling users to use sound visualization systems such as the Ripple display. On the other hand, I expect that ubiquitous ambient detection and notification devices may prove to be more viable, and enjoy greater use among both hearing and non-hearing users. For example, imagine a kettle equipped with the capability to send a notification over a local network to a desktop or mobile device, informing the user that water has boiled. Alternatively, sensors under doormats or inside a door detect and notify when a person approaches. If we consider Moore's law and the decreasing costs of such devices, I wouldn't doubt the possibility of a house or office containing many devices with detection and notification abilities.

[Wobbrock 03] - Motor Impairments

Wobbrock JO, Myers BA, Kembel JA. EdgeWrite: a Stylus-Based Text Entry Method Designed for High Accuracy and Stability of Motion. In: Proceedings of the 16th annual ACM symposium on User interface software and technology.Vol 5. ACM; 2003:70. Available at: http://portal.acm.org/citation.cfm?id=964696.964703.

• Comment: I curious as to whether a similar system exists that will support non-Roman alphabets; the Chinese alphabet for instance contains thousands of unique characters. From my understanding of written Chinese, many characters can be divided into halves or quarters (left and right, top and bottom), with more simplified glyphs in each half or corner. Perhaps an variation of EdgeWrite with a 2 x 2 grid of adjacent writing squares could facilitate input for Chinese and other languages.

Topic: Cognitive Impairments - References

Zoltan Foley-Fisher, Presenter

[Back 01]

Back M, Szymanski MH. The AirBook: force-free interaction with dynamic text in an assistive reading device. In: CHI'01 extended abstracts on Human factors in computing systems. ACM; 2001:251–252. Available at: http://portal.acm.org/citation.cfm?id=634216.

[Dawe 06]

Dawe M. Desperately seeking simplicity: how young adults with cognitive disabilities and their families adopt assistive technologies. In: Proceedings of the SIGCHI conference on Human Factors in computing systems. ACM; 2006:1152. Available at: http://portal.acm.org/citation.cfm?id=1124772.1124943.

[Lee 08]

Lee ML, Dey AK. Lifelogging memory appliance for people with episodic memory impairment. Proceedings of the 10th international conference on Ubiquitous computing - UbiComp '08. 2008:44. Available at: http://portal.acm.org/citation.cfm?doid=1409635.1409643.

[LoPresti 04]

LoPresti EF, Mihailidis A, Kirsch N. Assistive technology for cognitive rehabilitation: State of the art. Neuropsychological Rehabilitation. 2004;14(1):5–39. Available at: http://www.informaworld.com/index/789064993.pdf.

[Wu 08]

Wu M, Birnholtz J, Richards B, Baecker RM, Massimi M. Collaborating to Remember: A Distributed Cognition Account of Families Coping with Memory Impairments. Memory. 2008:825-834.

• Comment: Given the design considerations documented in this article, it appears as though many of them can be satisfied with existing services and technology. Google calendars allows users to share, set owner and group rights, and edit calendars from the web or on a mobile device. A group with Windows Mobile-equipped devices can synchronize their Exchange calendars and set reminders for individuals or for the entire group. The cost of large displays (and potentially even large wall-mounted touch displays) will come down in eventually come down and facilitate editing of synchronized shared calendars at home. One component of this solution that is currently missing is ubiquitous or wearable computers with synchronous capabilities, but I suspect that even these forms of technology are not far from being realized.

Topic: Visual Impairments - References

Mohan Raj, Presenter

[Emery 02]

Emery VK, Edwards PJ, Jacko JA, et al. Toward achieving universal usability for older adults through multimodal feedback. ACM SIGCAPH Computers and the Physically Handicapped. 2002;(73-74):53. Available at: http://portal.acm.org/citation.cfm?id=957214.

[Jacko 03]

Jacko JA, Scott IU, Sainfort F, et al. Older Adults and Visual Impairment: What Do Exposure Times and Accuracy Tell Us About Performance Gains Associated with Multimodal Feedback? CHI. 2003;(5):33-40.

• Comment: It is no surprise to me that redundantly coding feedback across multiple modalities for drag-and-drop interactions is beneficial to all types of users (normal vision and impaired vision) - redundancy encoding has also been discussed at length in CPSC 533C (Information Visualization). Inspired by what was learned in that course, I am curious as to how visually impaired individuals (i.e. those with AMD) respond to animation as a form of redundant feedback. For instance, during a drag-and-drop operation of a file to a folder, it is typical for a small animation (i.e. the folder opening) to occur when the file icon is placed over the target folder. Could animations such as this, or easily-detectable animation such as a flashing icon be justifiably added to multi-modal feedback patterns for visually-impaired users?

Clinical Psychology References

Clinical Conditions and Diagnoses - Review Papers

[Dubois 07]

B. Dubois, H.H. Feldman, C. Jacova, S.T. DeKosky, P. Barberger-Gateau, J. Cummings, A. Delacourte, D. Galasko, S. Gauthier, and G. Jicha, "Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS–ADRDA criteria," The Lancet Neurology, vol. 6, 2007, pp. 734-746.

[Feldman 05]

H.H. Feldman and C. Jacova, "Mild Cognitive Impairment," American Journal of Geriatric Psychiatry, vol. 13, 2005, pp. 645-655.

• MCI - cog. func. below normal levels, yet not dementia;
• subtypes - AAMI (age-assoc. memory imp.), AACD (age-assoc. cog. decline), MCIa (amnestic MCI), CIND (cog. impair not dementia)
• etiological (def): the cause, set of causes, or manner of causation of a disease or condition; the causation of diseases and disorders as a subject of investigation.
• is MCI prelude to dementia; what is earliest stage of definable dementia; are there benign forms of MCI?
• nosology (def): the branch of medical science dealing with the classification of diseases.
• AAMI - defined psychometrically by scores on mem. tests 1SD below norms; other cog. func. unimpaired; not caused by specific neurological, psychiatric, medical cond.; most overlap w/ normal ageing.
• AACD - cog. effects of ageing beyond mem. domain - learning, memory, attention, thinking, language, visuospatial func.; onset over at least 6 mo. w/ requisite for confirmatory collateral history from reliable informant; 1SD below norms on tests of one of these cog. domains; insufficient to meet diagnostic criteria for dementia, not accounted for by systemic, neurological, psychiatric disorders;
• MCIa - memory complaints, generally 1.5SD below norms on psychometric tests; cog func. otherwise normal with ADL: activities of daily living; clinical dementia rating of 0.5; possible extension alteration to MCI multiple-domain and MCI single non-memory domain
• CIND - no consensus to date on operational definitions of the condition and whether there should be specified psychometric norms applied
• MCI (criteria) - neither demented nor normal - report of cog. decline supported by impairment on objective cog. tasks, evidence of decline over time; syndrome associated within a widely heterogenous group of diseases / disorders, from medical to neurological to psychiatric - assessed etiologically, promote appropriate medical mgmt;
• prevalence rates: higher in referral-based samples likely because of spectrum bias - indvls presenting to dementia clinic are more likely to have AD (alzheimer's) at the MCI stage than indvls in primary care or volunteer community settings; suggestion that AACD captures a broader range of cog. impairments;
  • avg. 10% annual rate of progression from MCI to dementia - varied considerably across MCI subtypes and settings; rates of progression from AACI to dementia are reported to be lower than AACD to dementia;
  • rates of reversion or recovery to normal from MCI differs for subtypes and settings - evidence is accruing on incidence rates within these subtypes as well as on their different dementia outcomes;
• screening: early MCI recognition can allow necessary diagnostic work-up to be undertaken, reversible etiologies and risk factors to be treated, counselling to be provided, therapy to be initiated; need to develop valid screening tools that can discriminate between normal and MCI and identify MCI individuals most likely to progress to dementia; no widely accepted screening tests for MCI;
  • MMSE - mini-mental state exam
  • Neurotrax mindstreams - computerised test
  • diagnostically validated tests likely to have utility in general practise because they are capable to detecting MCI, alerting the practitioner to seek and treat reversible etiologies, guiding the need for specific referral;
• study designs in which diagnoses have been made clinically and independently of psychometric tests have more validity than studies in which the psychometric tests were part of the diagnostic algorithm;
  • studies have consistently identified episodic memory deficits as being predictive of later progression to dementia; semantic memory/language deficits are predictive of dementia; highest risk of dementia still belongs to group with disproportionate memory impairment; episodic memory impairment is feature of abnormal, clinically relevant, cognitive functioning that may herald the onset of dementia
  • reliability of clinical judgment must still be demonstrated, w/ consideration to speciality and expertise of the clinician
• neuroimaging: extent to which the neuroimaging findings from these highly selective studies generalise to MCI population that presented to dementia clinics and general practice is unknown; further studies: determine diagnostic usefulness of MRI and PET in real-world patients.
• prevention: no successful pharmacological interventions to slow/reduce incident rates of MCI from normal;
• caveats: predictive validity around various definitions of MCI that are in use have not been fully determined; generalizability of findings from highly specified samples to general MCI population will require additional study;

[Feldman 08]

H.H. Feldman, C. Jacova, A. Robillard, A. Gracia, T. Chow, M. Borrie, H.M. Schipper, M. Blair, A. Kertesz, and H. Chertkow, "Diagnosis and treatment of dementia: 2. Diagnosis," Canadian Medical Association Journal, vol. 178, 2008, pp. 825-836.