Abstract
Purpose :
Older adults with low vision are increasingly using technology to improve their visual function, but mild cognitive changes may be a limitation for some seniors. We assessed the Modified Telephone Interview for Cognitive Status (TICS) to determine if it predicts success in learning how to use and become proficient with visual-assistive apps on a smartphone.
Methods :
Adults aged 55+ (mean:73, SD:11), n=100) were enrolled in a clinical trial assessing smartphone apps and their impact on visual functioning. Subjects were initially randomized to one of three apps (SuperVision+, Seeing AI, or Aira) and completed in person or virtual training (as per subjects’ preference). After 6 months, subjects (n=56) opted to receive training on the other two apps. App proficiency was measured by the trainer’s assessment of the participant’s ability to use the iPhone and the app without cueing at the end of each of two training sessions. Those who were not proficient after the second training were offered a third session. TICS scores were assessed as a sum (total across all items), as well as for neurological domains: working memory (mental arithmetic), immediate word recall, and delayed word recall. Binary logistic regressions were used to assess predictors of app proficiency.
Results :
Age (OR=.892, 95%CI .830-.959, p=.002) and TICS Working Memory (OR=1.942, 95%CI 1.204-1.364, p=.007) were significant predictors of ultimate proficiency with the first visual-assistive app (Nagelkerke pseudo R2=0.374). Age (OR=.853, 95%CI .762-.956, p=.006) and TICS working memory (OR= 4.398, 95%CI= 1.345-14.381, p=.014) were also predictors of proficiency with the two additional extension apps (Nagelkerke pseudo R2=0.475). Most (76%) subjects were ulitimately proficient with the first app, and 6-months later, about half (52%) were proficient with the other two apps. Total TICS score was not a significant predictor of proficiency with the apps (all p>.05).
Conclusions :
Many studies rely on the use of TICS scores (total sum) to determine which subjects have sufficient cognition to participate in a study. Our work in this trial has shown that a TICS subscore for working memory may be more useful to help determine who may have subtle cognitive loss and needs additional support to learn a new visual assistive technology.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.