The Role of Sensory Changes in Everyday Technology use by People with Mild to Moderate Dementia
Emma Dixon, Amanda Lazar · 2020 · Proceedings of the 22nd International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS 2020) · doi:10.1145/3373625.3417000
Summary
This qualitative study investigates how sensory changes associated with dementia interact with everyday technology use — a topic almost entirely overlooked in prior research, which has focused predominantly on cognitive support such as memory aids, task simplification, and reduced interface complexity. The researchers conducted 30 semi-structured interviews: 11 with people living with mild to moderate dementia (average age 61.55, with diagnoses including Alzheimer's, Lewy Body, vascular dementia, and subcortical dementia) and 19 with experienced practitioners (occupational therapists, speech-language pathologists, activities directors, and dementia consultants, averaging 15 years of experience). Participants with dementia were recruited specifically for being technologically active, providing insight into issues that would likely be even more pronounced for less tech-savvy users. The study was analysed using constructivist grounded theory, with focused coding identifying instances where technology helped overcome sensory changes and where it created barriers. The research addresses a critical gap: while it is well-established that dementia affects vision, hearing, touch, and motor abilities alongside cognition, technology design for dementia has largely treated these as separate concerns rather than understanding their interplay.
Key findings
Three technological strategies emerged for accommodating sensory changes. First, stimulating at a desired level: participants used technology both to reduce overstimulation (noise-cancelling headphones in crowded environments, scrolling past cluttered content) and to provide beneficial stimulation (music for focus and emotional regulation). Second, adjusting built-in settings: participants made sophisticated use of operating system accessibility features — one participant with vascular dementia adjusted font sizes sometimes hourly due to fluctuating visual capabilities, going from size 14 in the morning to size 24 by afternoon. Practitioners noted that interface colour choices are critical, as "white can be overwhelming." Audio adjustments were equally important, with participants configuring voice assistants to use calming voices and personalizing notification sounds for comprehension. Third, switching devices: participants moved between devices to match sensory needs — shifting from books to audiobooks, from typing to voice dictation, and from phones to tablets for larger screens and easier touch targets. When none of these strategies sufficed, participants ceased using technologies entirely, abandoning social media platforms due to visual overstimulation and information overload. The study introduces the concept of "intentional sensory stimulation" — deliberately leveraging the optimal sensory mode to facilitate comprehension rather than simply reducing complexity.
Relevance
This research has profound implications for accessibility practice by demonstrating that dementia is not solely a cognitive condition — it involves fluctuating sensory abilities that profoundly affect technology use. For web and application developers, the findings reinforce the importance of robust personalization features: adjustable font sizes, colour contrast settings, audio controls, and the ability to reduce visual clutter. The concept of intentional sensory stimulation challenges the dominant "simplify everything" approach to dementia design, suggesting instead that the right kind of sensory input at the right time can actually enhance comprehension. The paper identifies a promising role for AI in automatically detecting and responding to fluctuating sensory needs — for instance, noticing when a user is squinting and suggesting larger text. For the broader accessibility community, the study highlights significant overlap between dementia-related sensory needs and those of other disability communities (vision impairment, hearing loss, autism's sensory sensitivities), suggesting that advances in one area could benefit others. The finding that poorly configured technology environments can trigger panic attacks and complete disengagement underscores that sensory accessibility is not just about convenience but about preventing genuine harm.
Tags: dementia · sensory changes · everyday technology · personalization · cognitive accessibility · aging · assistive technology · sensory processing
Standards referenced: WCAG