Understanding How Sensory Changes Experienced by Individuals with a Range of Age-Related Cognitive Changes Can Affect Technology Use
Emma Dixon, Amanda Lazar · 2022 · ACM Transactions on Accessible Computing · doi:10.1145/3511906
Summary
This qualitative study investigates how sensory changes experienced by people with age-related cognitive changes—including dementia, mild cognitive impairment (MCI), and subjective cognitive decline (SCD)—affect their technology use. The researchers conducted interviews with 22 people experiencing these conditions and 19 healthcare professionals who work with them, analyzing responses using thematic analysis. The study documents sensory changes across five domains: vision (reduced acuity, color perception changes, simultanagnosia, surface dyslexia), hearing (fluctuating sensitivity, difficulty filtering background noise, auditory agnosia, word deafness), speech and language (developing stutter, slowed speech), dexterity (challenges with precise motor movements, pressure sensitivity on touchscreens), and proprioception (fluctuations in motor memory, balance changes). Notably, these changes often fluctuate day-to-day or even hour-to-hour, creating unique challenges for technology design. A significant contribution is documenting how healthcare professionals observe a progression in accessible interaction modes: verbal communication works best in early/mild stages, visual prompting becomes preferred as verbal comprehension declines, and eventually tactile/embodied interactions using physical objects become most effective for triggering procedural motor memory in later stages.
Key findings
Participants described using existing accessibility features designed for other disabilities—voice-to-text, larger fonts, high contrast, screen readers—to accommodate their sensory changes. Color coding proved particularly useful for signaling urgency or organizing information. Split screens helped people who struggled to select items from clusters due to simultanagnosia. The study found that embodied cues using physical objects effectively trigger procedural memory. One striking example: a woman with dementia who used a wheelchair suddenly stood up and played tennis with proper form when she held a Wii remote with a Nerf tennis racket attachment—the familiar object sparked ingrained motor memories from her years as a tennis player. Healthcare professionals use smell/aromatherapy to engage people in the very late stages of dementia when other senses become less accessible—it remains one of the last ways to evoke positive responses and memories. Balance fluctuations create unique opportunities for voice-enabled smart speakers, allowing people to control lights and devices without standing (which could cause falls). However, this raises important design tensions between user autonomy and safety.
Relevance
This research is essential for practitioners designing technology for older adults or anyone with cognitive changes. The key insight is that sensory abilities fluctuate—sometimes dramatically within a single day—meaning static accessibility accommodations are insufficient. Technology needs adjustable, multi-modal interfaces that can adapt to varying ability levels. The findings suggest designers should consider the full progression of cognitive changes when designing interfaces, potentially offering different interaction modes (verbal, visual, tactile/embodied) that users can switch between as their needs change. The documented accommodation strategies—embodied cues, voice control, simplified interfaces, multi-sensory approaches—provide a practical toolkit for accessible design. For organizations, this research highlights the importance of involving both people with cognitive changes and healthcare professionals in user research, as each group offers distinct perspectives on the lived experience and practical accommodations.
Tags: dementia · cognitive accessibility · mild cognitive impairment · sensory changes · older adults · qualitative research · assistive technology