Population aging increases the strain on healthcare systems and highlights the value of gerontechnologies in promoting the autonomy and home-based living of older adults. However, their adoption remains limited, particularly due to age-related cognitive changes.
Cognitive Load Theory attributes certain difficulties in using digital technologies to the excessive demands placed on working memory. Yet, it provides limited insight into the executive functions involved in interface interaction-specifically inhibition, cognitive flexibility, and working memory updating. The concept of "executive load" may therefore provide a framework for examining examine how excessive demands on these functions affect user efficiency.
The primary objective of this study is to evaluate the impact of mental flexibility on the usability of a digital interface among individuals aged 65 or older living in senior residences who have an MMSE score of ≥ 24/30. Executive functions, cognitive reserve, technology acceptance, and digital skills are assessed during an initial visit.
Between 24 hours and one month later, participants perform a medical appointment-booking task on a tablet twice, using two interfaces that differ in executive load (low versus high). The order of interface presentation is randomized to control for potential order and practice effects. Performance, user experience, and cognitive load are recorded after each task.
The study aims to recruit 70 participants to obtain at least 50 complete datasets. Although the study offers no direct therapeutic benefit, it is expected to help better tailor gerontechnologies to the cognitive capabilities of older adults and facilitate the design of more accessible and inclusive digital interfaces, particularly in the healthcare sector.
Be aged 65 or older
Reside in a partner senior living facility
Understand French
Have signed an informed consent form for participation
Be subject to a legal protection measure
Have a major, uncorrected visual or hearing impairment preventing the reading of questionnaires, the completion of neuropsychological tests, or the use of a touchscreen tablet
Have a motor impairment of the upper limbs making the use of a touchscreen tablet impossible
Have a neurological or psychiatric condition likely to impair executive functions or participation in the assessment, including acute or progressive neurological disorders, significant neurological history, and unstabilized psychiatric disorders
Sequential
high executive load task
Other interventionhigh executive load task
low executive load task
Other interventionlow executive load task
Correlation between Trail Making Test Z-score and usability score (low executive load)
Evaluate the impact of mental flexibility on the usability of a digital interface =\> correlation between the Trail Making Test Z-score and the usability score (completion time in seconds) for the digital task under low executive load conditions. The Trail Making Test consists of two sheets (A and B). On sheet A, the participant must connect numbers in ascending order (time and number of errors are recorded). On sheet B, the participant must alternate between connecting numbers and letters (time, number of errors, and number of perseverations are recorded). A Z-score is calculated using the recorded scores.
Correlation between Trail Making Test Z-score and UEQ score (low executive load)
Evaluate the impact of mental flexibility on user experience =\> correlation between the Trail Making Test Z-score and the UEQ score under conditions of low executive load. UEQ (26 items) : a questionnaire evaluating user experience across six dimensions: attractiveness, perspicuity, efficiency, dependability, stimulation, and novelty. These dimensions can be grouped into two subscales: pragmatic (efficiency, clarity, dependability) and hedonic (stimulation and novelty). Each item is rated on a scale of 1 to 7, with results converted into composite scores. A score close to +3 indicates a very positive experience, while a score close to -3 indicates a negative experience. The score for each UEQ dimension will be recorded. The questionnaire is administered via interviewer-led assessment (taking approximately 15 minutes).
Correlation between Victoria Stroop Z-score and usability score (low executive load)
Evaluate the impact of inhibition on usability =\> correlation between the Victoria Stroop Z-score and the usability score (completion time in seconds) under low executive load conditions. The Victoria Stroop test consists of three cards (color, word, and interference). On the color card, participants must name the color of 24 colored circles (time, corrected errors, uncorrected errors, and total errors are recorded). On the word card, they must read 24 words printed in colored ink (time, corrected errors, uncorrected errors, and total errors are recorded). On the interference card, they must name the ink color of 24 words denoting a different color (e.g., the word "red" printed in yellow ink); time, corrected errors, uncorrected errors, and total errors are recorded. A Z-score is calculated based on the recorded scores.
Correlation between Victoria Stroop Z-score and UEQ score (low executive load)
Evaluate the impact of inhibition on the user experience =\> correlation between the Victoria Stroop Z-score and the UEQ score under low executive load conditions.
Correlation between 2-back and usability scores (low executive load)
Evaluate the impact of the update on usability =\> correlation between the 2-back d'score and the usability score (completion time in seconds) under low executive load conditions. The 2-back task involves presenting a series of 30 letters one by one. For each letter presented, the participant must indicate-by pressing a keyboard key-whether it is identical to the letter presented two items previously. It yields five metrics: the number of correctly detected targets, false alarms, missed targets, correctly rejected targets, and the d-prime (d') score. The d' score is used as the primary metric.
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