"Psychogeritechnology" in Japan: Exemplars from a super-aged society

Background: The burgeoning field of gerontechnology, which is the interdisciplinary field of applying technology to ageing issues, has focused primarily on "active ageing" and maintaining independence for older adults. To date, there has been less focus on people who develop dementia. Here, we argue for the field of gerontechnology to have a greater emphasis on clinical applications for dementia. This can be captured under the rubric of "psychogeritechnology," a term we have coined to describe the range of technology approaches to the prevention, prediction, screening, assessment, diagnosis, management, and monitoring of people at risk of, or living with, dementia. Aim: Using Japan as the world's leading "super-aged' nation as a paradigm, the purpose of this paper is to provide a narrative review of the use of innovative technology for the diagnosis, management and support of people at risk of, or living with, dementia. Methods: By following the "life course" of dementia, we will use clinical exemplars and case studies of psychogeritechnological applications from a Japanese context, specific to each stage of dementia, from the preclinical to the advanced stage. In the preclinical stage, the focus will be on prevention and early detection of degenerative cognitive-functional trajectories. In the early-stage of dementia, we will outline examples of screening, assessment, diagnosis, and clinical monitoring, as well as the use of technology to support independent living and autonomy. In the moderate stage, examples of safety monitoring systems, and assistive technology to foster independence, quality of life will be outlined. Finally, in the advanced stage of dementia, our focus will be on assistive technology in the care home setting, and the need to foster secure and efficient communication among care providers. We will discuss these applications in terms of the evolution of the "technological roadmap" for dementia, and the need for a theoretical underpinning for the field, a meaningful and flexible evaluation framework, and consideration of the "wider perspective" including safety-critical issues, ethical issues, and the relation to policy and health economics. Conclusions: Japan, as a rapidly ageing society, is on the forefront of developing technology to support people with dementia. The new field of psychogeritechnology must harness the potential of such developments, while furthering the methodology to implement and evaluate the changes.