## 4 Discussion  
Our study aimed to systematically and informedly customize the content of a cognitive stimulation program for IwD living in ARM, using the Musiquence platform. To the best of our knowledge, no similar studies aimed to include formal caregivers' and IwD's perspectives to customize content for cognitive stimulation activities implemented in interactive technologies. Still, our results are consistent with the existing literature, reporting that participatory design approaches are crucial to the development of technologies and content for people with special needs [23]. We experienced that, due to dementia-related cognitive deficits, IwD may not always provide the sought information explicitly. Hence, a close collaboration between researchers, formal caregivers, and IwD is required to successfully unveil information that reflects their perspectives and preferences, which can help to assure their engagement and motivation when performing the intervention. Concerning our first RQ, we intended to identify the preferential content for IwD living in the ARM to be implemented on a CCSP. During the interview, formal caregivers mentioned that it was challenging to personalize activities while closely supervising their performance. Additionally, we realized that there is still a considerable lack of specialized care units for IwD in the ARM and, consequently, limited human resources to develop occupational activities for IwD, which represented a challenge when recruiting our sample. As an alternative to personalizing the interventions' content, formal caregivers mentioned finding common interests of different IwD. For example, most IwD had similar ages and similar life experiences, facilitating the choice of songs and themes to use. Finding these shared experiences was our starting point to customize the content and generalize it to all participants. From these interviews with formal caregivers, we also understood the importance of customizing the content of cognitive stimulation activities, which led us to rely on a platform that responds to this need: Musiquence. Concerning our second RQ, we considered the information provided by formal caregivers, the reports of IwD, and the experience of the researcher in implementing the task, and created a set of guidelines on how to perform this type of study. Before defining  
Figure 5: (**a**) IwD performing Search activity, on Musiquence, in an AR-format; (**b**) IwD performing ADL activity, on Musiquence, in an AR-format and using real physical objects to answer. the contribution and role of IwD in the participatory design, it was important to gather information about the patient's cognitive profile to determine the most preserved and impaired cognitive functions, the stage of dementia, and the sociodemographic background. Most of the institutions from which we recruited our sample only provided the patients' Mini-Mental State Examination (MMSE) [31] score, a cognitive screening tool that does not allow a comprehensive and detailed assessment of cognitive functioning. As such, for the purposes of our study, having more information would be useful when determining the type and difficulty level of the tasks to be developed. Concomitantly, we found some supportive guidelines to be used when such participatory design approaches are adopted:  
1. Communicating with patients  
Most participants from our study had a low literacy level, a low-skilled occupation (e.g., farmer, seamlessness), and had little or no contact with technological devices. Consequently, we had to support them in fully comprehending the study's objectives and verbally expressing their preferences. Hence, we collected their preferences by employing what we thought was a straightforward task--selecting their preferred images. However, our decision to use 4 representative images for each theme resulted in a total of 56 images presented to IwD, which may have been overwhelming for some of our participants.