Reducing Loneliness of Older Adults in Long Term Care Facilities through Collaborative Augmented Reality

通过协作增强现实减少长期护理机构中老年人的孤独感

• 批准号: 10509214
• 负责人: LORRAINE C MION
• 金额: $ 24.4万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10509214
• 关键词: 3-Dimensional; Address; Adoption; Adult; Adverse event; Alzheimer' s Disease; Alzheimer' s disease care; Attention; Attitude; Augmented Reality; Balance training; Behavior; COVID-19; Characteristics; Cognition; Cognitive; Communities; Dementia; Depression and Suicide; Development; Diagnosis; Elderly; Elements; Enrollment; Environment; Exercise; Family; Family Caregiver; Family member; Feedback; Feeling; Goals; Health; Health care facility; High Prevalence; Image; Impaired cognition; Individual; Interactive Communication; Internet; Intervention; Intervention Studies; Interview; Link; Loneliness; Long-Term Care; Measures; Mediating; Mental Depression; Outcome; Participant; Patient Recruitments; Perception; Persons; Pilot Projects; Play; Procedures; Protocols documentation; Quality of life; Randomized; Research; Resources; Safety; Social Network; Technology; Testing; Training and Education; Visit; Visual; adverse outcome; arm; base; cardiovascular disorder risk; design; experience; head mounted display; health care service utilization; improved; improved mobility; mild cognitive impairment; mortality; novel strategies; participant retention; prevent; primary outcome; recruit; satisfaction; secondary outcome; social; social media; success; two-dimensional; usability; virtual imaging; virtual reality

Social connection is a critical health determinant essential in preventing loneliness (feeling of being alone or isolated). Loneliness is common among older adults with adverse consequences: increased risk of cardiovascular disease, depression, suicide, cognitive and physical decline, healthcare utilization and mortality. Long term care (LTC) residents are particularly prone to loneliness compared to older adults in the community (75% versus 43%): (1) >50% LTC residents have cognitive impairment or diagnosis of dementia, of which Alzheimer’s disease (AD) is the most common diagnosis (60-80%), and (2) loneliness is highly correlated with AD given its high prevalence of apathy (72%) and depression (40%). Maintaining social networks is critical in delaying further dementia progression and adverse events in AD. Interactive communication technology (ICT) interventions, such as social media and video-mediated visits, have recently been examined for their effects on loneliness among older adults with mixed results. One potential explanation is the lack of attention to social presence within the various ICTs. Social presence is the quality of the ICT as well as the participant’s perceptions that others are physically present in the mediated interaction. ICT satisfaction is based largely on the quality of the social presence afforded. Our long term goal is to maximize social connection and engagement through the use of head mounted display augmented reality (HMD-AR), thereby reducing loneliness among older adults in LTC, especially for those with AD. The purpose of this Stage 1 pilot study is to co-create HMD-AR activities with older adults and their families, determine feasibility, acceptability and satisfaction, and explore factors that influence acceptance and usability. The specific aims are (1) to examine the feasibility, acceptability, and satisfaction of co-created collaborative HMD-AR activities versus 2D audio-visual ICT among older adults with and without AD, their family member and LTC staff; and (2) to explore facilitators and barriers of HMD-AR implementation. We will recruit 8 older adult LTC residents and 8 family members to participate in 5 participatory-research sessions over 6 months to create a menu of collaborative HMD-AR activities. We will enroll 24 older adult LTC residents (8 with normal cognition, 8 with mild cognitive impairment, and 8 with mild stage AD) and a designated family member. Each older adult-family pair will participate in 8 sessions over 4 weeks using a 2-arm RCT design. Participants will be randomized to either 2D audio-visual ICT or HMD-AR. Our central hypothesis is that HMD-AR technology with a high social presence will result in better outcomes than 2D technology with lower social presence. Primary outcomes include feasibility, acceptability and satisfaction collected via qualitative and quantitative measures. The secondary outcome is loneliness, measured at baseline, after each session, at Week 4 and at Week 6. Last, one-on-one interviews will be conducted with older adults, family members and LTC staff to determine barriers and facilitators to HMD-AR use. Findings will inform the design and implementation of a Stage II study using HMD-AR to address loneliness among LTC AD adults.

社会联系是预防孤独感（孤独或孤立的感觉）确定的至关重要的健康。孤独感在老年人中很常见，后果不利：心血管疾病，抑郁症，自杀，认知和身体下降，医疗保健利用和死亡率的风险增加。与社区中的老年人相比，长期护理（LTC）居民特别容易孤独（75％对43％）：（1）> 50％> 50％LTC居民患有痴呆症的认知障碍或诊断，而阿尔茨海默氏病（AD）的诊断最高（60-80％）和（2）孤独感（AD）是最常见的（2）孤独感（2），这是高度的。 （72％）和抑郁症（40％）。维持社交网络对于延迟AD中进一步的痴呆症进展和不良事件至关重要。交互式通信技术（ICT）干预措施，例如社交媒体和视频介导的访问，最近我们检查了他们对老年人的孤独感的影响，结果好坏参半。一种潜在的解释是，在各个ICT中缺乏对社会存在的关注。社会存在是ICT的质量，也是参与者对其他人在介导的互动中存在物理存在的看法。 ICT满意度在很大程度上基于所提供的社会存在质量。我们的长期目标是通过使用头部安装的展示增强现实（HMD-AR）来最大化社会联系和参与度，从而减少了LTC中老年人的孤独感，尤其是对于那些患有广告的人。此阶段1试点研究的目的是与老年人及其家人共同创建HMD-AR活动，确定可行性，可接受性和满意度，并探索影响接受和可用性的因素。具体目的是（1）研究共同创建的合作HMD-AR活动的可行性，可接受性和满意度与具有和没有AD的老年人，其家人和LTC员工的老年人中的2D Audio-Visual ICT； （2）探索HMD-AR实施的促进者和障碍。我们将招募8位老年人LTC居民和8个家庭成员参加6个月的5个参与研究课程，以创建协作HMD-AR活动的菜单。我们将招募24名老年人LTC居民（8个具有正常认知的居民，8个有轻度认知障碍，8个带有轻度阶段AD的居民）和一个指定的家庭成员。每个老年人家庭对，将使用2臂RCT设计在4周内参加8个课程。参与者将被随机分配到2D Audio-Visual ICT或HMD-AR。我们的中心假设是，与社会存在较低的2D技术相比，具有较高社会存在的HMD-AR技术将带来更好的结果。主要结果包括通过定性和定量措施收集的可行性，可接受性和满意度。次要结果是孤独感，在基线，每次会议之后，在第4周和第6周时测量。上次，将对老年人，家庭成员和LTC员工进行一对一的访谈，以确定HMD-AR使用的障碍和协助者。调查结果将为使用HMD-AR解决LTC AD成人的孤独感的II期研究的设计和实施。