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: 10680586
• 负责人: NILANJAN SARKAR
• 金额: $ 18.95万
• 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 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10680586
• 关键词: 2 arm randomized control trial; 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; Development; Diagnosis; Diné Nation; Elderly; Elements; Enrollment; Environment; Exercise; Family; Family Caregiver; Family member; Feedback; Feeling; Goals; 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; Suicide; Technology; Testing; Training and Education; Visit; adverse outcome; cardiovascular disorder risk; design; experience; head mounted display; health care service utilization; health determinants; improved; 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的重要健康决定因素（孤独感或孤立感在老年人中很常见，它会带来不良后果：心血管疾病、抑郁、自杀、认知和身体衰退、医疗保健利用率和死亡率的风险增加）。与社区中的老年人相比，长期护理 (LTC) 居民特别容易感到孤独（75% 对 43%）：(1) > 50% 的 LTC 居民患有认知障碍或诊断为痴呆症，其中阿尔茨海默病 (AD)是最常见的(60-80%)，(2) 孤独与 AD 高度相关，因为冷漠 (72%) 和抑郁 (40%) 的患病率很高，维持社交网络对于延缓 AD 痴呆的进一步进展和不良事件至关重要。最近研究了社交媒体和视频访问等互动通信技术（ICT）干预措施对老年人孤独感的影响，结果好坏参半，一种可能的解释是各种 ICT 缺乏对社会存在的关注。社会存在感是一个人的品质ICT 以及参与者对 ICT 中介互动中实际存在的感知在很大程度上取决于所提供的社交存在的质量，我们的长期目标是通过使用增强头戴式显示器来最大限度地提高社交联系和参与度。现实（HMD-AR），减少 LTC 老年人的孤独感，尤其是 AD 患者。第一阶段试点研究的目的是与老年人及其家人共同创建 HMD-AR 活动，确定可行性和可接受性。和满意度，并探索因素具体目标是 (1) 研究共同创建的协作 HMD-AR 活动与 2D 视听 ICT 在患有和不患有 AD 的老年人、其家庭成员和长期护理人员中的可行性、可接受性和满意度。工作人员；(2) 探索 HMD-AR 实施的促进因素和障碍。我们将招募 8 名老年 LTC 居民和 8 名家庭成员参加 6 个月的 5 次参与式研究会议，以创建合作菜单。 HMD-AR 活动。我们将招募 24 名老年 LTC 居民（8 名认知正常，8 名轻度认知障碍，8 名轻度 AD），每对老年家庭成员将参加 8 次以上的课程。使用 2 臂 RCT 设计为期 4 周，参与者将被随机分配到 2D 视听 ICT 或 HMD-AR。主要结果包括通过定性和定量测量收集的可行性、可接受性和满意度。次要结果是在基线、每次会议后、第 4 周和第 6 周进行测量。与老年人、家庭成员和 LTC 工作人员一起进行，以确定 HMD-AR 使用的障碍和促进因素。研究结果将为使用 HMD-AR 解决 AD 成年人孤独症的第二阶段研究的设计和实施提供信息。