Impact of a Novel Socially Assistive Robotic Architecture on Engaging Older Adults with Mild Cognitive Impairment, Alzheimer's Disease, and Related Dementia in Long Term Care Settings

新型社交辅助机器人架构对长期护理机构中患有轻度认知障碍、阿尔茨海默病和相关痴呆症的老年人的影响

• 批准号: 10388275
• 负责人: LORRAINE C MION
• 金额: $ 70.84万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10388275
• 关键词: Address; Alzheimer' s Disease; Alzheimer' s disease related dementia; Animals; Applications Grants; Architecture; Assisted Living Facilities; Caregivers; Caring; Clinical; Clinical Trials; Cognitive; Crossover Design; Data; Dementia; Development; Discipline of Nursing; Disease; Elderly; Elements; Family; Family member; Focus Groups; Formal caregiver; Fostering; Frustration; Future; Goals; Grant; Health care facility; Human; Human Resources; Impaired cognition; Impairment; Individual; Intelligence; Intervention; Interview; Libraries; Long-Term Care; Long-Term Care Nursing; Mediating; Mediation; Medicare/Medicaid; Methods; Mission; Multi-Institutional Clinical Trial; Nature; Nursing Homes; Nursing Staff; Participant; Personal Satisfaction; Persons; Pharmacology; Physical Function; Prevalence; Procedures; Quality of Care; Quality of life; Randomized; Randomized Controlled Trials; Research; Resources; Robot; Robotics; Science; Site; Social Functioning; Social Interaction; Social intelligence; Social isolation; Stress; System; Technology; Testing; Time; Trust; United States Centers for Medicare and Medicaid Services; Work; adaptive robot; age related; algorithm development; assistive robot; base; care systems; cognitive function; design; effective intervention; future implementation; humanoid robot; implementation evaluation; implementation trial; improved; informal caregiver; innovation; mild cognitive impairment; mortality; multimodality; new technology; novel; novel strategies; robotic system; satisfaction; social; social assistive robot; software development; treatment as usual; user centered design; usual care arm; virtual; virtual environment

Project Summary/Abstract A large proportion of older adults residing in long term care (LTC) settings, such as nursing homes and assisted living facilities, suffer from Mild Cognitive Impairment (MCI), Alzheimer's disease (AD) and AD-related dementias (ADRD). Apathy is common in persons with AD and ADRD with prevalence rates up to 72%. It is associated with further cognitive decline, functional deficits, reduced quality of life, social isolation, and increased mortality. Apathy imposes significant burden on LTC staff and negatively impact quality of care, staff satisfaction and turnover. Since few pharmacologic options exist, a major strategy is to foster older adults' engagement in social, physical and cognitive activities, primarily those that are multimodal in nature. However, these interventions often require significant personnel time and resources, a major concern given the current nursing shortage and high turnover among LTC nursing personnel. The Centers of Medicare and Medicaid Services mandates LTC facilities to provide meaningful engaging activities for residents, which can be resource intensive and are difficult for many US LTC settings. In order to partially mitigate some of these issues, intervention based on an intelligent socially assistive robot (SAR) based architecture, called ARIA (Adaptive Robot-mediated Intervention Architecture), developed under a R21 grant, that can adaptively and dynamically interact with older adults with MCI, AD and ADRD who reside in LTC settings, is proposed in this grant application. This interdisciplinary proposal is directly aligned with the NIA goals of understanding and developing effective interventions using smart technology to reduce the burden of age-related diseases and address the special caregiver needs of those caring for persons with dementia (PWD). This multi-phase, multi-site, mixed methods clinical trial will systematically examine responsiveness and engagement among persons with MCI or dementia to two types of SARs (humanoid and animal), its effect on cognitive, physical and social function as well as the impact of SARs on informal and formal caregivers with a goal towards future scalability and sustainability. The specific aims of the proposed research are: Aim 1: To improve our novel social robotic interaction architecture through additional software development to a) make it more versatile in combining multimodal quantitative data capturing engagement, b) more robust such that non-experts can operate it and create new tasks by concatenating task primitives, and c) expand tasks to address varying degrees of cognitive and physical impairments of older adults (Months 1-18). Aim 2: To compare the effect of usual care (UC) group to UC+ARIA group on reducing apathy among older adults with mild cognitive impairment (MCI), mild dementia, or moderate dementia (Months 19-48). Aim 3: To identify barriers and facilitators to SAR implementation across sites to address future scalability and sustainability (Months 18-42). This study will contribute to the development of improved intelligent technology as an effective approach to engage older PWD with the long term goal of enhancing function and quality of life.

项目概要/摘要 很大一部分老年人居住在长期护理 (LTC) 环境中，例如疗养院和辅助机构 患有轻度认知障碍 (MCI)、阿尔茨海默病 (AD) 和 AD 相关痴呆症 （ADRD）。冷漠在 AD 和 ADRD 患者中很常见，患病率高达 72%。它与 进一步的认知能力下降、功能缺陷、生活质量下降、社会孤立和死亡率增加。 冷漠给长期护理中心 (LTC) 员工带来沉重负担，并对护理质量、员工满意度和护理质量产生负面影响。 周转。由于存在的药物选择很少，一个主要策略是促进老年人参与社会、 身体和认知活动，主要是那些本质上是多模式的活动。然而，这些干预措施常常 需要大量的人员时间和资源，考虑到当前护理短缺和高水平，这是一个主要问题 长期护理人员 (LTC) 护理人员的流动率。医疗保险和医疗补助服务中心授权长期护理中心设施 为居民提供有意义的参与活动，这可能是资源密集型的，并且对许多人来说是困难的 美国 LTC 设置。为了部分缓解其中一些问题，基于智能社交的干预 基于辅助机器人（SAR）的架构，称为 ARIA（自适应机器人介导的干预架构）， 在 R21 资助下开发的，可以自适应地、动态地与患有 MCI、AD 和 本拨款申请中建议居住在 LTC 环境中的 ADRD。这个跨学科的建议直接 与 NIA 的目标相一致，即利用智能技术理解和制定有效的干预措施 减轻与年龄有关的疾病的负担并满足护理人员的特殊护理需求 患有痴呆症（PWD）。这项多阶段、多地点、混合方法的临床试验将系统地检查 MCI 或痴呆症患者对两种类型的 SAR（人形和痴呆症）的反应和参与度 动物），其对认知、身体和社会功能的影响以及 SAR 对非正式和正式的影响 护理人员的目标是实现未来的可扩展性和可持续性。拟议研究的具体目标 目标 1：通过额外的软件开发来改进我们新颖的社交机器人交互架构 a) 使其在结合多模式定量数据捕获参与方面更加通用，b) 更加稳健 这样非专家就可以操作它并通过连接任务原语创建新任务，以及 c) 扩展任务 解决老年人（1-18 个月）不同程度的认知和身体障碍。目标 2： 比较常规护理 (UC) 组与 UC+ARIA 组对减少患有以下疾病的老年人冷漠的效果 轻度认知障碍 (MCI)、轻度痴呆或中度痴呆（19-48 个月）。目标 3：识别 跨站点实施 SAR 的障碍和促进因素，以解决未来的可扩展性和可持续性问题 （18-42 个月）。这项研究将有助于改进智能技术的发展作为有效的 使老年残疾人士实现增强功能和生活质量的长期目标的方法。