The BRAIN App: Building Relationships using Artificial Intelligence and Nostalgia

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PROJECT SUMMARY/ABSTRACT There are currently 5.8 million Americans living with dementia and, without significant breakthroughs, this figure will double to 11.6 million by 2040 (Gaugler, et al., 2019). Dementia interferes with a person’s ability to function by impairing memory, reasoning, judgment, language, initiation, and socialization, leading to many unfortunate outcomes, including social isolation / withdrawal (Semple, et al., 1982; Alexander & Geschwind, 1984; Liu, Gauthier, & Gauthier, 1991, Social Care Institute, 2019). Dementia is also associated with a variety of responsive behaviors, such as wandering, repetitive questioning, anxiety, agitation, aggression, and apathy (Cummings, 1997; Hay, et al., 2003; Lazarus, et al., 1987) . Responsive behaviors and dysfunction of the dementia care triad—i.e., the person with dementia (PWD), professional Care Partner (CP), and Family Member (FM)—are inexorably linked. Emergence of responsive behaviors can lead to disruption of the triad’s function. Conversely, poorly functioning triads can lead to responsive behaviors. Thus, it is imperative to maintain positive relationships and a high quality of life (QoL) within the triad to reduce responsive behaviors. One approach that has demonstrated improvements in QoL and relationships is Cognitive Stimulation Therapy (CST). While clinical trials on CST have shown improvement of cognition and QoL, the potential large-scale impact of CST has been hampered by low adherence, with less than 40% completing trials (Rai, et al, 2018). One likely reason for the low adherence to CST is the reliance on generic and/or non-digital tools (e.g., DVDs, board games, etc.) in facilitating the intervention. With this in mind, the proposed Phase 1 study will involve the creation and testing of an Alpha version of an app called “Building Relationships using Artificial Intelligence and Nostalgia” or BRAIN. The BRAIN App will be the first -ever artificial intelligence infused CST app for PWD. The app has two main goals: (1) to foster positive relationships between the care triad, and (2) to promote QoL while reducing responsive behaviors in PWD. The market-ready version of the app will consist of six main components, each of which will serve a different purpose and be intended for different users. The proposed project has the following Specific Aims: (1). Create an Alpha version of the app, which will include the six main components (Life Story Profiler, Team Leader Dashboard, CP Dashboard, Resident View, CP Training Dashboard, Admin Dashboard), plus one component that will be needed only for Phase 1 (Playlist Matching Dashboard); (2) Examine the app’s impact on engagement/affect for both PWD and professional Care Partners (CPs); (3) Examine satisfaction and ease of use of the app for both PWD and professional CPs. (4) Examine the impact of the app on the nature of the relationship between the PWD and CPs. This Phase 1 project will lay the groundwork for a Phase 2 project in which: (1) an improved app would be created, based upon lessons learned in Phase 1; (2) AI will be used to recommend activities for PWD; (3) additional content will be curated and created; (4) a crossover trial with a large sample will be conducted; (5) we will examine the effects of implementing the intervention over a longer period of time; and (6) we will examine the impact of the app on responsive behaviors and QoL (for PWD) and burden and stress (for CPs).