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（孤独或被孤立的感觉）的关键健康决定因素。孤独在老年人中很常见，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%的长期护理（LTC）居民有认知障碍或被诊断为痴呆症，其中阿尔茨海默病（AD）是最常见的诊断（60-80%），(2)孤独感与AD高度相关，因为它的高患病率冷漠（72%）和抑郁症（40%）。维持社交网络对于延缓阿尔茨海默病的进一步痴呆进展和不良事件至关重要。互动通信技术（ICT）干预措施，如社交媒体和视频媒介访问，最近被研究了它们对老年人孤独感的影响，结果好坏参半。一种可能的解释是，在各种信息通信技术中，缺乏对社会存在的关注。社会存在是指信息通信技术的质量以及参与者对他人在中介互动中实际存在的感知。信息和通信技术满意度主要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头戴式显示器增强现实（HMD-AR）来最大化社会联系和参与，从而减少老年LTC老年人的孤独感，特别是那些患有AD的老年人。本第一阶段先导研究的目的是与老年人及其家庭共同创建HMD-AR活动，确定可行性、可接受性和满意度，并探讨影响可接受性和可用性的因素。具体目的是：(1)在有和没有AD的老年人、他们的家庭成员和LTC工作人员中，检查共同创建的协同HMD-AR活动与2D视听ICT的可行性、可接受性和满意度；(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名家庭成员参加为期6个月的5次参与式研究会议，以创建HMD-AR协作活动菜单。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）和一名指定的家庭成员。采用双臂随机对照试验设计，每对老年人家庭将参加为期4周的8次试验。参与者将被随机分配到2D视听ICT或HMD-AR。我们的中心假设是，具有高社会存在感的HMD-AR技术将比具有低社会存在感的2D技术产生更好的结果。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。次要结果是孤独感，在每次治疗后、第4周和第6周的基线上测量。最后，将与老年人、家庭成员和LTC工作人员进行一对一访谈，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LTC AD成人孤独感的II期研究的设计和实施提供信息。