Project 2: Technology Support for Cognition and Social Engagement for Aging Adults with Mild Cognitive Impairment (MCI)

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Project Summary Currently 15-20% of adults aged 65+ have Mild Cognitive Impairment (MCI) and a large percentage of these individuals will develop Alzheimer's Disease and Alzheimer's Disease Related Dementias (AD/ADRD). Individuals with MCI demonstrate difficulties performing a wide range of everyday activities and experience social isolation. Investigators have begun to look at technology-based interventions to improve the functioning of aging adults with cognitive impairment. Most of these efforts have focused on the provision of cognitive training or rehabilitation and have not included other aspects of functioning such as everyday activities or social engagement. The goal of this Stage 1 (NIH Stage Model) Intervention Development cross-site project is to develop, using a user-centered design approach, and evaluate an innovative intelligent adaptive software package aimed at providing cognitive and social support and engagement to older adults with MCI. The system will be designed to adapt to the needs and abilities of the user. Phase 1, akin to Stage 1a, will involve interviews with aging adults with MCI and care providers to gather information on challenges encountered in everyday activities and types of technology support features of potential benefit. We will also evaluate different features of the system (e.g., adaptive interface features), with an iterative design approach with diverse samples of individuals with MCI. We anticipate conducting two rounds of usability testing per site. Phase 2, akin to Stage 1b, will involve pilot testing to evaluate the feasibility and usability of the system with a sample of 68 individuals with MCI at each of the three CREATE sites (N=204) and to gather preliminary data on the efficacy of the proposed system. We will use a waitlist control, pre-post design (waitlist group will receive the technology after six months and assessed again at 12 months). A battery of measures that includes demographic information, attitudes towards technology, tablet proficiency, technology experience, performance of activities targeted in the training components, functional independence and well-being, social support/isolation, and quality of life will be administered at baseline, 6 months post randomization, and after another 6 months for the waitlist group. We will also assess potential cognitive ability changes. We will conduct interviews 6-month post intervention to assess likes, dislikes, and challenges with the system. Our goal is to develop a unique and highly innovative technology tool that can provide adaptive support to aging individuals with MCI, even as cognition might deteriorate further. Speech data collected as part of an embedded reminiscence feature will advance fundamental knowledge of how speech and language production data might serve as an early indicator of cognitive decline. The project will yield important information on the feasibility of using technology-based approaches to support everyday activities and cognition for persons with MCI and insight on barriers to the implementation of technology-based interventions. We will also gain understanding of the challenges aging adults with MCI encounter in everyday activities.