Prototype Multimedia ADRD Falls Prevention System for Family Caregivers

摘要跌倒是一个常见且代价高昂的问题，尤其是在有认知障碍的人身上。 由于阿尔茨海默病和相关痴呆症(PwADRD)。秋季成本预计将达到677亿美元 这增加了家庭照顾者(CG)的负担。伤害性跌倒是人们无法 留在家里，导致家庭和社会的护理费用显著增加。 大多数FP努力未能解决理解跌倒风险或改变行为的问题。为回应NIA的请求 “支持居家生活、保留功能和促进有效沟通的护理技术” 创新的预防跌倒干预措施，供居家中的PwADRD CGs使用，他们被归类为At 将开发和测试跌倒的中到高风险。目标：开发治疗痴呆症的瀑布(FS-D)， 创新的CG提供的日常治疗，使用专有的多媒体和行为干预 促进沟通和鼓励FP行为的方法，以减少PwADRD跌倒。 严格的第一阶段研究计划将：a)开发包括CG培训的FS-D原型 软件、多媒体和支持工具，用于定制、执行和审查日常CG提供的进度 会议；b)进行中试测试和c)进行混合方法的初步临床试验。 具体目标和里程碑/交付成果是：a)开发原型；1.制作多媒体资产； 2.制作人工智能算法；3.创建CG培训/日常管理工具。 B)试飞样机。1.测试CG的易用性和可接受性；2.检查CG和 痴呆症亚型；3.必要时重复；4.评估干预相关性和二元参与度。 C)进行初步研究。1.招募和招募20名CG-PwADRD二元代表 阿尔茨海默病、血管性痴呆、路易体痴呆和帕金森氏病痴呆；2.提供研究成分：初步； 1个月FS-D干预及随访评估；3.长、中、短期测量 PwADRD和CG的结果；4.通过使用重复的 控制受试者间预期高方差和比较定性FS-D的措施设计 结果按照研究策略中描述的预先确定的阈值进行测量。 FS-D将提供一个难得的机会，通过打破令人沮丧的循环 未能识别跌倒威胁或改变行为，可能会减轻CG负担。FS-D是一种迫切需要的 家庭CG使用的预防跌倒干预。维持在家中的经济和生活质量效益 通过预防跌倒来为普华永道谋生，将为这一庞大的高危人群的所有利益攸关方带来好处。

ABSTRACT Falls are a common and expensive problem, especially in persons with cognitive impairment due to Alzheimer’s Disease and Related Dementias (PwADRD). Fall costs are expected to reach $67.7 billion this year and add to family caregiver (CG) burden. Injurious falls are a frequent reason people are unable to remain at home, resulting in significantly increased care costs to the family and society. Most FP efforts fail to address understanding fall risks or changing behavior. In response to NIA requests for ‘Care technology to sustain in-home living, preserve function and promote effective communication’, an innovative falls prevention intervention for use by CGs of PwADRD living at home who are classified as at moderate to high fall risk for falls will be developed and tested. Goal: Develop FallScape for Dementia (FS-D), an innovative CG-provided daily treatment utilizing proprietary multimedia and behavioral intervention methods to facilitate communication and encourage FP behaviors that will reduce PwADRD falls. The rigorous Phase 1 research plan will: a) develop a FS-D prototype that includes CG training software, multimedia and support tools to customize, conduct and review progress in daily CG-provided sessions; b) Perform pilot testing and c) conduct a mixed methods preliminary clinical trial. Specific Aims and milestones/deliverables are: a) Develop prototype; 1. Produce multimedia assets; 2. Craft Artificial Intelligence algorithms; 3. Create CG training/daily administration tools. b) Pilot test prototype. 1. Test CG ease of use and acceptability; 2. Examine customization for CG and dementia sub-types; 3. Iterate as necessary; 4. Evaluate intervention relevance and dyad engagement. c) Conduct preliminary study. 1. Recruit and enroll 20 CG-PwADRD dyads representing those with Alzheimer’s, vascular, Lewy-body and Parkinson’s disease dementias; 2. Provide study components: initial; one-month FS-D intervention and a follow-up evaluation; 3. Measurement of long, medium and short -term outcomes for PwADRD and for CG; 4. Assess Feasibility by evaluating quantitative outcomes using a repeated measures design to control for anticipated high between-subject variance and comparing qualitative FS-D outcome measures to pre-determined threshold values as described in the research strategy. FS-D will offer a rare opportunity to empower both CG and PwADRD by breaking the frustrating cycle of failure to recognize fall threats or change behavior and may mitigate CG burden. FS-D is an urgently needed falls prevention intervention for family CG use. The economic and quality of life benefits of sustaining in-home living for PwADRD by preventing falls will accrue to all stakeholders for this large, high-risk population.