Prototype Multimedia ADRD Falls Prevention System for Family Caregivers

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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.