Jigsawdio: an AudioVisual Jigsaw Puzzle for People with Alzheimer's Disease and Alzheimer's-Disease-Related Dementias

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Social isolation leads to loneliness, which is linked to depression, stress, high blood pressure, and poor sleep, all of which accelerate cognitive decline. The prolonged social isolation that resulted from the COVID-19 pandemic has further highlighted the importance of social connection. Developing new strategies to support AD/ADRD patients and their families is a public health priority, particularly when social and family connections are disrupted. Jigsawdio has created an audiovisual jigsaw puzzle that combines photographs and audio recordings of memories that can be completed alone or with others. Individual pieces are encoded with customized audio recordings that play when the piece is set into place. Our product innovation is driven by several premises. First, according to the Alzheimer’s Society, memory care research shows that even though a person with ADRD may no longer recognize a loved one, their time together has a lasting, positive impact. Second, studies have shown that the emotional state of AD/ADRD patients can be bolstered through nostalgia and reminiscence. Despite being cognitively impaired, people with AD/ADRD experience nostalgia in a manner similar to non-impaired adults. Reminiscence therapy (RT) uses memories and past experiences with tangible prompts, such as photographs or music, to evoke memories and stimulate conversation. For AD/ADRD patients, RT has been shown to have positive effects on quality of life, communication, and mood. Third, opportunities for social experiences that evoke emotional memories can improve mood and decrease agitation in AD/ADRD patients. Fourth, jigsaw puzzles have been shown to reduce stress and agitation. Focusing on a puzzle provides a “breather” from stress and can enhance mood through fun, flow, and mastery. Because of the pandemic, socially engaging activities are desperately needed. Jigsawdio has previously developed a recordable audio puzzle prototype designed for general use. To translate this product for AD/ADRD users, we have assembled a team with expertise in storytelling, nostalgia, AD/ADRD psychology, technology development for AD/RD users, and mental determinants of well-being and happiness. The overall objective of this Phase I STTR proposal is to conduct interviews to create storylines, develop a minimum viable product for AD/ADRD patients, and conduct a usability and acceptability study with participants living in a memory care facility. To achieve these objectives, we will complete the following aims: 1) Conduct in-depth interviews with families, caregivers, and facility staff to collect stories of memorable events and create multiple storylines for each memory care resident. 2) Develop customized audiovisual jigsaw puzzles for memory care residents. The Jigsawdio team will design and engineer an MVP consisting of hardware and software designed for AD/ADRP users. 3) Determine the feasibility and usability of the puzzles for memory care residents. The success of our Phase I project will allow us to refine the Jigsawdio MVP for AD/ADRD users based on user feedback and engage in a large-scale user clinical trial to evaluate the effects of Jigsawdio on emotional well-being, agitation, depression, and anxiety.