Impact of a Novel Socially Assistive Robotic Architecture on Engaging Older Adults with Mild Cognitive Impairment, Alzheimer's Disease, and Related Dementia in Long Term Care Settings

新型社交辅助机器人架构对长期护理机构中患有轻度认知障碍、阿尔茨海默病和相关痴呆症的老年人的影响

• 批准号: 10570270
• 负责人: NILANJAN SARKAR
• 金额: $ 69.6万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10570270
• 关键词: Address; Alzheimer' s Disease; Alzheimer' s disease related dementia; Animals; Applications Grants; Architecture; Assisted Living Facilities; Caregivers; Caring; Clinical; Clinical Trials; Cognitive; Crossover Design; Data; Dementia; Development; Discipline of Nursing; Disease; Elderly; Elements; Family; Family member; Focus Groups; Formal caregiver; Fostering; Frustration; Future; Goals; Grant; Health care facility; Human; Human Resources; Impaired cognition; Impairment; Individual; Intelligence; Intervention; Interview; Libraries; Long-Term Care; Long-Term Care Nursing; Mediating; Mediation; Medicare/Medicaid; Methods; Mission; Multi-Institutional Clinical Trial; Nature; Nursing Homes; Nursing Staff; Participant; Personal Satisfaction; Persons; Phase; Physical Function; Prevalence; Procedures; Quality of Care; Quality of life; Randomized; Randomized, Controlled Trials; Research; Resources; Robot; Robotics; Science; Site; Social Functioning; Social Interaction; Social intelligence; Social isolation; Stress; System; Technology; Testing; Time; Trust; United States Centers for Medicare and Medicaid Services; Work; adaptive robot; age related; algorithm development; assistive robot; care systems; cognitive function; design; effective intervention; future implementation; humanoid robot; implementation evaluation; implementation trial; improved; informal caregiver; information gathering; innovation; mild cognitive impairment; mortality; multimodality; new technology; novel; novel strategies; pharmacologic; robotic system; satisfaction; social; social assistive robot; software development; treatment as usual; user centered design; usual care arm; virtual; virtual environment

Project Summary/Abstract A large proportion of older adults residing in long term care (LTC) settings, such as nursing homes and assisted living facilities, suffer from Mild Cognitive Impairment (MCI), Alzheimer's disease (AD) and AD-related dementias (ADRD). Apathy is common in persons with AD and ADRD with prevalence rates up to 72%. It is associated with further cognitive decline, functional deficits, reduced quality of life, social isolation, and increased mortality. Apathy imposes significant burden on LTC staff and negatively impact quality of care, staff satisfaction and turnover. Since few pharmacologic options exist, a major strategy is to foster older adults' engagement in social, physical and cognitive activities, primarily those that are multimodal in nature. However, these interventions often require significant personnel time and resources, a major concern given the current nursing shortage and high turnover among LTC nursing personnel. The Centers of Medicare and Medicaid Services mandates LTC facilities to provide meaningful engaging activities for residents, which can be resource intensive and are difficult for many US LTC settings. In order to partially mitigate some of these issues, intervention based on an intelligent socially assistive robot (SAR) based architecture, called ARIA (Adaptive Robot-mediated Intervention Architecture), developed under a R21 grant, that can adaptively and dynamically interact with older adults with MCI, AD and ADRD who reside in LTC settings, is proposed in this grant application. This interdisciplinary proposal is directly aligned with the NIA goals of understanding and developing effective interventions using smart technology to reduce the burden of age-related diseases and address the special caregiver needs of those caring for persons with dementia (PWD). This multi-phase, multi-site, mixed methods clinical trial will systematically examine responsiveness and engagement among persons with MCI or dementia to two types of SARs (humanoid and animal), its effect on cognitive, physical and social function as well as the impact of SARs on informal and formal caregivers with a goal towards future scalability and sustainability. The specific aims of the proposed research are: Aim 1: To improve our novel social robotic interaction architecture through additional software development to a) make it more versatile in combining multimodal quantitative data capturing engagement, b) more robust such that non-experts can operate it and create new tasks by concatenating task primitives, and c) expand tasks to address varying degrees of cognitive and physical impairments of older adults (Months 1-18). Aim 2: To compare the effect of usual care (UC) group to UC+ARIA group on reducing apathy among older adults with mild cognitive impairment (MCI), mild dementia, or moderate dementia (Months 19-48). Aim 3: To identify barriers and facilitators to SAR implementation across sites to address future scalability and sustainability (Months 18-42). This study will contribute to the development of improved intelligent technology as an effective approach to engage older PWD with the long term goal of enhancing function and quality of life.

项目摘要/摘要 有很大比例的老年人居住在长期护理(LTC)环境中，如疗养院和受助机构 生活设施，患有轻度认知障碍(MCI)、阿尔茨海默病(AD)和AD相关痴呆 (ADRD)。冷漠在AD和ADRD患者中很常见，患病率高达72%。它与以下内容关联 进一步的认知衰退、功能缺陷、生活质量下降、社会孤立和死亡率增加。 冷漠给长期护理人员带来了沉重的负担，并对护理质量、工作人员满意度和 营业额。由于几乎没有药物选择，一个主要的战略是培养老年人参与社会， 身体和认知活动，主要是那些本质上多式联运的活动。然而，这些干预措施往往 需要大量的人员时间和资源，这是目前护理人员短缺和高水平的主要关切 长期护理人员的离职率。医疗保险和医疗补助服务中心要求LTC设施 为居民提供有意义的参与性活动，这可能是资源密集型的，对许多人来说是困难的 美国LTC设置。为了部分缓解其中一些问题，基于智能的社会干预 基于辅助机器人(SAR)的架构，称为ARIA(自适应机器人中介干预架构)， 在R21拨款下开发，可以自适应和动态地与患有MCI、AD和 居住在LTC环境中的ADRD，是在本赠款申请中提出的。这项跨学科的建议直接 与NIA的目标保持一致，即利用智能技术了解和开发有效的干预措施 减轻与年龄有关的疾病的负担，满足照顾者的特殊需要 患有痴呆症(PWD)。这项多阶段、多地点、混合方法的临床试验将系统地检查 MCI或痴呆症患者对两种类型SARS(类人和非典型肺炎)的反应性和参与性 动物)对认知、身体和社会功能的影响以及SARS对非正式和正式的影响 具有未来可伸缩性和可持续性目标的护理人员。拟议研究的具体目标 目标1：通过额外的软件开发改进我们的新型社交机器人交互架构 A)使其在组合多模式定量数据捕获参与度方面更加灵活，b)更加稳健 使得非专家可以操作它并通过连接任务原语来创建新任务，以及c)扩展任务 以解决老年人不同程度的认知和身体障碍(1-18个月)。目标2：实现 比较常规护理(UC)组和UC+ARIA组在减少老年人冷漠方面的效果 轻度认知障碍(MCI)、轻度痴呆或中度痴呆(19-48个月)。目标3：确定 跨站点实施SAR的障碍和促进者，以应对未来的可扩展性和可持续性 (18-42个月)。这项研究将有助于发展完善的智能技术作为一种有效的 以提高功能和生活质量为长期目标，让老年残疾患者参与进来。