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.

项目总结/摘要 很大一部分老年人居住在长期护理（LTC）环境中，如养老院和辅助 生活设施，患有轻度认知障碍（MCI），阿尔茨海默病（AD）和AD相关痴呆症 （ADRD）.冷漠在AD和ADRD患者中很常见，患病率高达72%。与其相关联 进一步认知能力下降、功能缺陷、生活质量下降、社会孤立和死亡率增加。 冷漠给LTC工作人员带来了沉重的负担，并对护理质量、工作人员满意度和 周转由于几乎没有药物选择，一个主要的策略是促进老年人参与社会， 身体和认知活动，主要是那些多模态的性质。然而，这些干预措施往往 需要大量的人力时间和资源，这是目前护理短缺和高 LTC护理人员的流动率。医疗保险和医疗补助服务中心授权LTC设施 为居民提供有意义的参与活动，这可能是资源密集型的，对许多人来说是困难的 US LTC设置。为了部分缓解这些问题，基于智能社会的干预措施 基于辅助机器人（SAR）的架构，称为ARIA（自适应机器人介导干预架构）， 在R21补助金下开发的，可以自适应地和动态地与MCI，AD和 ADRD谁居住在LTC设置，建议在此拨款申请。这一跨学科的建议直接 与NIA的目标相一致，即理解并利用智能技术制定有效的干预措施， 减少与年龄有关的疾病的负担，并满足照顾者的特殊照顾需求 痴呆症（PWD）这项多阶段、多中心、混合方法的临床试验将系统地检查 MCI或痴呆患者对两种类型SAR（人形和 动物），其对认知，身体和社会功能的影响，以及SAR对非正式和正式 护理人员的目标是实现未来的可扩展性和可持续性。拟议研究的具体目标 目标1：通过额外的软件开发来改进我们新颖的社交机器人交互架构 a）使其在组合多模态定量数据捕获参与方面更通用，B）更鲁棒 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 解决老年人不同程度的认知和身体障碍（1-18个月）。目标2： 比较常规护理（UC）组与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：查明 跨站点实施SAR以解决未来可扩展性和可持续性的障碍和促进因素 （第18-42个月）。本研究将有助于开发改进的智能技术作为一种有效的 使老年残疾人参与提高功能和生活质量的长期目标的方法。