Prototype Multimedia ADRD Falls Prevention System for Family Caregivers

摘要福尔斯是一种常见且昂贵的问题，尤其是在认知障碍的人群中 阿尔茨海默病和相关痴呆症（PwADRD）。预计秋季成本将达到677亿美元 今年，增加了家庭照顾者（CG）的负担。受伤的福尔斯是一个常见的原因，人们无法 留在家中，导致家庭和社会的护理费用大幅增加。 大多数FP的努力未能解决理解跌倒风险或改变行为。根据NIA的要求， “护理技术，以维持家庭生活，保持功能和促进有效的沟通”， 创新的福尔斯预防干预措施，供居住在家中的PwADRD CG使用， 将开发和测试福尔斯的中度至高度跌倒风险。目标：开发痴呆症瀑布景观（FS-D）， 一种创新的CG提供的日常治疗，利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，这将减少PwADRD福尔斯。 严格的第一阶段研究计划将：a）开发一个包括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 会话; B）进行试点测试和c）进行混合方法的初步临床试验。 具体目标和里程碑/可交付成果是：a）开发原型; 1.制作多媒体资产; 2.手工制作人工智能算法; 3.创建CG培训/日常管理工具。 B）中试样机。1.测试CG的易用性和可接受性; 2.检查CG的自定义， 痴呆亚型; 3.必要时进行迭代; 4.评估干预的相关性和二元参与。 （三）进行初步研究。1.招募并入组20个CG-PwADRD二元组，代表那些 阿尔茨海默氏症、血管性痴呆、路易体痴呆和帕金森氏症; 2.提供研究组成部分：初始; 一个月的FS-D干预和随访评估; 3.长期、中期和短期的衡量 PwADRD和CG的结果; 4.通过使用重复的 测量设计，以控制预期的高受试者间方差，并比较定性FS-D 根据研究策略中所述的预先确定的阈值测量结果。 FS-D将提供一个难得的机会，通过打破令人沮丧的循环， 无法识别跌倒威胁或改变行为，并可能减轻CG负担。FS-D是一个迫切需要的 家庭CG使用的福尔斯预防干预。维持家庭生活的经济效益和生活质量 通过防止福尔斯跌倒来为PwADRD而生活，将为这一庞大的高风险人群的所有利益相关者带来好处。

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.