Assessing a Novel Virtual Environment that Primes Individuals Living with AD/ADRD to Accomplish Activities of Daily Living.

摘要 阿尔茨海默病及其相关痴呆（AD/ADRD）的患病率正在增长， 长寿和更多的老年人口。维持健康和生活质量的护理挑战 患有痴呆症的人（PLWD）也会产生持续的护理人员工作压力的平行健康问题 导致工作人员更替率高，客户和工作人员福祉面临更多风险，业务成本增加。 提高日常生活活动（ADL）的完成率对提高儿童的生活质量有着积极的影响。 生命、健康和医疗保健成本。然而，在没有压力的情况下持续完成ADL仍然是一个挑战。 我们假设进行虚拟ADL活动将对实际ADL活动产生积极影响， 更易于管理和更有效的ADL完成，减少护理人员的压力和改善健康， 尊严和生活质量。 Mentia是一家处于早期阶段的数字健康公司，它开发了一种新的技术平台DevaWorld™ 专注于改善受AD/ADRD影响的人的行为健康。DevaWorld的独特之处在于， 专为护理二人组设计，PLWD是一个积极的参与者，即使他们的认知能力下降可能是 严重。该平台由一个媒体丰富的3D虚拟家庭与互动参与刺激，建立 在护理二分体内的沟通，并培养一种代理和身份感。拟议的工作旨在 展示DevaWorld的容忍度和接受度，并评估虚拟ADL活动对两者的影响 合作伙伴的照顾二分体，特别注意如何一致排练的日常生活能力的内部 PWLD的DevaWorld减轻了护理人员的压力。 这项工作有两个目标： 目标1：扩展DevaWorld，以包括最常被视为ADL挑战的环境和活动 建成我们假设玩家可以通过虚拟世界的互动来准备进行ADL。这一目标 需要在DevaWorld中共同设计设置，活动和交互式化身动作，以引导玩家 选择ADLs 目标2：证明DevaWorld在住宿护理环境中的接受度和可行性。定性 使用生态瞬时评估（EMA）和独立性定量措施进行评估 通过ADL量表评估将用于研究队列的虚拟ADL对他们实际ADL的影响。 ADL（AIM 1）。在这个两个地点的研究中，第一个结果将是二人组接受DevaWorld的可行性。 一个真实世界的场景第二个结果将衡量DevaWorld在减少焦虑方面的潜力。 二分体，导致更有效的ADL完成。

ABSTRACT The prevalence of Alzheimer’s disease and its related dementias (AD/ADRD) is growing due to increasing longevity and larger older-age populations. Care challenges to maintain the health and quality of life for persons living with dementia (PLWD) also creates a parallel health problem of persistent caregiver job stress leading to high staff turnover, additional risks to client and staff wellbeing, and higher operational costs. Improving the rate of completion of activities of daily living (ADL) has a known positive impact on the quality of life, health, and healthcare costs. Yet consistently completing ADLs, and without stress, remains a challenge. We hypothesize that undertaking virtual ADL activities will positively impact actual ADL activities resulting in more manageable and more efficient ADL completion, decreasing caregiver stress and improving the health, dignity, and quality of life for PLWD. Mentia is an early-stage digital health company that has developed DevaWorld™, a novel technology platform focused on improving behavioral health for people impacted by AD/ADRD. DevaWorld is unique in that it is designed for care dyads, with the PLWD being an active participant even though their cognitive decline may be severe. The platform consists of a media-rich 3D virtual home with interactive engagement stimuli that build communication within the care dyad and foster a sense of agency and identity. The proposed work aims to demonstrate tolerance and acceptance of DevaWorld and assess the impact of virtual ADL activities on both partners of the care dyad, paying particular attention to how the consistent rehearsal of ADLs inside DevaWorld by PWLD reduces caregiver stress. This work has two aims: Aim 1: Expand DevaWorld to include environments and activities most often cited as challenges to ADL completion. We hypothesize that players can prepare to perform ADLs via virtual world interactions. This aim entails co-designing settings, activities, and interactive avatar actions within DevaWorld to prime the player in selected ADLs. Aim 2: Demonstrate acceptance and feasibility of DevaWorld in a residential care setting. Qualitative assessments using ecological momentary assessments (EMAs) and quantitative measures of independence through ADL scale assessments will be used to study the impact of the cohort’s virtual ADLs on their actual ADLs (AIM 1). In this two-site study, the first outcome will be dyads’ acceptance and feasibility of DevaWorld in a real-world setting. The second outcome will measure DevaWorld’s potential for reducing anxiety within the dyad, leading to more efficient ADL completion.