A Social Engaging Restorative Virtual Environment (SERVE) Volunteer Intervention to Support Social Engagement and Well-Being in Older Adults with Cognitive Impairment

项目摘要 随着年龄的增长，认知和日常功能会出现与年龄相关的下降， 疾病的倾向，以及轻度认知障碍（MCI）和阿尔茨海默氏症等疾病的发作 疾病相关性痴呆（ADRD）。MCI患者患痴呆症的风险很高，因此 需要进行干预以改善或维持当前的功能水平或延迟进一步的认知衰退， 以及改善MCI患者的生活质量。基于虚拟现实的方法是可移植的，可适应的， 成本效益高，与门诊治疗相比，提供了更好的治疗机会。除了展示 有效性，干预研究的另一个关键目标是了解“如何和为什么” 干预工作。不充分了解的基本原则或作用机制， 干预妨碍执行。因此，拟议工作的目标是生成和测试VR- 基于干预，以改善MCI老年人的健康和生活质量，同时 解开干预的假设机制的行动和干预成功的主持人。这 该项目具有高度创新性，因为它使用了基于VR的交付方法，并利用了老年人的人力资本。 寻求志愿者经验的个人，与其他人进行有意义的社会和认知参与 MCI患者作为干预伙伴。志愿者的加入也将提供有意义的 为志愿者提供经验，并提高干预的可扩展性。第一阶段的活动 行为干预项目将包括一个新的虚拟现实干预的生成（通过完善 我们已经开发的VR模块沿着新模块的创建）， 培训社区干预人员（老年志愿者）的教学材料，以及 干预效果干预开发将采用以用户为中心的迭代设计方法， 生成和评估社会参与恢复性虚拟环境（SERVE），这将提供旧的 成年MCI患者通过各种社交和认知参与机会进行社交互动 在自己的家中开展合作活动。干预将配对MCI个人与非受损 老年志愿者MCI参与者和志愿者将在共享的虚拟空间内进行远程互动， 有效地参与和协作共享活动。我们假设，基于实证研究， 老龄化的理论模型，服务将增加老年人的社会支持感知 参与者与MCI，并增加感知社会支持将减少孤独，改善福祉， 提高生活质量。我们的试点数据和越来越多的研究文献表明， VR环境中的空间存在将是干预成功的重要调节因素。

Project Summary With increasing age comes age-associated declines in cognitive and everyday functioning, a greater propensity for illness, and the onset of disorders such as mild cognitive impairment (MCI) and Alzheimer’s Disease Related Dementias (ADRD). People with MCI are at a high risk for developing dementia and thus interventions are needed to improve or maintain current levels of function or delay further cognitive decline, as well as to improve the quality of life among those with MCI. VR-based approaches are portable, adaptable, and cost-effective, which offers enhanced access compared to outpatient treatments. In addition to demonstrating efficacy, another crucial goal of intervention research is developing an understanding of “how and why” interventions work. Insufficient understanding of the underlying principles or the mechanisms of action of interventions impedes implementation. As such, the goal of the proposed work is to generate and test a VR- based intervention to improve the wellbeing and quality of life of older adults with MCI while simultaneously untangling the intervention’s hypothesized mechanisms of action and moderators of intervention success. This project is highly innovative as it is using a VR-based delivery method and harnesses the human capital of older individuals seeking volunteer experiences to engage in meaningful social and cognitive engagement with other older adults with MCI as intervention partners. The inclusion of volunteers will also provide meaningful experiences for the volunteers and enhance the scalability of the intervention. The activities of this Stage I behavioral intervention project will include the generation of a new VR intervention (through the refinement of VR modules that we have already developed along with the creation of new modules), the development of instructional materials to train community interventionists (older adult volunteers), and the preliminary testing of intervention efficacy. The intervention development will apply a user-centered iterative design approach to generate and evaluate the Social Engaging Restorative Virtual Environment (SERVE), which will provide older adults with MCI an opportunity for social interaction through a variety of social and cognitively engaging collaborative activities within their own homes. The intervention will pair MCI individuals with non-impaired older adult volunteers. MCI participants and volunteers will interact remotely within a shared virtual space and productively engage and collaborate in shared activities. We hypothesize, based on empirical research and theoretical models of aging, that SERVE will increase perceived social support among the older adult participants with MCI, and that increases in perceived social support will reduce loneliness, improve wellbeing, and enhance quality of life. Our pilot data and a growing body of research literature suggest that perceived spatial presence within the VR environment will be an important moderator of intervention success.