Project Summary/Abstract It is highly beneficial and meaningful for individuals with Alzheimer’s disease (IAD) to age-in-place. Prolonging time at home helps preserve their memories, spatial awareness and socio-emotional connections. At the same time, undue care burden is imposed and is associated with high rates of depression and anxiety among family caregivers. While relocation to long term care is an option, the alarming increase in annual costs with assisted living and nursing home admission creates significant financial constraints on the families. There is a significant need for novel technological solutions to promote independence, health, and safety of IAD to age-in-place. To address this need, we propose to develop a smart home-based social assistive robot (SAR) called Mobile Assistive Robot with Smart Sensing (MARSS). Our innovative SAR will: a) have four evidence-supported modalities of care built in- activity engagement and assistance, telehealth, home safety, and caregiver-care recipient connectivity; and b) a training program to enable a non-technology expert (caregiver, family member or health professional) to scale and program the modalities to fit with the disease severity and context of the IAD. MARSS will be developed and tested in accordance to the NIH Stage Model of Intervention Development. We have already pilot-tested a lab-based model of MARSS (Stage Ia). Now our priority is to pilot test the technology in the community (with 8 dyads of IAD and caregivers) and verify its implementation fidelity, robustness as well as behavior change techniques to optimize target engagement of IADs and caregivers (Aim I- Stage IB). To address Aim II (Stage III), we will conduct an 18-month randomized controlled trial to validate the real-world efficacy of MARSS. We will recruit 60 dyads in two staggered cohorts of IAD and caregivers and randomly assign them to the intervention (n=30) or a control group (n=30). We will gather repeated measures data on the IAD’s functional independence, safety, and physical and cognitive health, and the caregiver’s perceived care burden, autonomy and wellbeing over nine data points, 2 months apart. To account mechanism-focused change, we will objectively collect data on the technology’s utilization to tease out the influence of the MARSS’s modalities on the intervention outcomes. In addition to much needed empirical evidence on AD-based SARs, the findings will contribute knowledge to create and test advanced yet pragmatic technological solutions to strengthen aging-in-place of IAD.

Project Narrative Individuals with Alzheimer’s disease (IAD) are at high-risk of premature relocation to long-term care settings primarily due to caregiver burden and concerns with functional capacity and safety. We propose to develop and test a smart home-linked assistive robot, Mobile Assistive Robot with Smart Sensing (MARSS), to support care of IAD in their own home, as well as optimize the behavior mechanism leading to its adoption. This research will contribute to the knowledge on innovative (yet real world) technological solutions to promote independence, health, and safety of IAD to sustain living at home, as well as the behavioral mechanisms involved in adoption of such technologies.