Developing a therapeutic, music-based mobile application to combat neuropsychiatric symptoms in people living with Alzheimer's disease and related dementias

Project Summary More than 6 million people in the United States are living with Alzheimer’s Disease and Related Dementias (ADRD). Music-based interventions have been shown to decrease common ADRD behaviors (agitation, depression) through melody and tempo to modulate parasympathetic nerve activity, which leads to changes in heart rate, music-induced relaxation/movement, and enhanced mood regulation. Since many music interventions are only available in institutional settings, family caregivers often lack resources and have limited access to digital-based applications to deliver an intervention while providing informal care for their loved ones at home. In this proposal, we will develop, a mobile application, “Tune Den,” created specifically for the use by people with ADRD supported by their family caregivers. Tune Den's unique design tailored for people living with ADRD and their family caregivers is expected to have a therapeutic benefit for the users and to reduce neuropsychiatric symptoms and change activity levels. Therefore, the overall impact of this app could prevent or delay pharmacological interventions. The proposed aims describe our development of app: (1) Tune Den will be created to respond to changes in heart rate and sedentary behaviors in a wearable device based on movements of people with ADRD. Depending on the assessment of an individual’s preferred songs and physiological signal response to those songs, the app will learn participants’ responses and begin to auto-play playlists, titrating the music dose based on physiological reactions. The musical experience will be personalized to either positively stimulate or soothe and relax. (2) We will test the usability of the app. We will recruit an advisory committee of social workers and music therapists to test the app for two weeks. The stakeholders will report feature functionality using the Usefulness, Satisfaction and Ease of Use questionnaire. Focus groups will be held to expand stakeholder’s perception on the acceptability of the app. (3) We will determine the performance and usability of the app for use by people with ADRD and their family caregivers providing care at home. Thirty dyads will be recruited to test Tune Den for two weeks. Following the testing period, family caregivers will complete the USE survey and rate key features like auto play and music dose. Our study team has expertise in music therapy, aging and neuro- rehabilitative technologies, and older adults living with dementia and family caregiving. The successful completion of Phase I will lead to a Phase II study to determine the clinical efficacy of Tune Den in which we will perform a rigorous trial.