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

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.