Project 2: Technology Support for Cognition and Social Engagement for Aging Adults with Mild Cognitive Impairment (MCI)

Project Summary
Currently 15-20% of adults aged 65+ have Mild Cognitive Impairment (MCI) and a large percentage of these
individuals will develop Alzheimer's Disease and Alzheimer's Disease Related Dementias (AD/ADRD).
Individuals with MCI demonstrate difficulties performing a wide range of everyday activities and experience
social isolation. Investigators have begun to look at technology-based interventions to improve the functioning
of aging adults with cognitive impairment. Most of these efforts have focused on the provision of cognitive
training or rehabilitation and have not included other aspects of functioning such as everyday activities or
social engagement. The goal of this Stage 1 (NIH Stage Model) Intervention Development cross-site project is
to develop, using a user-centered design approach, and evaluate an innovative intelligent adaptive software
package aimed at providing cognitive and social support and engagement to older adults with MCI. The system
will be designed to adapt to the needs and abilities of the user. Phase 1, akin to Stage 1a, will involve
interviews with aging adults with MCI and care providers to gather information on challenges encountered in
everyday activities and types of technology support features of potential benefit. We will also evaluate different
features of the system (e.g., adaptive interface features), with an iterative design approach with diverse
samples of individuals with MCI. We anticipate conducting two rounds of usability testing per site. Phase 2,
akin to Stage 1b, will involve pilot testing to evaluate the feasibility and usability of the system with a sample of
68 individuals with MCI at each of the three CREATE sites (N=204) and to gather preliminary data on the
efficacy of the proposed system. We will use a waitlist control, pre-post design (waitlist group will receive the
technology after six months and assessed again at 12 months). A battery of measures that includes
demographic information, attitudes towards technology, tablet proficiency, technology experience, performance
of activities targeted in the training components, functional independence and well-being, social
support/isolation, and quality of life will be administered at baseline, 6 months post randomization, and after
another 6 months for the waitlist group. We will also assess potential cognitive ability changes. We will conduct
interviews 6-month post intervention to assess likes, dislikes, and challenges with the system. Our goal is to
develop a unique and highly innovative technology tool that can provide adaptive support to aging individuals
with MCI, even as cognition might deteriorate further. Speech data collected as part of an embedded
reminiscence feature will advance fundamental knowledge of how speech and language production data might
serve as an early indicator of cognitive decline. The project will yield important information on the feasibility of
using technology-based approaches to support everyday activities and cognition for persons with MCI and
insight on barriers to the implementation of technology-based interventions. We will also gain understanding of
the challenges aging adults with MCI encounter in everyday activities.

Grant Number: 5P01AG073090-04
NIH Institute/Center: NIH
Principal Investigator: Walter Boot