SBIR-STTR Award

Alzheimer’s disease affects approximately 5.4 million Americans (NIA, 2017) and by 2050, this number is expected to more than double to 13.8 million.1 Until cures for the dementias are discovered, new technologies are imperative that can help reduce the emotional burden of AD/ADRD for older adults and their care givers (Goal C of NIA’s strategic plan). In this STTR (Small Business Technology Transfer) Phase I study, we test the feasibility and technological merit of a new virtual reality (VR) platform, Rendever, with residents with mild cognitive impairments (MCI) and mild to moderate Alzheimer’s disease (AD) and Alzheimer’s disease-related-dementias (ADRD) and their adult children who live at a distance. The aims are to evaluate (1) the acceptability, engagement, and usability challenges of Rendever with this population, and (2) level of cognitive impairment (MCI, mild to moderate AD/ADRD) for which Rendever is best suited. Rendever enables older adults in residential care communities to maintain important family relationships, engage fully with life, and reconnect with their past. No VR technology, to our knowledge, has been tested with older adults as a way to enhance their family relationships, primarily because VR platforms typically lack sophisticated networking abilities. Rendever is highly innovative in that it is the only product on the market that incorporates live streaming and networking technology through one VR platform that allows everyone on the network to experience the same content at the same time, regardless of location. Preliminary testing of Rendever among residents without cognitive impairments shows that it increases positive emotions, energy, social well-being, and physical/mental health.2 However, the feasibility of Rendever with residents with dementia, as well as its remote capabilities with family members, have never been tested. Thus, this pilot study tests the feasibility of two components of Rendever—virtual travel into the past (e.g., traveling to one’s childhood home and familiar locations) and virtual family picture worlds—across three time points with 20 residents with MCI and 20 residents with mild to moderate AD/ADRD and their adult children who live at a distance. Phase I will be successful when we effectively adapt the technology to the participants through continuous feedback provided by interviews, self-report measures (e.g., user satisfaction, engagement, affect, enjoyment), and human and computerized coding of affect and engagement throughout the pilot testing. The end product is a networked, portable VR platform of travel adventures and virtual family photos that residents and their adult children who live at a distance can experience together and that can then be tested in a Phase II, multi-site clinical trial. Rendever has the potential to help residents with dementia reclaim their personal vitality and remain connected with their family, reduce the guilt, sadness, and anxiety of family members, and revolutionize existing thoughts on aging.

Public Health Relevance Statement:
This Phase I STTR tests the feasibility and technological merit of a new virtual reality program called Rendever with older adults with cognitive impairments (mild cognitive impairments and mild to moderate dementia) in residential care communities and their adult children who live at a distance. Rendever can help residents maintain important family relationships, engage fully with life, and reconnect with their past through virtual picture worlds and virtual travel. These goals are accomplished with its unique networking and livestreaming capabilities in a single platform.

Project Terms:
Adopted; Adult; Adult Children; Affect; Aging; Alzheimer's Disease; Alzheimer's disease related dementia; American; Anxiety; base; Behavioral; Brain; Businesses; care costs; Caregivers; Caring; Childhood; Code; Cognition; Cognitive; Communities; Computer software; computerized; cost; Costs and Benefits; Dementia; Depressed mood; Dropout; Elderly; Emotional; Equilibrium; experience; Eye; Family; Family member; Family Relationship; Feedback; Funding; Goals; Guilt; Healthcare; Home environment; hospice environment; Human; Impaired cognition; innovation; Interview; irritation; Life; Location; Long-Term Care; Love; Measures; Mental Health; mild cognitive impairment; Multi-Institutional Clinical Trial; negative affect; Neurologic; new technology; novel; Parents; Participant; Patient Self-Report; Phase; phase 1 study; Physiological; Pilot Projects; Population; portability; positive emotional state; prevent; Preventive measure; Process; programs; psychologic; Public Health; Reporting; Research; Research Personnel; Residential Treatment; Sampling; satisfaction; Small Business Technology Transfer Research; social; Social Well-Being; Societies; Space Perception; Strategic Planning; Stream; Stress; success; Technology; Technology Transfer; Testing; Thinking; Time; time use; Travel; usability; virtual; virtual reality; Work

The United States is experiencing a public health crisis on a massive scale due to the number of people with dementia, lack of cures, and challenges associated with caregiving for this population.1,2 Until cures for the dementias are discovered, new technologies and interventions are imperative that can reduce the stress and emotional burden of Alzheimer's disease (AD) and Alzheimer's disease-related-dementias (ADRD) for older adults and their family members (NIA strategic plan). Unfortunately, COVID-19 has exacerbated challenges related to social isolation and poor mental health in senior living communities. The virtual reality (VR) program, Rendever, provides an innovative and affordable solution to these challenges by enabling older adults in senior living communities to maintain important family relationships, engage fully with life, and reconnect with their past, regardless of physical location, through its advanced communication and network capabilities. There is neurological, behavioral, and physiological evidence that virtual environments allow people to feel the emotional presence of others in ways that surpass their location in space.3 Unfortunately, little research has examined its impact on older adults' social relationships, primarily due of a lack of networking and communication capabilities of other VR programs. Phase I tested the feasibility of Rendever with residents with mild cognitive impairments (MCI) or mild to moderate dementia and their family members who lived at a distance. Our results showed it to be safe, easy to use, highly satisfying, and transformative for the 21 resident- family member dyads who used it. Residents with MCI and dementia equally loved the VR, with residents with dementia reporting greater immersion. This Phase II project expands our test of the livestreaming and network features of Rendever with 192 resident-adult child dyads across 12 senior living communities in Central California and Boston with an experimental design. Our aims focus on the impact of Rendever on the quality of life of residents and their adult children who live at a distance and whether this association depends upon residents' level of cognitive impairment. We also focus on the adult children and whether participating in Rendever with their parent reduces care-giver guilt. If Phase II is successful, Rendever will be the only product that allows residents to still travel, view family photos and videos, and go back in time to one's childhood home and other memorable locations with one's family in VR and share stories while doing it, despite geographical separation and cognitive/physical challenges. Importantly, Phase II will provide a rigorous, scientific test of whether Rendever can improve residents' and family members' quality of life.

Public Health Relevance Statement:
This Phase II STTR continues to refine and test the livestreaming and networking capabilities of Rendever, which is a virtual reality (VR) platform designed to help older adults maintain important family relationships, engage fully with life, and reconnect with their past. Specifically, we examine the impact of Rendever on the quality of life of residents in senior living communities and their adult children who live at a distance, and determine whether this impact depends upon the residents' level of cognitive impairment (i.e., mild cognitive impairment vs. mild to moderate Alzheimer's disease and Alzheimer's disease-related-dementias). The findings will validate the long-distance feature of Rendever by providing a rigorous, scientific test of it with 192 resident-adult child dyads, with the ultimate goal of improving quality of life (e.g., reducing loneliness, improving mental health and thriving) and reducing caregiver guilt.

Project Terms:
Adult; 21+ years old; Adult Human; adulthood; Affect; Elderly; advanced age; elders; geriatric; late life; later life; older adult; older person; senior citizen; Alzheimer's Disease; AD dementia; Alzheimer; Alzheimer Type Dementia; Alzheimer disease; Alzheimer sclerosis; Alzheimer syndrome; Alzheimer's; Alzheimer's disease dementia; Alzheimers Dementia; Alzheimers disease; Primary Senile Degenerative Dementia; dementia of the Alzheimer type; primary degenerative dementia; senile dementia of the Alzheimer type; Back; Dorsum; Boston; California; Child; 0-11 years old; Child Youth; Children (0-21); youngster; Communication; Control Groups; Experimental Designs; Family; Family Relationship; Family Relations; Geography; Goals; Guilt; hospice environment; Hospices; Loneliness; lonely; Long-Term Care; extended care; longterm care; Love; Mental Health; Mental Hygiene; Psychological Health; Parents; Public Health; Quality of life; QOL; Research; Social isolation; Societies; Stress; Surveys; Survey Instrument; Technology; Testing; Time; Travel; United States; Caregivers; Care Givers; Family member; Healthcare; health care; Mediating; Caring; improved; Phase; Physiological; Physiologic; Neurologic; Neurological; Childhood; pediatric; satisfaction; Baseline Surveys; Cognitive Disturbance; Cognitive Impairment; Cognitive decline; Cognitive function abnormal; Disturbance in cognition; cognitive dysfunction; cognitive loss; Impaired cognition; Life; programs; Location; Amentia; Dementia; American; experience; Adult Daughters; Adult Offspring; Adult Sons; Adult Children; novel technologies; new technology; Reporting; Emotional; Modeling; Care giver Burden; care giver stress; caregiver stress; Caregiver Burden; QOC; Quality of Care; response; virtual reality; Intervention Strategies; interventional strategy; Intervention; video chat; video conferencing; Videoconferencing; Data; randomisation; randomization; randomly assigned; Randomized; Strategic Planning; Cognitive; Small Business Technology Transfer Research; STTR; follow-up; Active Follow-up; active followup; follow up; followed up; followup; Feeling; feelings; Behavioral; pandemic disease; pandemic; active control; caregiving; care giving; cost; design; designing; community living; Population; innovation; innovate; innovative; loved ones; mild cognitive impairment; mild cognitive disorder; Preventive measure; Preventative measure; negative affect; negative affectivity; care costs; phase 1 testing; phase 1 evaluation; phase I evaluation; phase I testing; Alzheimer's disease related dementia; AD related dementia; ADRD; Alzheimer related dementia; virtual environment; COVID-19; COVID19; CV-19; CV19; corona virus disease 2019; coronavirus disease 2019; social relationships; Immersion; feasibility testing; Home