Mild Cognitive Impairment Clinical Trial
Official title:
Evaluating a Digital Memory Notebook Intervention to Improve Independence and Quality of Life
This study will investigate the efficacy of a smart home / digital memory notebook (DMN)
partnership that will allow for real-time intervention and thereby facilitate acquisition and
use of the DMN to support everyday independence. The DMN is an app that is installed on a
mobile tablet. The smart home technology discovers and recognizes generalizable activities
and provides information about functional status and health-related variables for older adult
participants. This study will examine how smart home prompts affect individuals' DMN use,
ability to maintain activity routines, and overall wellbeing. Prompts will center on helping
users organize and schedule daily activities, record both routine and uncommon events that
may need to be remembered, and record activities performed and important associated event
information (e.g., when, what, where). Prompting will help to promote everyday functional
independence by encouraging frequent and regular notebook use and reducing memory
difficulties. The DMN will also help to support functional independence by notifying
individuals about appointments or prompting individuals to initiate important activities of
daily living (e.g., take medications).
This study will also involve a machine learning technique to gain a better understanding of
the contexts in which individuals adhere or do not adhere to the prompts. This activity-aware
intervention will be deployed in the homes of older adults with memory difficulties, to
assess the usability of the technology as well as to evaluate in a naturalistic setting the
efficacy of the technology for increasing everyday functional independence and quality of
life and decreasing care-partner burden. This contribution is significant because it will
demonstrate that intelligent technologies can improve the efficacy of traditional memory
rehabilitation techniques, extend functional independence, reduce caregiver burden, and
improve quality of life.
Approximately 30 older adults who complain of memory problems will be recruited for this
study. Over the course of six months, participants will complete questionnaires, open-ended
questions, and cognitive and motor screens. Participants will also undergo training to learn
to use a DMN to support daily activities and will continue to use the DMN for three months
following training. Additionally, half of the participants' homes will be equipped with our
"smart home in a box" technology that will support DMN use with context-aware prompting
technology.
During month one, participants in both conditions will complete a cognitive and motor screen
as well as questionnaires assessing depression, quality of life, coping, everyday memory, and
functional abilities. Care-partners/informants (when available) will also complete the same
questionnaires as well as an additional questionnaire about caregiver burden. The
questionnaires will be administered monthly (6x total) for the duration of the study.
During month two, graduate students will train study participants to use the DMN using a
training manual and workbook in 6-8 training sessions (depending on participants comfort with
the DMN) over 3-4 weeks. Supervision will include review of audiotapes and use of a checklist
to monitor fidelity of the training content and process. Participants and care-partners will
also answer open-ended questions designed to help improve the DMN and its training procedure
as well as the prompting technology and its integration with the DMN at each assessment
period. In addition, participants and care-partners will complete questionnaires about their
satisfaction and perception of ease of use of the DMN and interface as well as a
questionnaire concerning likeability and cognitive demand.
During months three through five, data collection will continue. Participants in the smart
home condition will use the DMN in conjunction with prompting technology for the third month,
only the DMN for the fourth month, and again the DMN and prompting technology for the fifth
month. Control participants will use only the DMN for all three months. Control participants
will rely on traditional methods (e.g., time-based alarm cues, sticky notes) to support DMN
use rather than activity-aware prompting technology.
During month six, participants will complete a post-test cognitive and motor screen identical
to the initial screen. Participants will also complete the set of the previously described
questionnaires and open-ended questions.
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