Multi-modal Large Language Model-Empowered Talk Therapy for Older Adults With ADRD

Purpose

The purpose of this study is to test the usefulness and the effect of Smart Virtual Reminiscence (SVR) therapy intervention on the Behavioral and Psychological Symptoms of Dementia (BPSD) of patients with Alzheimer's Disease and Related Dementias (ADRD). SVR is designed to help older adults improve their psychological well-being and cognition. This research supports our long-term goal of designing and implementing intelligent interactive systems to improve the health of individuals with ADRD.

Conditions

  • Mild Cognitive Impairment
  • Dementia
  • BPSD
  • BPSD (Behavioral and Psychological Symptoms of Dementia)
  • Reminiscence Therapy

Eligibility

Eligible Ages
Over 65 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • age ≥ 65 years - diagnosis of MCI (mild cognitive impairment) or mild ADRD - access to a reliable internet connection - community-dwelling - elevated behavioral and psychological symptoms of dementia (BPSD), indicated by a HABC (Healthy Aging Brain Care) monitor score above 14 on caregiver report or self report (indicating elevated levels of BPSD) - presence of one or more specific BPSD behaviors (e.g., agitation, anxiety, depression, apathy, or sleep disturbances) - ability to consent for themselves.

Exclusion Criteria

  • lives in an assisted living facility or nursing home - has moderate to severe ADRD as measured by the Quick Dementia Rating System - has a life expectancy of less than 6 months. For the care partner: Inclusion criteria: - ≥ 21 years old - self-identified care partner (e.g., is knowledgeable about the patient's daytime and nighttime behaviors) of a community-dwelling patient diagnosed with MCI or mild ADRD who will also participate in the study Exclusion criteria: - has MCI or dementia - has a severe mental illness or substance abuse - has a life expectancy of less than 6 months.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Active Comparator
Patient Music Therapy 		Patient listens to Youtube playlist
  • Other: Music Therapy
    Participants in the attention control group will receive a curated playlist of calming music that they need to listen to twice a week for 12 weeks. The music can be conveniently accessed online (e.g., through YouTube).
Experimental
Smart Virtual Reminiscence Therapy 		Patient uses Smart Virtual Reminiscence Therapy
  • Device: Smart Virtual Reminiscence Therapy
    SVR Therapy is delivered through a computer program that can be accessed using a personal computer or smart device. It uses virtual reality, automated speech recognition, and large language models to achieve virtual therapist-patient interaction. The SVR therapy platform also automatically sources multi-modal reminiscence materials (e.g., images, text, etc.) through search engines and databases to facilitate the reminiscence therapy sessions. Each participant will participate in two 25-60 min (depending on content) sessions/week across 12 weeks. Each session will include multiple trials of reminiscence, such as music, sports, arts, etc. Each trial takes about 10 minutes to finish. The exact number of trials finished will depend on each patient's speed, preference, and how long they engage in the interaction with the SVR system. The participants can take breaks as needed.
    Other names:
    • SVR Therapy

Recruiting Locations

Sidney & Lois Eskenazi Hospital
Indianapolis, Indiana 46202
Contact:
Katrina Coppedge
317-278-1602
kcoppedg@iu.edu

More Details

Status
Recruiting
Sponsor
Indiana University

Study Contact

Katrina Coppedge, BA
317-278-1602
kcoppedg@iu.edu

Detailed Description

Nonpharmacological approaches, such as Reminiscence Therapy (RT), have been a major investigation for ADRD in recent years, but lack of human facilitators, lack of training, technology adaptation, and lack of multi-sensory features are major implementation barriers. In addition, a good RT requires utilizing the personal life experiences of patients as topics of sharing, while showing concrete objects such as photographs, videos, and music that are memorable to the individuals. However, older adults may have a hard time collecting these materials for themselves. To address these limitations, the researchers have developed a novel SVR that is delivered through a computer program that can be accessed using a personal computer or smart device, and includes new functions so that there is no need for a human therapist to facilitate the RT sessions, and so that older adults and care partners do not need to collect reminiscence materials in advance. SVR presents a virtual therapist (avatar) who interacts with older adults through verbal (speech) and non-verbal communication (eye gaze, body language, etc.), understands the user's speech, and guides the user through reminiscence sessions. In this study, patient/caregiver dyads will be randomized to receive SVR intervention or an attention control intervention (listening to music). Participants randomized to SVR will either visit the study site (accompanied by the caregiver) to complete SVR sessions or complete the sessions at home, up to twice a week for 12 weeks. Participants randomized to the control arm will receive a curated playlist of calming music, accessible online, that they need to listen to twice a week for 12 weeks. Patient BPSD will be collected at baseline and monthly for 3 months.