Currently submitted to: JMIR Aging
Date Submitted: Apr 30, 2019
Open Peer Review Period: May 2, 2019 - May 15, 2019
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Using iPads to Improve Moods for Older Adults with Dementia and Interactions with their Caregivers
Individuals with Alzheimer’s disease or related dementia (ADRD) represent a significant and growing segment of the older adult (65 years and over) population. Individuals with ADRD are often challenged expressively and may experience difficulties with sharing their feelings or moods. Availability of and easy access to tablets and smart phones facilitates use of information and communication technologies (ICTs) as delivery mechanisms for non-pharmacological interventions, especially for older adults with ADRD. Evidence of the impact of ICTs in different community settings on quality-of-life and mood with older adults and their caregivers is needed for widespread adoption and sustainment of these technologies.
This projects’ research aim was to determine extent of the effects of ICTs (iPad) on positive mood change, and examine effects of study variables on participants’ mood changes and caregivers’ daily activities.
The ICT (iPad) intervention was developed and its impact evaluated in five tablet engagement pilots (2017-2018). The primary outcome was caregiver-assessed participants’ mood (n=1,096) before and after an iPad engagement session using an 8-point mood visual analog scale. Session impact on caregiver daily activities was captured for a sub-sample of participants (n=544). Frequency distributions were computed for each of the study variables, including the degree of patients’ mood changes. χ2 tests of association were calculated to determine the impact of the variables on mood changes for all patients, as well as those being treated in skilled nursing facilities and in-home, and then those that affected caregiver daily activities.
iPad interventions substantially improved most patients’ mood. Cumulatively, 51% showed mood improvement while another 41% of patients maintained an already-positive mood resulting from the caregiver engagement session. χ2 analyses demonstrated that positive mood changes resulted from using music (χ2(15) = 93.84, P < .001), using YouTube as the sole app (χ2(6) = 18.38, P=.005), or when cared for in a skilled nursing facility (χ2(6) = 236.36, P < .001) across all participants. Positive improvements in the caregivers’ day occurred for patients with a movement disorder (χ2(2) = 10.04, P=.007), or when socialization was a component of other interventions (χ2(2) = 35.26, P < .001).
The study is one of the first to explore the impact of ICTs, in particular tablets such as iPads and apps such as YouTube, to improve mood in older adults and enhance caregiver perceptions about their patient interactions, especially those with ADRD. Importantly, these pilot data substantiate ICTs as part of a person-centered engagement approach, as beneficial alternatives to pharmaceutical interventions for mood enhancement. However, a more comprehensive study that explores the ICT impact on additional quality of life and clinical outcomes is needed to confirm these preliminary findings.
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