ASU Roybal Behavioral Intervention Development (BID) Core

Abstract (The Behavioral Intervention Development [BID] Core) Behavior and lifestyle Interventions have shown promising effects on cognition, functional status, and quality of life (QoL) in older adults with cognitive decline (defined as subjective cognitive decline [SCD], mild cognitive impairment [MCI], or Alzheimer’s disease and related dementias [ADRD]). However, these interventions have not been translated to make successful real-life impacts in older adults living alone with cognitive decline, which is attributable to multifaceted reasons such as not targeting Mechanisms of Behavior Change (MoBC) and being excluded by clinical trials if caregivers were not available. These barriers could be overcome with technology, e.g., artificial intelligence and wearable devices that improved intervention uptake in older adults, including those with cognitive decline and reach health disparity-susceptible populations that are disproportionately affected by ADRD (e.g., African and Hispanic Americans). Hence, the goal of the Arizona State University Roybal Center for Older Adults Living Alone with Cognitive Decline (ASU Roybal) is to develop infrastructure and conduct clinical trials of MoBC-driven, technology-enabled interventions to delay ADRD and improve QoL in older adults living alone with cognitive decline. The goals of the BID Core are to support the conduct of 12 clinical trials of MoBC-driven, technology-enabled interventions for behavior and lifestyle change in older adults living alone with cognitive decline and their advancement to the next stage of the NIH’s Stage Model. Trial Investigators will engage in clinical trials aimed at applying digital technologies to modify MoBC and/or biological targets for behavior and lifestyle change to improve proximal and long-term outcomes. For example, Trial 1 (Stage IB) will test the effectiveness of a virtual coaching intervention on increasing physical activity among older adults living alone with SCD. Trial 2 (Stage 1) will test if a virtual intervention that focuses on MoBC targets of interpersonal and social processes will result in increased ability to care for one’s physical, emotional, and social needs and plan for care. The BID Core will be co-led by Fang Yu (senior trialist who developed and tested iPad exergame and reminiscing interventions via Stages 0 & 1 ADRD trials) and Thomas Parsons (leading scientist for novel technology research such as developing and testing Virtual Patient to deliver cognitive behavioral therapy). The specific aims are to 1) ensure timely implementation and completion of clinical trials of MoBC-driven, technology-enabled interventions in older adults living alone with cognitive decline; and 2) assist in the development and grant submission of next-stage trials to test the effects of the MoBC-driven, technology-enabled interventions on mechanistic, proximal, and long-term outcomes in older adults living alone with cognitive decline. A timeline will be set up for each Trial Investigator. The BID Core is innovative in using technology to empower older adults living alone with cognitive decline and maintain their safety and QoL. It will enact a standard individualized process to grow a cadre of scientists and interventions and assess common strength-based and patient-reported outcomes.