Using Immersive Virtual Reality to Enhance Social Interaction Among Older Adults: A Cross-Site Investigation.

Background and Objectives: Virtual reality (VR) applications are increasingly being targeted toward older adults as a means to maintain physical and cognitive skills and to connect with others, especially during the coronavirus disease 2019 era. Our knowledge about how older adults interact with VR is limited, however, since this is an emerging area and the related research literature is still rather slim. The current study focused specifically on older adults' reactions to a social-VR environment, examining participant's views about the possibility of meaningful interactions in this format, the impacts of social-VR immersion on mood and attitude, and features of the VR environment that affected these outcomes. Research Design and Methods: The researchers designed a novel social-VR environment with features intended to prompt conversation and collaborative problem-solving among older adults. Participants were recruited from 3 diverse geographic locations (Tallahassee, FL; Ithaca, NY; and New York City, NY), and were randomly assigned to a partner from one of the other sites for social-VR interaction. The sample consisted of 36 individuals aged 60 and older. Results: Reactions to the social VR were quite positive. Older adults reported high levels of engagement in the environment and perceived the social VR to be enjoyable and usable. Perceived spatial presence was found to be a central driver of positive outcomes. A majority of the participants indicated a willingness to reconnect with their VR partner in the future. The data also identified important areas for improvement that were of concern to older adults, such as the use of more realistic avatars, larger controllers more suited to aging hands, and more time for training/familiarization. Discussion and Implications: Overall, these findings suggest that VR can be an effective format for social engagement among older adults.

Loneliness before and during the COVID-19 pandemic: A systematic review with meta-analysis.

The COVID-19 pandemic and measures aimed at its mitigation, such as physical distancing, have been discussed as risk factors for loneliness, which increases the risk of premature mortality and mental and physical health conditions. To ascertain whether loneliness has increased since the start of the pandemic, this study aimed to narratively and statistically synthesize relevant high-quality primary studies. This systematic review with meta-analysis was registered at PROSPERO (ID CRD42021246771). Searched databases were PubMed, PsycINFO, Cochrane Library/Central Register of Controlled Trials/EMBASE/CINAHL, Web of Science, the World Health Organization (WHO) COVID-19 database, supplemented by Google Scholar and citation searching (cutoff date of the systematic search December 5, 2021). Summary data from prospective research including loneliness assessments before and during the pandemic were extracted. Of 6,850 retrieved records, 34 studies (23 longitudinal, 9 pseudolongitudinal, 2 reporting both designs) on 215,026 participants were included. Risk of bias (RoB) was estimated using the risk of bias in non-randomised studies-of interventions (ROBINS-I) tool. Standardized mean differences (SMD, Hedges' g) for continuous loneliness values and logOR for loneliness prevalence rates were calculated as pooled effect size estimators in random-effects meta-analyses. Pooling studies with longitudinal designs only (overall N = 45,734), loneliness scores (19 studies, SMD = 0.27 [95% confidence interval = 0.14-0.40], Z = 4.02, p < .001, I 2 = 98%) and prevalence rates (8 studies, logOR = 0.33 [0.04-0.62], Z = 2.25, p = .02, I 2 = 96%) increased relative to prepandemic times with small effect sizes. Results were robust with respect to studies' overall RoB, pseudolongitudinal designs, timing of prepandemic assessments, and clinical populations. The heterogeneity of effects indicates a need to further investigate risk and protective factors as the pandemic progresses to inform targeted interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Innovative Interventions Augmented with Technology to Reduce Risk for Depression and Suicide in Aging Adults

This symposium will focus on innovative technological interventions that assist with remote treatment. Specifically, it will address late life depression in older adults and the ways in which technology can be adapted to meet their needs. Virtual tools, such as the ones that will be presented today, are particularly significant in the current COVID-19 pandemic when access to face-to-face interactions is limited and symptoms of distress and anxiety are likely to be exacerbated. First, Dr. Sara Czaja will focus on the PRISM trial to discuss the role of technology in providing support for aging adults suffering from depression. Second, Dr. Samprit Banerjee will speak about the feasibility of predicting homework (HW) adherence to psychotherapy of depression in middle-aged and older adults using passively collected data by mHealth apps. Third, Dr. Jo Anne Sirey will present the PROTECT program and its goal of reducing depression severity in elder abuse victims in a remote setting. Fourth and finally, Dr. Dimitris Kiosses will focus on the development and feasibility of the patient-customized WellPATH tablet application for recently hospitalized older adults.

A Dyadic Technology-Based Intervention for Informal Caregivers and Patients With Dementia

Most intervention programs in the dementia domain have exclusively focused on the caregiver (CG) or the patient (CR), despite evidence of a reciprocal interaction between the dyad. This presentation will describe a randomized controlled trial that is evaluating the feasibility and efficacy of an innovative dyadic intervention (DT) that is delivered through an interactive technology that includes an evidenced-based CG component, an evidenced-based cognitive training component for the CR and a dyadic component. The program is designed to: be synergistic and emphasize issues important to CGs in the earlier stages of caregiving. The sample involves 200 informal CGs and CRs with early-stage dementia. Data will be presented regarding factors influencing the feasibility of implementing a dyadic intervention such as recruitment challenges (e.g., mutual consent and eligibility), and mutual engagement of both the CG and CR. Strategies implemented to maintain the trial during the COVID-19 pandemic will also be discussed.

Challenges of Implementing the PRISM 2.0 Trial for Supporting Social Connectivity Through Technology

Following the success of the Personal Reminder Information and Social Management (PRISM) trial, which found that a specially designed computer system for older adults can enhance social connectivity and reduce loneliness among older adults at risk for social isolation, the PRISM 2.0 trial sought to replicate and extend these results to a new technology platform (tablet rather than desktop) with expanded social features and diverse populations of older adults, including older adults living in rural areas, assisted living communities, and senior housing. This symposium discusses the aims of the trial conducted by the Center for Research and Education on Aging and Technology Enhancement (CREATE), challenges encountered (including challenges related to the COVID-19 pandemic), and solutions to those challenges. S. Czaja will begin with an overview of the PRISM 2.0 system and the trial. J. Sharit will discuss challenges encountered working within the context of assisted living facilities and with impaired participants. This will be followed by a discussion of technical challenges encountered during the course of the trial presented by N. Charness. W. Rogers will present training issues involved (both with respect to participants and assessors). Finally, W. Boot will describe challenges encountered with measuring and quantifying technology use during the trial. Lessons learned are applicable to many types of technology interventions administered in diverse contexts. D. Plude, Deputy Director in the Division of Behavioral and Social Research of NIA, will serve as discussant.

PRISM 2.0: A Technology System to Support Resource Access and Social and Cognitive Engagement

Social isolation and lack of engagement are common among older adults and present a risk for emotional, physical and cognitive decline. Technology offers the potential of remediating these risks and enhancing opportunities for connectivity. In this paper we present an overview of the PRISM 2.0 multi-site RCT, which evaluated a simple to use Personalized Reminder Information and Social Management System (PRISM) among a sample of two hundred and forty-eight adults age 65+ in diverse contexts (Rural Locations, Assisted Living Communities and Senior Housing). PRISM 2.0 is a tablet-based system, intended to provide support for access to resources and information, new learning, social and cognitive engagement, and memory. We describe the goals and content of PRISM, the user-centered design process, and measurement strategies. We also discuss the challenges of conducting the trial during the COVID-19 pandemic and the strategies used to adapt the trial protocol within the three contexts.

PRISM 2.0: Technical Challenges

PRISM 2.0 was designed to run on Android tablets and made use of both customized apps that relied on Google’s browser and e-mail functionality as well as commercial apps, such as Microsoft’s Skype for videoconferencing. We also made use of functionality provided by our partner AT&T, such as their sim cards to provide cell-based internet connectivity to participants who did not have access to Wi-Fi internet services to their home (cable, DSL), as well as tablet management software to deploy updates. The Miami site provided central management and tablet deployment and redeployment services and support as well as coordinating locally provided tech support at the three sites. We discuss some of the technical challenges associated with these arrangements. We focus on how changes to the operating system broke some of our apps necessitating substitution of other apps and provision of new training, and how Covid-19 affected technical support.

Adapting Training and Use of an Application for Cognitively Impaired Older Adults Amidst COVID-19

The emergence of COVID-19 and social distancing requirements have resulted in disruptions to daily life, reduced opportunities for social engagement, and diminished resource access for millions of older adults. Individuals with cognitive impairments (CI) are particularly vulnerable to risk for social isolation. This presentation will discuss the PRISM-CI pilot trial, which aims to examine the feasibility and potential efficacy of the PRISM-CI software system on enhancing connectivity and quality of life among a diverse sample of 50 older adults aged 65 and over with a CI. PRISM-CI, adapted from the PRISM system (developed by the Center for Research and Education on Aging and Technology Enhancement) for this population, is intended to support social engagement, memory, and access to resources and information. We will present data regarding the feasibility and perceived value of PRISM-CI and discuss the challenges, and strategies used, to adapt the PRISM-CI trial during the pandemic. We used a multi-modal approach to provide remote training and specialized tablet instruction that includes individualized training sessions tailored to individuals’ learning needs, hobbies, and prior technology use. The adapted protocol also involves the use of remote access software for troubleshooting. We will also discuss how participant feedback guided the inclusion of additional features, such as Zoom videoconferencing and virtual library access, for the PRISM-CI application. Finally, we will demonstrate how the adaptation of the PRISM-CI protocol holds promise for the use of flexible, remote technology approaches to reach socially isolated older adults to foster psychosocial well-being.

Effects of the COVID-19 Outbreak on Elder Mistreatment and Response in New York City: Initial Lessons.

New York City is currently experiencing an outbreak of COVID-19, a highly contagious and potentially deadly virus, which is particularly dangerous for older adults. This pandemic has led to public health policies including social distancing and stay-at-home orders. We explore here the impact of this unique crisis on victims of elder mistreatment and people at risk of victimization. The COVID-19 outbreak has also had a profound impact on the organizations from many sectors that typically respond to protect and serve victims of elder mistreatment. We examine this impact and describe creative solutions developed by these organizations and initial lessons learned in New York City to help inform other communities facing this pandemic and provide guidance for future crises.