Effect of an interactive therapeutic robotic animal on engagement, mood states, agitation and psychotropic drug use in people with dementia: a cluster-randomised controlled trial protocol

Affiliations


Abstract

Introduction: Apathy, agitated behaviours, loneliness and depression are common consequences of dementia. This trial aims to evaluate the effect of a robotic animal on behavioural and psychological symptoms of dementia in people with dementia living in long-term aged care.

Methods and analysis: A cluster-randomised controlled trial with three treatment groups: PARO (robotic animal), Plush-Toy (non-robotic PARO) or Usual Care (Control). The nursing home sites are Australian Government approved and accredited facilities of 60 or more beds. The sites are located in South-East Queensland, Australia. A sample of 380 adults with a diagnosis of dementia, aged 60 years or older living in one of the participating facilities will be recruited. The intervention consists of three individual 15 min non-facilitated sessions with PARO or Plush-Toy per week, for a period of 10 weeks. The primary outcomes of interest are improvement in agitation, mood states and engagement. Secondary outcomes include sleep duration, step count, change in psychotropic medication use, change in treatment costs, and staff and family perceptions of PARO or Plush-Toy. Video data will be analysed using Noldus XT Pocket Observer; descriptive statistics will be used for participants' demographics and outcome measures; cluster and individual level analyses to test all hypotheses and Generalised Linear Models for cluster level and Generalised Estimation Equations and/or Multi-level Modeling for individual level data.

Ethics and dissemination: The study participants or their proxy will provide written informed consent. The Griffith University Human Research Ethics Committee has approved the study (NRS/03/14/HREC). The results of the study will provide evidence of the efficacy of a robotic animal as a psychosocial treatment for the behavioural and psychological symptoms of dementia. Findings will be presented at local and international conference meetings and published in peer-reviewed journals.


Similar articles

Use of a Robotic Seal as a Therapeutic Tool to Improve Dementia Symptoms: A Cluster-Randomized Controlled Trial.

Moyle W, Jones CJ, Murfield JE, Thalib L, Beattie ERA, Shum DKH, O'Dwyer ST, Mervin MC, Draper BM.J Am Med Dir Assoc. 2017 Sep 1;18(9):766-773. doi: 10.1016/j.jamda.2017.03.018. Epub 2017 Aug 2.PMID: 28780395 Clinical Trial.

The Cost-Effectiveness of Using PARO, a Therapeutic Robotic Seal, to Reduce Agitation and Medication Use in Dementia: Findings from a Cluster-Randomized Controlled Trial.

Mervin MC, Moyle W, Jones C, Murfield J, Draper B, Beattie E, Shum DHK, O'Dwyer S, Thalib L.J Am Med Dir Assoc. 2018 Jul;19(7):619-622.e1. doi: 10.1016/j.jamda.2017.10.008. Epub 2018 Jan 9.PMID: 29325922 Clinical Trial.

Effect of a robotic seal on the motor activity and sleep patterns of older people with dementia, as measured by wearable technology: A cluster-randomised controlled trial.

Moyle W, Jones C, Murfield J, Thalib L, Beattie E, Shum D, O'Dwyer S, Mervin MC, Draper B.Maturitas. 2018 Apr;110:10-17. doi: 10.1016/j.maturitas.2018.01.007. Epub 2018 Jan 13.PMID: 29563027 Clinical Trial.

Withdrawal versus continuation of chronic antipsychotic drugs for behavioural and psychological symptoms in older people with dementia.

Declercq T, Petrovic M, Azermai M, Vander Stichele R, De Sutter AI, van Driel ML, Christiaens T.Cochrane Database Syst Rev. 2013 Mar 28;(3):CD007726. doi: 10.1002/14651858.CD007726.pub2.PMID: 23543555 Review.

Care-Delivery Interventions to Manage Agitation and Aggression in Dementia Nursing Home and Assisted Living Residents: A Systematic Review and Meta-analysis.

Jutkowitz E, Brasure M, Fuchs E, Shippee T, Kane RA, Fink HA, Butler M, Sylvanus T, Kane RL.J Am Geriatr Soc. 2016 Mar;64(3):477-88. doi: 10.1111/jgs.13936.PMID: 27000321 Review.


Cited by

Distributed Caregiving for Cognitively Impaired Individuals: A Case Report.

Alemi Y, Loughman B, Uriyo M.Cureus. 2023 Feb 6;15(2):e34677. doi: 10.7759/cureus.34677. eCollection 2023 Feb.PMID: 36909032 Free PMC article.

Nursing procedures for advanced dementia: Traditional techniques versus autonomous robotic applications (Review).

David L, Popa SL, Barsan M, Muresan L, Ismaiel A, Popa LC, Perju-Dumbrava L, Stanculete MF, Dumitrascu DL.Exp Ther Med. 2022 Feb;23(2):124. doi: 10.3892/etm.2021.11047. Epub 2021 Dec 7.PMID: 34970347 Free PMC article. Review.

Robot Pets as "Serious Toys"- Activating Social and Emotional Experiences of Elderly People.

Ihamäki P, Heljakka K.Inf Syst Front. 2021 Aug 14:1-15. doi: 10.1007/s10796-021-10175-z. Online ahead of print.PMID: 34413702 Free PMC article.

Understanding Engagement in Dementia Through Behavior. The Ethographic and Laban-Inspired Coding System of Engagement (ELICSE) and the Evidence-Based Model of Engagement-Related Behavior (EMODEB).

Perugia G, van Berkel R, Díaz-Boladeras M, Català-Mallofré A, Rauterberg M, Barakova E.Front Psychol. 2018 May 24;9:690. doi: 10.3389/fpsyg.2018.00690. eCollection 2018.PMID: 29881360 Free PMC article.

Video-calls to reduce loneliness and social isolation within care environments for older people: an implementation study using collaborative action research.

Zamir S, Hennessy CH, Taylor AH, Jones RB.BMC Geriatr. 2018 Mar 2;18(1):62. doi: 10.1186/s12877-018-0746-y.PMID: 29499659 Free PMC article.


KMEL References


References

  1.  
    1. Australian Institute of Health and Welfare. Dementia in Australia. Canberra, AIHW, 2012. Cat no. AGE 70.
  2.  
    1. World Health Organisation. Dementia: a public health priority. Switzerland: World Health Organisation, 2012.
  3.  
    1. Yeager CA, Hyer L. Apathy in dementia: relations with depression, functional competence, and quality of life. Psycho Rep 2008;102:718–22. 10.2466/pr0.102.3.718-722 - DOI - PubMed
  4.  
    1. Brodaty H, Draper B, Low LF. Nursing home staff attitudes towards residents with dementia: strain and satisfaction with work. J Adv Nurs 2003;44:583–90. 10.1046/j.0309-2402.2003.02848.x - DOI - PubMed
  5.  
    1. Astrom S, Nilsson M, Norberg A et al. . Staff burnout in dementia care: relations to empathy and attitudes. Int J Nurs Stud 1991;28:65–75. 10.1016/0020-7489(91)90051-4 - DOI - PubMed
  6.  
    1. Maher AR, Maglione M, Bagley S et al. . Efficacy and comparative effectiveness of atypical antipsychotic medications for off-label uses in adults: a systematic review and meta-analysis. JAMA 2011;306:1359–69. 10.1001/jama.2011.1360 - DOI - PubMed
  7.  
    1. Libin A, Cohen-Mansfield J. Therapeutic robocat for nursing home residents with dementia: preliminary inquiry. Am J Alzheimer Dis Other Demen 2004;19:111–16. 10.1177/153331750401900209 - DOI - PubMed
  8.  
    1. Kramer S, Friedman E, Bernstein P. Comparison of the effect of human interaction, animal-assisted therapy, and AIBO-assisted therapy on long-term care residents with dementia. Anthrozoös 2009;22:43–57. 10.2752/175303708X390464 - DOI
  9.  
    1. Tamura T, Yonemitsu S, Akiko I et al. . Is an entertainment robot useful in the care of elderly people with severe dementia? J Gerontol A Biol Med Sci 2004;59:83–5. 10.1093/gerona/59.1.M83 - DOI - PubMed
  10.  
    1. Wada K, Shibata T. Living with seal robots—its sociopsychological and physiological influences on the elderly at a care house. IEEE Trans Robot 2007;23:972–80. 10.1109/TRO.2007.906261 - DOI
  11.  
    1. Moyle W, Cooke M, Beattie E et al. . Exploring the effect of companion robots on emotions in older people with dementia: a pilot RCT. J Gerontol Nurs 2013;39:46–53. 10.3928/00989134-20130313-03 - DOI - PubMed
  12.  
    1. Rowland JT, Basic D, Storey JE et al. . The Rowland Universal Dementia Assessment Scale (RUDAS) and the Folstein MMSE in a Multicultural Cohort of Elderly Persons. Int Psychogeriatr 2006;18:111–20. 10.1017/S1041610205003133 - DOI - PubMed
  13.  
    1. Khachiyants N, Trinkle D, Son SJ et al. . Sundown syndrome in persons with dementia: an update. Psychiatry Investig 2011;8:275–87. 10.4306/pi.2011.8.4.275 - DOI - PMC - PubMed
  14.  
    1. Cohen-Mansfield J. Conceptualization of agitation: results based on the Cohen-Mansfield Agitation Inventory and the Agitation Behaviour Mapping Instrument. Int Psychogeriatr 1996;8:309–15. 10.1017/S1041610297003530 - DOI - PubMed
  15.  
    1. Koss E, Weiner M, Ernesto C et al. . Assessing patterns of agitation in Alzheimer's disease patients with the Cohen-Mansfield Agitation Inventory. Alzheimer Dis Assoc Disord 1997;11(Suppl. 2):S45–50. 10.1097/00002093-199700112-00007 - DOI - PubMed
  16.  
    1. Chenoweth L, King MT, Jeon YH et al. . Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet Neurol 2009;8:317–25. 10.1016/S1474-4422(09)70045-6 - DOI - PubMed
  17.  
    1. Hinze JL. Pass 2005 user's guide. Kaysville, UT: Number Cruncher Statistical Systems, 2004.
  18.  
    1. Campbell AJ, Robertson MC, Gardner MM et al. . Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomized, controlled trial. J Am Geriatr Soc 1999;47:850–3. - PubMed
  19.  
    1. Ballard C, Hanney ML, Theodoulou M et al. . The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial. Lancet Neurol 2009;8:151–7. - PubMed