Effects of coach robot pepper versus tablet training on psychosocial and physical outcomes of persons with dementia: A mixed-methods study

BACKGROUND

The evidence of social robots for people with dementia (PwD) living at home is unclear. The aim was to explore the effects of Coach Pepper (socially assistive humanoid robot system "AMIGO" combined with external tablet-based training) versus an exclusively tablet-based training on quality of life, motivation, cognition, mobility, care dependency, depression, and neuropsychiatric symptoms, as well as the user experience with Coach Pepper.

METHODS

The study (2019-2020) includes a randomized controlled trial with complementary interviews using content analysis. The intervention group (16 PwD) received Coach Pepper and the control group (16 PwD) an exclusively tablet-based training for three weeks. Data were collected using standardized questionnaires (AES, MOCA, DEMQOL, PAS, TUG, GDS, NPI) and interviews.

RESULTS

In both groups, PwD were >80 years old and mainly female. The mild stage of Alzheimer's was predominant in both groups. The comparison of quality of life (DEMQOL questionnaire) between the groups showed a significantly greater increase in the Coach Pepper group (X̅: 5.48 vs. -0.31; med: 4 vs. 2 points, p = 0.0226). Furthermore, global quality of life increased significantly in the Coach Pepper group (X̅: 0.4 vs. -0.2; med: 1.0 vs. 0.0 points; p = 0.013). All other outcomes did not differ significantly. Main qualitative results: Attitude/feelings - PwD reacted mainly positively to Pepper. The PwD were generally not afraid of Pepper and did not feel repulsed. They found Pepper nice/pleasant and funny. Communication, social contacts - Pepper was received well and integrated as a family member. His presence was not disturbing, more an enrichment. PwD regarded Pepper as a friend, child and contact person. He promoted communication in PwD. The life of PwD "bloomed" and they bonded with Pepper, which caused feelings of sadness after Pepper moved out. Meaningful activities- music and dance activities stimulated PwD particularly positively.

CONCLUSION

Coach Pepper significantly increased the quality of life of the PwD in the robot group. As the additional qualitative results demonstrate, this increase can be attributed in particular to the promotion of communication and social contacts by Pepper. Further research should focus on the increase of Pepper's communication skills and program content.

Psychosocial effects of the humanoid socially assistive robot Coach Pepper on informal caregivers of people with dementia: A mixed-methods study

BACKGROUND

Dementia care is largely provided by informal caregivers, which can present significant challenges and increase caregivers' burden. Humanoid socially assistive robots (SARs) have the potential to provide assistance, but evidence is missing. The aim was to explore the psychosocial effects of Coach Pepper (humanoid SAR system "AMIGO" combined with a tablet PC-based dementia training) versus an exclusive tablet PC-based dementia training on informal caregivers of people with dementia living at home (as well as their experiences).

METHOD

A randomized controlled trial with a complementary qualitative part was performed (May 2019-March 2020). 32 informal caregivers of people with dementia living at home participated in the study. The intervention group received Coach Pepper and the control group received only the tablet-based dementia training. The duration of the intervention was three weeks per household. Data was collected at baseline and after the intervention by standardized questionnaires for caregiver burden (primary outcome), quality of life, depressive symptoms and affect. Additionally, interviews about caregivers' experiences were conducted in the intervention group.

RESULT

Participants were on average 58.2 (±12.5) years old and predominantly female (68.8%). Quality of life, depressive symptoms and affect demonstrated no significant differences regarding between-group mean changes, neither did caregivers' burden, which showed decreasing tendencies of burden in the intervention and control group (Zarit Burden Interview, -2.7±8.7 vs. -4.4±6.4, p=0.2552). Qualitative findings revealed that participants had positive attitudes regarding Coach Pepper and experienced it as neutral in terms of burden. Some stated that Coach Pepper provided relief/more free time by entertaining the persons with dementia. However, some participants stated that they had to invest additional time until the person with dementia was able to engage with Coach Pepper and that its usability should be improved in certain areas (e.g., communication) to constitute more support for caregivers.

CONCLUSION

Coach Pepper had no significant psychosocial effects on informal caregivers of people with dementia. Qualitative findings demonstrated the participants' positive attitudes but highlighted a need for improvement regarding its usability. This study contributes to the development/modification of Coach Pepper based on caregivers' needs in dementia care.

Effects of a Humanoid Socially Assistive Robot Versus Tablet Training on Psychosocial and Physical Outcomes of Persons With Dementia: Protocol for a Mixed Methods Study

Background

New technologies, like socially assistive robots (SARs), may have the potential to support caregivers at home. Still, the evidence for people with dementia in home care is unclear because a lot of studies are performed in a laboratory or institutional setting, and mainly use robots in prototype stages.

Objective

This study aims to explore the effects of the refined, commercially-available, humanoid SAR Pepper combined with a tablet PC–based dementia training program (Coach Pepper) versus an exclusively tablet PC–based dementia training program on psychosocial and physical outcomes of people with dementia living at home, including caregivers and dementia trainers. We hypothesize that Coach Pepper has a more positive effect on the primary outcome motivation (stable or decreased apathy) of people with dementia.

Methods

A mixed methods study will be performed, including a randomized controlled, parallel, 2-arm study with a complementary qualitative part. This sample includes 40 PWD living at home and 40 relatives, each complemented with five professional caregivers and dementia trainers. The intervention group will receive Coach Pepper (a SAR connected with a tablet PC–based dementia training program), and the control group will receive exclusively tablet PC–based training without the SAR. The duration of the intervention will be three weeks per household. Data will be collected at baseline and during and after the intervention by standardized questionnaires, sensor data of the robot, and tablet PC, as well as semistructured interviews, focus groups, and observation.

Results

To date, no results are available for this study protocol. The study intervention started in May 2019 and will end in Spring 2020.

Conclusions

The intervention of this study can be seen as a nonpharmacological intervention, including cognitive and physical training by a robot. This study will help to further refine SAR for the specific needs of people with dementia living at home.

International Registered Report Identifier (IRRID)

DERR1-10.2196/14927