Robot-Delivered Cognitive Stimulation Games for Older Adults

Acceptability Assessment of an Executive Function Training Game FISHERMAN for Older Adults

Objective: In recent years, an increasing number of gamification tools have been developed for older adults; however, few studies have explored the acceptability of these tools after initial use and sustained use in older adults. In the current study, we focus on "FISHERMAN," an executive function training game containing a cognitive game and an exergame, with the aim of investigating and comparing the acceptability of both versions of "FISHERMAN" after initial use and 3 months of sustained use in older adults. Materials and Methods: Seventy-six older adults were randomly assigned to the cognitive game training group or the exergame training group. Participants completed two 1-hour sessions per week for 12 weeks. Acceptability was evaluated through a validated, 7-point, self-rating, Interactive Technology Art Installation Technology Acceptance Model Questionnaire after the first and last training sessions, with higher ratings representing higher acceptability. The questionnaire included 22 items and 9 acceptability dimensions: usage behavior, intention to use, perceived usefulness, perceived ease of use, perceived playfulness, subjective norm, image, output quality, and result demonstrability. Descriptive statistics were conducted to evaluate acceptability after initial and sustained use. Two-way (time: initial use and sustained use; group: cognitive game group and exergame group) repeated ANOVAs were conducted to investigate the differences in acceptability. Post hoc, within-group, paired-sample t test analyses were performed to evaluate changes in game acceptability for each group over time. Results: After initial use and 3 months of sustained use, the average scores for overall acceptability and individual dimensions exceeded 5.5 of 7 points in both groups. The two groups presented different changes from initial use to sustained use. The overall acceptability, usage behavior, perceived usefulness, and perceived ease of use were significantly improved after training within the cognitive game group, while perceived playfulness was significantly reduced within the exergame group. Conclusions: The current study provided preliminary evidence that older adults had high acceptability for both the cognitive game and exergame versions of "FISHERMAN." After sustained use, acceptability of the cognitive game increased and acceptability of the exergame decreased, highlighting the importance of assessing game acceptability after initial and sustained use.

My Precious Friend: Human-Robot Interactions in Home Care for Socially Isolated Older Adults

OBJECTIVES

Using a friendship framework, we explored interactions between a multi-functional companion robot and older adults residing in a low-resource community in South Korea.

METHODS

We conducted in-depth interviews with 12 older adults who kept a doll-shaped companion robot called Hyodol for 18 months on average. We applied the Framework Analysis Method to explore three types of friendship (i.e., friendships of utility, pleasure, and the good) that participants cultivated with the robot.

RESULTS

The most common aspect of utility companionship reported by all participants was Hyodol's role as their health coach who reminded them to take medication and to exercise. Participants also found pleasure in playing with Hyodol and reported reduced feelings of loneliness. In the absence of other social supports, all participants also regarded Hyodol as a surrogate family member or human-friend, and interacted with Hyodol as such.

CONCLUSIONS

Findings illustrated high acceptability of Hyodol among these socially isolated older adults especially during the global COVID-19 pandemic, suggesting that a humanoid like Hyodol could be complementary to homecare services for solo-living older adults.

CLINICAL IMPLICATIONS

Well-designed robot interventions, as complements to existing aging service and clinical interventions, have a potential to improve health behaviors among socially isolated older adults.

Investigating the effectiveness of Socially Assistive Robot on Depression and Cognitive Functions of Community Dwelling Older Adults with Cognitive Impairments

We evaluated a socially assistive robot (SAR) named Hyodol during a six-week intervention. This study enrolled 69 older adults with cognitive decline. To screen the eligibility, we have used the following three criteria, namely Korean-Mini-Mental Status Exam score ≤ 26). Clinical Dementia Rating 0.5-2), and Diagnostics and Statistical Manual V. Participants were divided into three groups based on their cognitive function (i.e. very mild cognitive impairment (vMCI), mild cognitive impairment (MCI), and moderate cognitive impairment (MOCI). The groups were instructed to use Hyodol at home for a six-week period. Baseline and post-intervention surveys were performed after six weeks to examine the changes in perceived health, depression, and cognitive function. The vMCI group showed a reduction in the depression score after the intervention (t = -2.447, p = 0.040), in comparison to their peers in the control group. Further, the MCI group showed an improvement in the cognitive function score after the intervention (t = 2.690, p = 0.021). No significant improvement was found among MOCI participants who used the SARs. The significance of this study was to examine whether participants with different levels of cognitive functioning would diverge after a period of intervention using the Hyodol SARs. Moreover, it presented preliminary data for services and policies for home care treatment targeted to cognitive decline in older adults.

A dichotomic approach to adaptive interaction for socially assistive robots

Socially assistive robotics (SAR) aims at designing robots capable of guaranteeing social interaction to human users in a variety of assistance scenarios that range, e.g., from giving reminders for medications to monitoring of Activity of Daily Living, from giving advices to promote an healthy lifestyle to psychological monitoring. Among possible users, frail older adults deserve a special focus as they present a rich variability in terms of both alternative possible assistive scenarios (e.g., hospital or domestic environments) and caring needs that could change over time according to their health conditions. In this perspective, robot behaviors should be customized according to properly designed user models. One of the long-term research goals for SAR is the realization of robots capable of, on the one hand, personalizing assistance according to different health-related conditions/states of users and, on the other, adapting behaviors according to heterogeneous contexts as well as changing/evolving needs of users. This work proposes a solution based on a user model grounded on the international classification of functioning, disability and health (ICF) and a novel control architecture inspired by the dual-process theory. The proposed approach is general and can be deployed in many different scenarios. In this paper, we focus on a social robot in charge of the synthesis of personalized training sessions for the cognitive stimulation of older adults, customizing the adaptive verbal behavior according to the characteristics of the users and to their dynamic reactions when interacting. Evaluations with a restricted number of users show good usability of the system, a general positive attitude of users and the ability of the system to capture users personality so as to adapt the content accordingly during the verbal interaction.

Participatory Design, Development, and Testing of Assistive Health Robots with Older Adults: An International Four-year Project

Participatory design includes stakeholders in the development of products intended to solve real-life challenges. Involving end users in the design of robots is vital for developing effective, useful, acceptable and user-friendly products that meet expectations, needs and preferences. This four-year international project developed and evaluate a home-based robot for mood stabilization and cognitive improvement in older adults with mild cognitive impairment and age-related health needs. The dailycare robot was developed in collaboration with experts, carers, relatives and older adults, through six phases. Two phases were dedicated to cognitive stimulation games. This paper provides a summary of the participatory design and mixed-methods evaluation processes undertaken to develop, refine and test the robot. The final robot and games were acceptable to older adults, and useful for delivering stimulating activities and providing reminders for medication, health and wellbeing checks. Personalization is required to optimize human-robot interaction, and imagery and speech should be consistent with local users. Functions should be personalizable to accommodate individual health needs and preferences. This project highlights the importance of participatory design and testing robotics in end-user environments, as technical issues associated with long-term use were uncovered. Recommendations for future development and the design of assistive health robots are made.