Objectives Dementia caregivers (CGs) are at heightened risk for developing problems with anxiety and depression. Much attention has been directed toward developing and deploying interventions designed to protect CG health, but few have been supported by rigorous empirical evidence. Technology-based interventions that are effective, scalable, and do not add greatly to the CG burden are of particular interest.Methods We conducted a nine-month randomized controlled trial in 63 homes evaluating People Power Caregiver (PPCg), a system of sensors in the home connected to cloud-based software that alerts CGs about worrisome deviations from normal patterns (e.g., falls, wandering).Results CGs in the active condition had significantly less anxiety than those in the control condition at the six-month assessment. Greater anxiety reduction in the active condition at the six-month assessment was associated with greater interaction with PPCg via SMS text messages. There were no differences in anxiety at the three-month or nine-month assessments or in depression at any assessment.Conclusions PPCg shows promise for reducing anxiety associated with caring for a =person with dementia.Clinical implications Technology-based interventions can help reduce CG anxiety, a major adverse consequence of caregiving that may be difficult to treat due to other demands on caregiver time and energy.

Abstract Emotional impairments are a common symptom of neurodegenerative disorders that can be devastating for persons with the dementia (PWDs) and family members who provide care (i.e., caregivers). Emotional functioning can be well characterized and quantified using laboratory assessments of behavioral, physiological, and self-reported responses to emotional stimuli. However, continuous declines in functioning make it especially difficult for PWDs and caregivers to visit a research laboratory repeatedly over time. In order to understand changes in emotional functioning across time and their impact on PWDs and caregivers longitudinally, there is a need for technology to support remote assessments of emotional functioning. We developed a portable version of laboratory assessments—Laboratory in a Suitcase Assessment (LISA)—to collect data from PWDs and their caregivers remotely in their homes. In a shippable suitcase, LISA provides the necessary equipment for: (a) presenting emotional stimuli via laptop screen and headphones; (b) obtaining audio and video recordings of participants’ behavior; (c) obtaining continuous ratings of emotional experience via a rating dial; (d) measuring cardiovascular, electrodermal, and somatic responses from PWDs and caregivers via wearable devices; (e) synchronizing behavior and physiology; and (f) maintaining two-way communication with participants via Zoom. We present high quality physiological, behavioral, and self-report data collected using LISA with 17 PWD-caregiver dyads. Data collected with LISA are comparable to data collected in the laboratory, indicating that LISA could enable researchers to continue data collection further into the course of disease when travel to in-person laboratory sessions would no longer be feasible.

BACKGROUND:As the disease progresses, people with dementia (PWDs) gradually lose their ability to conduct activities of daily living (ADLs) independently and increasingly rely on family caregivers (CGs) for assistance and support. This can lead to CGs experiencing increased burden. These dyadic processes may be manifested by (a) CGs' increased physical proximity to PWDs (reflecting greater needs for CGs to monitor PWD's needs and safety, and (b) CGs' increased movement (reflecting greater needs to assist PWDs with ADLs and taking on additional household responsibilities). Working with an industry partner, we developed a wearable watch that measured: (a) physical proximity between PWDs and CGs; and (b) movement of CGs and PWDs in their homes. In the current study, we examined how these wearable-based measures correlated with standard measures of PWD's ADLs and CG's burden. METHOD:PWDs and CGs each wore a low-energy Bluetooth watch that provided long-battery-life (up to four months). The watches broadcasted information about proximity to three Bluetooth receivers placed in different rooms (which helped us determine the proximity between the PWDs and CGs) and used a three-axis accelerometer to determine movement on a second-by-second basis. In a nationwide US sample, 27 PWDs diagnosed with dementia or mild cognitive impairment and their co-residing familial CGs wore these watches over a six-month period. CGs also completed online questionnaires assessing PWDs' ADLs (Lawton Instrumental Activities of Daily Living) and their own perceived burden from caregiving (Zarit Burden Interview) at the beginning and the end of the study. RESULT:Over the six-month period, greater increases in PWD-CG proximity were associated with greater increases in CG's burden (r = 0.57, p = .009). In addition, greater increases in CGs' (but not PWDs') movement were associated with greater decreases in PWD's ADLs (r = -0.55, p = .005). CONCLUSION:These wearable devices show promise of providing scalable remote measures that are associated with ADLs in PWDs and burden in CGs. Findings also underscore the dyadic nature of dementia caregiving, with assessments of CGs useful for understanding changes in ADLs in PWDs, and assessments of PWDs useful for understanding changes in burden in CGs.

As the disease progresses, people with dementia (PWDs) gradually lose their ability to conduct activities of daily living (ADLs) independently and increasingly rely on family caregivers (CGs) for assistance and support. This can lead to CGs experiencing increased burden. These dyadic processes may be manifested by (a) CGs’ increased physical proximity to PWDs (reflecting greater needs for CGs to monitor PWD’s needs and safety, and (b) CGs’ increased movement (reflecting greater needs to assist PWDs with ADLs and taking on additional household responsibilities). Working with an industry partner, we developed a wearable watch that measured: (a) physical proximity between PWDs and CGs; and (b) movement of CGs and PWDs in their homes. In the current study, we examined how these wearable-based measures correlated with standard measures of PWD’s ADLs and CG’s burden. PWDs and CGs each wore a low-energy Bluetooth watch that provided long-battery-life (up to four months). The watches broadcasted information about proximity to three Bluetooth receivers placed in different rooms (which helped us determine the proximity between the PWDs and CGs) and used a three-axis accelerometer to determine movement on a second-by-second basis. In a nationwide US sample, 27 PWDs diagnosed with dementia or mild cognitive impairment and their co-residing familial CGs wore these watches over a six-month period. CGs also completed online questionnaires assessing PWDs’ ADLs (Lawton Instrumental Activities of Daily Living) and their own perceived burden from caregiving (Zarit Burden Interview) at the beginning and the end of the study. Over the six-month period, greater increases in PWD-CG proximity were associated with greater increases in CG’s burden ( r = 0.57, p = .009). In addition, greater increases in CGs’ (but not PWDs’) movement were associated with greater decreases in PWD’s ADLs ( r = -0.55, p = .005). These wearable devices show promise of providing scalable remote measures that are associated with ADLs in PWDs and burden in CGs. Findings also underscore the dyadic nature of dementia caregiving, with assessments of CGs useful for understanding changes in ADLs in PWDs, and assessments of PWDs useful for understanding changes in burden in CGs.