Personalised cues and wayfinding in early to moderate stage AD
Research type
Research Study
Full title
Personalised cues and wayfinding in early to moderate stage Alzheimer’s disease (AD)
IRAS ID
257481
Contact name
Saif Sharif
Contact email
Sponsor organisation
Southern Health NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Summary of Research
In this study, we will interview people living with Alzheimer’s disease (AD) about fond memories from their past. Thinking about special memories can trigger feelings of wanting to return to those cherished moments. In social psychology we call this emotion nostalgia. This emotion can be triggered by reminders, such as keepsakes or pictures. We aim to select 7 nostalgia-evoking pictures (cues) for each participant, based on their interview responses.
The main aim of this study is to investigate whether these nostalgic pictures help people with AD learn and navigate a new environment. Becoming lost or confused about which way to go in an environment is commonly experienced by people with AD. We want to see if placing meaningful pictures will help people with AD find their way.In a computer-based task participants will move through a virtual maze using a joystick. It will appear as if they are walking along a corridor with multiple turns and decisions to make about which way go. There will be nostalgic pictures on the corridor walls in one task and control pictures (do not trigger nostalgia) in the other.
All participants have early to moderate stage AD and therefore have capacity to give consent. The study will take place over two sessions. The first visit will involve cognitive screening, joystick training, four personality-related questionnaires and the interview. The study partner will also complete the personality questionnaires and will be present during the interview.
In the second visit, participants will repeat the joystick training and will complete two route learning tasks, questionnaires and a picture recall and recognition task. The study partner will complete a neuropsychological assessment and questionnaire, both based on the participant.
More generally, this study may highlight a therapeutic design feature to help create more supportive environments for people with AD.
Summary of Results
This research was funded by the Economic and Social Research Council, as part of the principal investigator, Alice Oliver, doctorate in Psychology at the University of Southampton. The research team involved consultant and chief investigator, Dr Saif Sharif, at Memory Assessment and Research Centre. As well as a team of academic supervisors, Professor Tim Wildschut, Dr Edward Redhead, Dr Matthew Parker and collaborators, Professor Constantine Sedikides and Professor Richard Cheston. All of whom are affiliated with either University of Southampton, University of Portsmouth or University of West England.
We conducted the study at Memory Assessment and Research Centre, Moorgreen hospital, Southampton, UK. Southern Health NHS Foundation Trust was the sponsor for this research.
In everyday life, people living with Alzheimer’s disease experience difficulties. For example, individuals become lost and disorientated more easily and find learning new environments especially challenging. On top of this, indoor environments are often poorly designed. The Department of Health, UK, in 2015, outlined the importance of creating supportive environments for people living with dementia. One of their key design recommendations is to install recognisable and meaningful landmarks (or cues) to help a person with dementia with navigation. Researchers and laypeople voice a need for cues which are personal and trigger positive emotions.
In this research, we draw upon the emotion, nostalgia, to create personalised landmarks for people with Alzheimer’s disease. We do this by interviewing individuals about fond memories from their past. Then, we select a number of pictures which reflect each individuals' past events. For example, a individual may recall a childhood memory of a road trip to the beach with their family. We would then select a picture of the place (e.g., St Ives, Cornwall) and car (e.g., 1966 blue Ford Popular) they spoke of in the interview. These pictures are then mounted on the walls of a life-like virtual environment.
During the 12 month long project, we aimed to recruit 36 participants living with early to moderate stage Alzheimer’s disease. Despite our best efforts, we fell short of this target due to challenges with identifying suitable participants. We recruited 28 participants, however, in total, 21 participants completed the study.
As we did not meet our recruitment target, some of our findings remain inconclusive as the sample size was not large enough. We hope to continue the project to address this.
However, some significant results did emerge. Here is what we found. Nostalgic landmarks (compared to control landmarks) improved recognition ability and offered psychological benefits. That is, nostalgic landmarks significantly increased feelings of social connectedness, self-continuity, meaning in life, self-esteem, and positive affect.
For the first time, this project presents scientific evidence that landmarks which personally trigger nostalgia enhance the recognition of landmarks and provide psychological benefits for people with Alzheimer’s disease.
Going forward, we hope this work is informative for dementia design guidelines and practices. We plan to disseminate the findings by publishing this research in peer-reviewed scientific journals.
REC name
South Central - Hampshire A Research Ethics Committee
REC reference
20/SC/0210
Date of REC Opinion
29 Jun 2020
REC opinion
Further Information Favourable Opinion