Home-Based Cognitive Intervention for Healthy Older Adults Through Asking Robots Questions: Randomized Controlled Trial

Abstract

Background: Asking questions is common in conversations, and while asking questions, we need to listen carefully to what others say and consider the perspective our questions adopt. However, difficulties persist in verifying the effect of asking questions on older adults' cognitive function due to the lack of a standardized system for conducting experiments at participants' homes.

Objective: This study examined the intervention effect of cognitive training moderated by robots on healthy older adults. A focus on the feasibility of the intervention at participants' homes was also maintained. Feasibility was evaluated by considering both the dropout rate during the intervention and the number of questions posed to each participant during the experiment.

Methods: We conducted a randomized controlled trial with 81 adults older than 65 years. Participants were recruited through postal invitations and then randomized into 2 groups. The intervention group (n=40) received sessions where participants listened to photo-integrated stories and posed questions to the robots. The control group (n=41) received sessions where participants listened to photo-integrated stories and only thanked the robots for confirming participation. The participants participated in 12 dialogue sessions for 2-3 weeks. Scores of global cognitive functioning tests, recall tests, and verbal fluency tasks measured before and after the intervention were compared between the 2 groups.

Results: There was no significant intervention effect on the Telephone Interview for Cognitive Status-Japanese scores, recall tests, and verbal fluency tasks. Additionally, our study successfully concluded with no participant dropouts at follow-up, confirming the feasibility of our approach.

Conclusions: There was no statistically significant evidence indicating intervention benefits for cognitive functioning. Although the feasibility of home-based interventions was demonstrated, we identified areas for improvement in the future, such as setting up more efficient session themes. Further research is required to identify the effectiveness of an improved cognitive intervention involving the act of asking questions.

Keywords: cognitive intervention; digital health; home-based experiment; older adults; robots; technology adoption.

Figure 1.. The CONSORT (Consolidated Standards of Reporting Trials) diagram flowchart.

Figure 2.. Session timelines for the intervention and control groups.

Figure 3.. Experimental devices for participants. (A) Android app and original dialogue with robot Bono-06. (B) App screen during the experiment.

Figure 4.. Box plots for the relationship between the frequency of device use by participants in the intervention group (horizontal axis) and the total amount of their utterances (vertical axis). Boxes represent IQRs. White circles indicate the mean values. Black lines in boxes indicate the median values. Observations outside the first (third) quartile (i.e., outside of 1.5 × IQR) are indicated by black circles. No participant selected “4: never” for C and D.