Wayfinding in Aging and Alzheimer's Disease within a Virtual Senior Residence This Academic Research Enhancement Award project will engage undergraduate and graduate students in a research project examining ways to support wayfinding in older adults. Early stage Alzheimer's disease (AD) is characterized by episodic memory loss and a gradual decline in ability to perform complex mental operations. A hallmark sign of early stage AD is problems wayfinding with the result of getting lost. Most people with early stage AD have problems getting lost in familiar and unfamiliar environments. In AD, wayfinding problems have been linked to anxiety, decreased social interaction, wandering behavior, falls, elopement, and institutionalization. Relocating to a new residence such as independent or assisted living is a time in which people with AD are most vulnerable to experiencing wayfinding problems as they are leaving a highly familiar environment and relocating to a complex environment when their wayfinding abilities are declining. Often these residences are not designed to facilitate wayfinding as they are complex, confusing, and lack distinctiveness. Problems in wayfinding can affect adaptation to the new living situation, and cause individuals'worlds to shrink as they avoid situations in which they fear getting lost. Beginning research suggests that using salient, or distinctive, environmental cues can help older adults remember learn and remember environments. The use of simulated, three-dimensional computer environments, called virtual reality (VR), are valid measures of place learning performance for older adults and those with early stage AD. In addition, eye tracking, which records eye scanning patterns and fixations, has the potential to elucidate how environmental information such as cues or landmarks are used in wayfinding. The proposed project will test the influence of adding salient environmental cues such as vivid pictures, fountains and other visual elements to key areas within a senior residential environment depicted in a novel VR program called the virtual senior living (VSL). By tracking eye gaze during wayfinding tasks in the VSL, the researchers can determine how subjects select and attend to visual cues and how this affects place learning. The wayfinding ability in both standard (few cues) and salient (distinctive cues placed in key locations) routes will be tested in 40 older adults with normal cognition and 40 older adults with early stage AD. Subjects will be asked to find their way repeatedly to a specific destination in each route in multiple learning trials for 2 consecutive days. Wayfinding performance, including how fast the subjects learn the route, the directional errors they make, and the distance they travel over time will be compared between groups and routes. Eye tracking data will be analyzed, including the frequency and time fixating on cues to determine differences between groups. The long term goals of this research are to determine scientifically valid methods to enhance senior residences so that older adults and those with Alzheimer's Disease, can more easily learn and remember their environments so that they can maintain independence, social engagement, and safety;and have the comfort of knowing where they are.

Public Health Relevance

The work outlined in this AREA proposal will provide a more comprehensive understanding of how seniors with and without Alzheimer's disease use environmental information to find their way in senior living residences;and how using distinctive cues may enhance wayfinding ability for those who are at risk for getting lost. A better understanding of how the physical environment can be used to support independence in wayfinding is essential for independence and well-being. In addition, this AREA proposal will provide a meaningful research experience to undergraduate and graduate students which will help to supply outstanding students to graduate schools and to in nursing practice.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Academic Research Enhancement Awards (AREA) (R15)
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Nursing and Related Clinical Sciences Study Section (NRCS)
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Silverberg, Nina B
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Grand Valley State University
Schools of Nursing
United States
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Davis, Rebecca; Ohman, Jennifer M; Weisbeck, Catherine (2017) Salient Cues and Wayfinding in Alzheimer's Disease within a Virtual Senior Residence. Environ Behav 49:1038-1065
Davis, Rebecca; Ohman, Jennifer (2016) Wayfinding in ageing and Alzheimer's disease within a virtual senior residence: study protocol. J Adv Nurs 72:1677-88
Davis, Rebecca; Weisbeck, Catherine (2016) Creating a Supportive Environment Using Cues for Wayfinding in Dementia. J Gerontol Nurs 42:36-44