Demonstrating feasibility of using a robot to deliver a multicomponent intervention to reduce delirium in hospitalized elderly patients living with dementia

Vigorous Mind, Inc. received a $499,981 Project Grant from the National Institute on Aging under the Aging Research program (CFDA 93.866) awarded on August 1, 2025, with a completion date of July 31, 2026. The grant funds the development and feasibility demonstration of an autonomous robot designed to deliver a multicomponent non-pharmacological intervention to reduce delirium in hospitalized elderly patients living with dementia. Delirium, an acute disturbance in attention and cognition, affects more than 2.6 million U.S. older adults annually and is associated with increased morbidity, falls, functional decline, extended hospital stays, and substantial healthcare costs exceeding $164 billion annually. The robot-based intervention addresses the gap in scalable, less labor-intensive alternatives to traditional multicomponent non-pharmacological approaches such as the Hospital Elder Life Program (HELP) and ABCDEF Bundle, which typically require nurses, families, or volunteers and demonstrate 43%-53% effectiveness in delirium prevention compared to usual hospital care.

The project leverages Vigorous Mind's expertise in developing AI-powered autonomous robotic solutions for elderly healthcare settings. By automating the delivery of multicomponent interventions through robotic technology, this initiative aims to reduce the labor intensity of evidence-based delirium prevention protocols while maintaining or improving their clinical effectiveness and scalability across hospital environments. The work is performed in Massachusetts and represents the National Institute on Aging's continued investment in innovative technological approaches to address critical challenges in aging research and dementia care.

Abstract

Delirium, an acute disturbance in attention and cognition and the most common complication afflicting hospitalized elderly, affects more than 2.6 million U.S. Older adults annually. Delirium associates with greater morbidity, falls, functional decline, nursing effort, daily hospital costs, hospital length of stay, and nursing home placement; IT contributes to more than $164 billion in annual healthcare costs in the U.S. And accounts for double the mortality in the subsequent year. People with dementia incur greater risk for incident delirium than the general population, while delirium itself may forecast or predisposes subsequent development of dementia. Furthermore, delirium in individuals with dementia can accelerate the trajectory of the underlying cognitive decline. The adjusted mean difference in costs associated with delirium in adrd patients with versus without delirium were $34,828. Patients with a variety of underlying conditions incur greater delirium risk. As common as delirium is, 60% of delirium cases remain undiagnosed. At least 30% to 40% of delirium cases are preventable. We lack convincing, reproducible evidence that any pharmacological intervention effectively either prevents or treats delirium, while multicomponent non-pharmacological approaches probably do so by 43%-53% compared to usual hospital care. These also reduce the risk of falls by 62% among hospitalized non-ICU patients 65 years and older. The most commonly used multicomponent non-pharmacological methods such as help (hospital elder life programs) and abcdef (in the ICU) are typically administered by nurses, families or volunteers and are labor intensive. A less labor intensive, scalable approach is needed. Robots are increasingly being adopted in healthcare to carry out various tasks that enhance patient care. The goal of this project is to develop an application that builds personalized multicomponent non-pharmacological interventions for hospitalized non-ICU elderly patients for preventing delirium, and to test the feasibility of using an autonomous navigating robot to deliver the intervention at the bedside. The primary outcome measures will be the percentage of successful delivery of the non-pharmacological interventions by the robot. Secondary outcomes will be satisfaction of nurses, patients and families with the robot application.