The Use of Socially Assistive Robots in the Design of Intelligent Cognitive Therapies for People with Dementia Adriana Tapus, Cristian T ¸˘ apus ¸, and Maja J Matari´ c Abstract— Currently the 2 percent growth rate for the world’s older population exceeds the 1.2 rate for the world’s population as a whole. By 2050, the number of individuals over the age 85 is projected to be three times more than there is today. Most of these individuals will need physical, emotional, and cognitive assistance. In this paper, we present a new adaptive robotic system based on the socially assistive robotics (SAR) technology that tries to provide a customized help protocol through motivation, encouragements, and com- panionship to users suffering from cognitive changes related to aging and/or Alzheimer’s disease. Our results show that this approach can engage the patients and keep them interested in interacting with the robot, which, in turn, increases their positive behavior. I. INTRODUCTION In recent years, the rehabilitation and assistive technology has focused on developing more flexible and customizable robotic systems. The main goal of these robots is to support disabled and elderly people with special needs in their home environment, and therefore to improve their quality of life. Moreover, most advanced countries are becoming aging societies, and the percentage rate of people with special needs has already significantly grown. The American Alzheimer’s Association reported that more than one million residents in assisted living residences and nursing homes have some form of dementia or cognitive impairment and that number is increasing every day [3]. The rapidly increasing number of people suffering from Alzheimer’s disease could cripple healthcare services in the next few decades. The latest estimate is that 26.6 million people were suffering from Alzheimer’s disease worldwide in 2006, and that the number will increase to 100 million by 2050, or 1 in 85 of the total population [4]. More than 40% of those cases will be in late-stage Alzheimer’s, requiring a high level of attention equivalent to nursing home care. Dementia is a disorder that Manuscript received January 31, 2009; This work is supported by the USC NIH Aging and Disability Resource Center (ADRC) pilot program and National Academies Keck Futures Initiative program. We are also grateful to our partner: Silverado Senior Living - The Huntington, Alhambra, CA, USA. Many thanks to Vida Gwinn (facility administrator), Cheryl Stollman (Activities Program Director), Jessi Nunez and Zena Buccola (Activities Assistants), Rudy Medina (Plamt Operations Supervisor), Tamara Mitchel (Administrator Assistant), and all the personnel for all their help and their support. Dr. Adriana Tapus is with the Robotics Research Lab/Interaction Lab, Department of Computer Science, University of Southern California, Los Angeles, USA (phone: +1 (213) 740 6245: fax: +1 (213) 821 5696; e-mail: tapus@robotics.usc.edu) Dr. Cristian T ¸˘ apus ¸ is with Google, Inc., Mountain View, USA (e-mail: crt@google.com) Prof. Maja J. Matari´ c is with the Robotics Research Lab/Interaction Lab, Department of Computer Science, University of Southern California, Los Angeles, USA (e-mail: mataric@usc.edu) progressively affects the brain. People with dementia may not be able to think well enough to do normal activities, such as getting dressed, eating, speaking, etc.. They usually lose their ability to solve problems or control their emotions. Their personalities and usual behavior change. Memory loss is a common symptom of dementia. Dementia appears in the second half of the life, usually after the age of 65. The frequency of dementia increases with age, from 2% in 65-69- year-olds to more than 20% in 85-89-year-olds. Therefore, most of these people need some kind of assistance. While there is no cure to dementia, medication and special therapy may improve symptoms or slow down the disease. Non- pharmacological treatments focus on physical, emotional, and mental activity. Engagement in activities is one of the key elements of good dementia care [1]. Activities (e.g., music therapy [2], arts and crafts) help individuals with dementia and cognitive impairment maintain their functional abilities and can enhance quality of life. Other cognitive rehabili- tation therapies and protocols focus on recovering and/or maintaining cognitive abilities such as memory, orientation, and communication skills. Finally, physical rehabilitation therapies that focus on motor activities help individuals with dementia rehabilitate damaged functions or maintain their current motor abilities so as to maintain the greatest possible autonomy. Little long-term research has been done in the area of therapeutic robots for individuals suffering from dementia and cognitive impairment. In their research work [7], Libin and Cohen-Mansfield describe a preliminary study which compares the benefits of a robotic cat and a plush toy cat as interventions for elderly persons with dementia. Fur- thermore, Kidd, Taggart, and Turkle [6] use Paro, a seal robot, to explore the role of the robot in the improvement of conversation and interaction in a group. Marti, Giusti, and Bacigalupo [8] justify a non-pharmacological therapeutic approach to the treatment of dementia that focuses on social context, motivation, and engagement by encouraging and facilitating non-verbal communication during the therapeutic intervention. Our methodology focuses on hypothesis-testing by using the socially assistive robotics(SAR) [5], [9], [10], [11] tech- nology aimed at providing affordable personalized cognitive assistance, motivation, and companionship to users suffering from cognitive changes related to aging, dementia and/or Alzheimer’s disease. This work aims to validate that a robotic system can establish a productive interaction with the user, and can serve to motivate and remind the user about specific tasks/cognitive exercises.