Two ASU programs target cognitive decline and isolation in older adults who live alone

By 2034, the number of Americans over 65 is projected to exceed the number under 18 for the first time. A substantial fraction of those older adults will live alone - a circumstance correlated with accelerated cognitive decline, loneliness, and reduced access to informal care. Researchers at Arizona State University's Edson College of Nursing and Health Innovation presented two technology-enabled programs at the 2026 AAAS Annual Meeting in Phoenix designed to address that overlap of aging, isolation, and cognitive risk.

Both programs emerge from ASU's Roybal Center for Older Adults Living Alone with Cognitive Decline, which develops behavioral interventions following the NIH Stage Model - a structured framework that moves programs from theoretical development through testing toward real-world implementation. The goal is scalability: interventions that work in controlled trials but require specialist delivery or expensive infrastructure will not reach the populations that need them.

I-PASS: physical activity as dementia prevention

The first program, I-PASS, addresses a gap between what older adults know and what they do. Regular physical activity reduces the risk of Alzheimer's disease and related dementias, but fewer than half of U.S. older adults meet national recommendations for weekly activity. For adults over 60 who live alone, the barriers are compounded by the absence of exercise partners, reduced mobility, and the social isolation that often accompanies living without housemates.

I-PASS is designed for adults 60 and older who are less physically active and live alone. The intervention combines wearable activity trackers - which provide objective feedback on movement - with virtual coaching and structured goal-setting. The program also addresses social connection and stress resilience, recognizing that cognitive decline risk is influenced by social and psychological factors alongside the physical ones.

Associate Professor Molly Maxfield leads the I-PASS work. The study is currently examining whether the combination of technology, coaching, and goal-setting can move participants from below to above activity thresholds in a sustained way - and whether those changes translate into measurable cognitive benefits over time.

EPIC LA+: support for people already living with dementia alone

The second program, EPIC LA+, addresses a population that prevention-focused research often overlooks: people who are already in the early stages of Alzheimer's disease or other dementias and live without a household caregiver. This group faces particular challenges around daily management, future planning, and communicating their needs to family members and medical providers.

EPIC LA+ is delivered entirely via Zoom, making it accessible regardless of geography or transportation limitations. The structure consists of six group sessions and one individual meeting, focused on practical daily skills and care planning. Participants learn to communicate about memory challenges, manage everyday tasks, and articulate their care values and preferences for future decision-making - conversations that become harder to have as dementia advances.

Pilot data from EPIC LA+ showed 100% participant retention across the sessions - an unusually high figure for behavioral interventions in this population. Participants also showed improvements in mood, communication confidence, self-care, and preparedness for future care needs. These early results were strong enough to support the launch of a randomized clinical trial, led by Assistant Professor Abigail Gomez-Morales, to more rigorously evaluate the program's effects.

Scalability as the core design principle

Both programs reflect a deliberate design choice to work within existing technology that older adults can access - wearables and Zoom rather than proprietary platforms requiring specialized hardware. The AAAS session title, "Tech Solutions for Older Adults Living Alone with Cognitive Decline," was presented under the meeting's theme of "Science @ Scale," underscoring that the research goal is not a tightly controlled efficacy demonstration but a system that can reach millions of people who would otherwise lack access to structured cognitive health support.

Significant work remains. The randomized trial for EPIC LA+ will determine whether the pilot improvements replicate under more rigorous conditions. I-PASS is still generating longitudinal data on whether activity improvements persist and translate into cognitive outcomes. Both programs involve self-reported measures and Zoom-based delivery, which may introduce challenges around data quality and participant engagement that laboratory settings do not.