# A Randomized Controlled Trial of Visual Cues, Signage, and Spaced-Retrieval Education within Long Term Care Communities to Assist with Wayfinding

> **NIH NIH R01** · GRAND VALLEY STATE UNIVERSITY · 2022 · $396,348

## Abstract

Project Summary/ Abstract
The ability to locate and travel successfully to a destination, known as wayfinding, is a significant problem for
older adults with cognitive disorders. Relocating to a new residence such as independent or assisted living is a
time in which older adults with cognitive problems are most vulnerable to experiencing difficulties finding their
way. Often these long term care communities are not designed to facilitate wayfinding as they are complex,
confusing, and lack distinctiveness. Wayfinding problems can cause an individual's world to shrink, leading to
a smaller life space (the spatial extent of travel within the community), decreased engagement, and dependence
upon others for activities of daily living. The overall goal of the proposed project is to assess the contribution of
salient visual cues and Spaced Retrieval (SR) on wayfinding ability and life space in older adults with
wayfinding problems who live in senior communities. Salient cues, such as vivid pictures, statues and bright,
distinctive signage can make senior residential communities more memorable and distinctive. This study has
three specific aims: a) To examine the effect of salient cues with and without spaced retrieval education on
wayfinding ability initially and over time in older adults who have wayfinding deficits in long term care
communities; and b) To determine the effects of salient visual cues and SR on life space; and c) to determine
subject characteristics that are most amenable to the intervention; and which subject characteristics place
persons at risk for less responsiveness to the intervention so that the intervention can be appropriately targeted.
There are three arms to the clinical trial to which nine care communities will be randomly assigned, including
Arm 1 (control; no change to the care community); Arm 2 (colorful and familiar objects and signage placed
within the care community); and Arm 3 (Arm 2 cues plus SR). Participants will be individuals within the
communities who exhibit problems finding their way. They will be asked to find their way repeatedly to
specific destinations over a period of a year. Wayfinding performance, including how fast the participants find
the test location and the errors they make compared between study Arms. Life space will also be measured and
compared between Arms. It is hypothesized that individuals who are in care communities which are enhanced
with salient cues will improve wayfinding when compared to care communities without salient cues. In
addition, Spaced Retrieval, which is an evidence-based memory strategy, is hypothesized to positively influence
subjects' use of the cues and improve wayfinding performance. Finally, it is hypothesized that wayfinding
ability will correlate with life space. The long term goals of this research are to test an evidence based
intervention to enhance senior residences so that older adults who have wayfinding problems can more easily
learn and remember their enviro...

## Key facts

- **NIH application ID:** 10348656
- **Project number:** 5R01AG056384-05
- **Recipient organization:** GRAND VALLEY STATE UNIVERSITY
- **Principal Investigator:** Rebecca Davis
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $396,348
- **Award type:** 5
- **Project period:** 2018-06-01 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10348656

## Citation

> US National Institutes of Health, RePORTER application 10348656, A Randomized Controlled Trial of Visual Cues, Signage, and Spaced-Retrieval Education within Long Term Care Communities to Assist with Wayfinding (5R01AG056384-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10348656. Licensed CC0.

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