FUNCTIONAL INDEPENDENCE IN OLDER SMOKING CLAUDICANTS

老年吸烟者的功能独立性

• 批准号: 3746418
• 负责人: WILLIAM R FLINN
• 金额: --
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3746418
• 关键词: aerobic exercise; arteriosclerosis; behavior modification; bioenergetics; body composition; body physical activity; cardiovascular function; clinical trials; cognitive behavior therapy; disabling disease; disease /disorder proneness /risk; functional ability; human old age (65+); human subject; human therapy evaluation; longitudinal human study; nutrition education; nutrition of aging; nutrition related tag; pain; peripheral blood vessel disorder; physical therapy; respiratory function; smoking cessation; tobacco abuse

This study complements the Intervention Study (IS) by performing a developmental trial in older smokers with disabling peripheral arterial disease (PAD) who were excluded from IS. This was deemed necessary because of the poor compliance of smokers to health promoting behaviors and our need to develop effective interventions for the treatment of PAD in these patients. The goal is to determine the effectiveness of an aggressive risk factor modification program (ARFM) with and without a cognitive-behavioral smoking cessation intervention on functional independence (claudication pain, exercise capacity), cardiovascular disease (CVD) risk factors, psychosocial functioning and health care utilization and expenditures in older smokers with claudication. Smoking is the major risk factor for PAD, followed by diabetes, hypertension, and hyperlipidemia. Exercise training and dietary modification reduce risk factors for CVD, and in patients with PAD they may complement each other to improve functional independence and prevent the progression and complications from atherosclerotic CVD. However, older smokers rarely engage in exercise, eat prudent diets or avoid alcohol; hence, their ability to comply to an ARFM program is suspect. This dysfunctional behavior may be related to the duration and cumulative exposure of older smokers to nicotine, but also could be a manifestation of depression. We hypothesize that in older smokers with PAD, behavioral-related dependencies will limit their ability to comply with and derive clinical, functional, and psychosocial benefits from an ARFM that does not include a supplemental cognitive-behavioral smoking cessation program. Therefore, a randomized clinical trial will determine the effects of an ARFM intervention on functional and exercise capacity, cardiac and peripheral vascular function, risk factors for CVD, health services utilization and cost, and long-term functional independence in older smokers with disabling PAD. The results of this trial will have implications for reducing CVD complications and improving the functional independence of a disabled population of older patients at high risk for CVD-related morbidity and mortality.

本研究通过执行一项研究来补充干预研究 (IS) 外周动脉功能障碍的老年吸烟者的发育试验 疾病 (PAD) 被排除在 IS 之外。 这被认为是必要的 因为吸烟者对健康促进行为的依从性较差 以及我们需要制定有效的干预措施来治疗 PAD 在这些患者中。 目标是确定一个方案的有效性 积极的风险因素修正计划（ARFM），有或没有 认知行为戒烟干预对功能的影响 独立性（跛行疼痛、运动能力）、心血管 疾病（CVD）危险因素、心理社会功能和医疗保健 患有跛行的老年吸烟者的利用和支出。 吸烟是 PAD 的主要危险因素，其次是糖尿病， 高血压、高脂血症。 运动训练和饮食 改良可减少 CVD 的危险因素，对于 PAD 患者 可以相互补充，以提高功能独立性并防止 动脉粥样硬化 CVD 的进展和并发症。 然而， 老年吸烟者很少锻炼、饮食谨慎或避免吸烟 酒精;因此，他们遵守 ARFM 计划的能力值得怀疑。 这种功能失调的行为可能与持续时间和累积有关。 老年吸烟者接触尼古丁，但也可能是一种表现 抑郁症。 我们假设患有 PAD 的老年吸烟者， 行为相关的依赖性将限制他们遵守的能力 并从 ARFM 中获得临床、功能和心理社会效益 不包括补充认知行为吸烟 戒烟计划。 因此，随机临床试验将确定 ARFM 干预对功能和运动能力的影响， 心脏和周围血管功能、CVD 危险因素、健康 服务利用率和成本，以及长期功能独立性 患有 PAD 的老年吸烟者。 这次试验的结果将有 对减少 CVD 并发症和改善功能的影响 高风险老年患者的残疾人群体的独立性 CVD 相关的发病率和死亡率。