Meaningful Activity Intervention for Persons with Mild Cognitive Impairment

对轻度认知障碍患者进行有意义的活动干预

• 批准号: 8505035
• 负责人: Yueh-Feng Yvonne Lu
• 金额: $ 18.49万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-05 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8505035
• 关键词: Activities of Daily Living; Address; Affect; Alzheimer' s Disease; American; Automobile Driving; Awareness; Caregivers; Climacteric; Clinical; Cognitive; Communication; Consent; Costs and Benefits; Data; Distal; Elderly; Employee Strikes; Family; Family Caregiver; Feasibility Studies; Gerontology; Goals; Health; Human; Impaired cognition; Intervention; Life; Measures; Memory; Modeling; Occupations; Outcome; Participant; Patients; Perception; Performance; Persons; Physical Function; Physical activity; Pilot Projects; Problem Solving; Program Evaluation; Psyche structure; Quality of life; Randomized; Randomized Clinical Trials; Research; Research Personnel; Risk; Ritual compulsion; Sample Size; Self Management; Suggestion; Support Groups; Supportive care; Telephone; Testing; Time; Training; Work; base; cognitive change; comparison group; depressive symptoms; design; disability; efficacy testing; eligible participant; experience; functional decline; improved; innovation; meetings; mild cognitive impairment; normal aging; post intervention; premature; prevent; problem solving therapy; satisfaction; skills; social; statistics; success; theories

DESCRIPTION (provided by applicant): Mild cognitive impairment (MCI) affects as many as 20% of older adults who are at a greater risk of developing Alzheimer's disease (AD). MCI involves functional decline that may include decrements in engagement in meaningful activities and one's own sense of confidence/mastery, and it is associated with depressive symptoms, poor satisfaction with family communication, and declining physical function. Existing interventions for MCI patients and caregivers often focus on a single problem, such as memory or physical activity and there are no available multi-faceted supportive care interventions to meet the needs of the MCI patients and their caregivers in order to prevent premature disengagement and risk for depressive symptoms. The Daily Enhancement of Meaningful Activity (DEMA) intervention uses a family dyadic, strengths-based, and positive health approach that builds on existing dyadic skills and values to accomplish meaningful activity engagement to address the priority needs for efficacious interventions to prevent premature disengagement and depressive symptoms in MCI patients. The DEMA builds on our previous descriptive work and gerontology theory, the model human occupation, and components of the Problem-Solving Therapy. Our preliminary findings showed that the intervention and measures were acceptable, and suggestions were solicited from the participants for improving delivery. The purpose of this pilot study is to 1) evaluate the feasibility and satisfaction of the revised DEMA intervention; and 2) estimate effect sizes for the intervention through the incorporation of a comparison group. The MCI-caregiver dyads (n = 36 dyads) will be randomized to the DEMA or informational support groups; each group will receive 6 bi-weekly sessions (2 face-to-face and 4-phone delivered) with a trained intervener. The data from MCI patients and caregivers outcomes will be collected at pre-intervention, immediately (two weeks) post-intervention, and 3 months post-program evaluation. Descriptive statistics analysis will be used for satisfaction with and perception of the DEMA or informational support groups and general linear mixed models will be used to estimate the effect sizes of the intervention on the proximal and distal outcomes. Findings will inform the design of a subsequent R01 to: 1) test the efficacy of DEMA for MCI patient-caregiver dyads in a longitudinal randomized clinical trial; and 2) explore the costs/benefits of implementation. If it is found to be efficacious, DEMA has the potential to slow the rate of disability progression from MCI to AD and improve quality of life outcomes for patients and caregivers.

描述（由申请人提供）：轻度认知障碍（MCI）影响多达20％的老年人患阿尔茨海默氏病（AD）的风险更大。 MCI涉及功能下降，可能包括减少参与有意义的活动和自己的信心/掌握感，并且与抑郁症状，对家庭交流的满意度不佳以及身体机能下降有关。 MCI患者和看护人的现有干预措施通常集中在单一问题上，例如记忆或体育锻炼，并且没有可用的多方面支持护理干预措施来满足MCI患者及其护理人员的需求，以防止过早脱离接触和抑郁症状的风险。有意义的活动（DEMA）干预的每日增强使用家庭二元，基于优势和积极的健康方法，以现有的二元技能和价值观为基础，以完成有意义的活动参与，以满足有效干预措施的优先需求，以防止MCI患者的过早剥夺和抑郁症状。 DEMA建立在我们以前的描述性工作和老年度理论，模型人类职业以及解决问题疗法的组成部分的基础上。我们的初步发现表明，干预和措施是可以接受的，并且从参与者那里提出建议以改善交付。这项试点研究的目的是1）评估修订后的DEMA干预的可行性和满意度； 2）通过合并比较组估算干预措施的效果大小。 MCI养护者二元组（n = 36个二元组）将随机分为DEMA或信息支持组；每个小组将通过训练有素的干预者进行6个每两周的每两周一次（2次面对面和4个手机）。 MCI患者和护理人员预后的数据将在干预前，干预后（两周）和计划后3个月收集。描述性统计分析将用于满足DEMA或信息支持组的感知，并将使用一般线性混合模型来估计干预对近端和远端结果的效果大小。调查结果将为随后的R01的设计提供信息：1）在一项纵向随机临床试验中测试DEMA对MCI患者护理人员二元组的功效； 2）探索实施的成本/收益。如果发现它是有效的，DeMA有可能减慢从MCI到AD的残疾进展速度，并改善患者和护理人员的生活质量。