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，他们患阿尔茨海默病 (AD) 的风险更大。 MCI 涉及功能衰退，可能包括参与有意义的活动和个人自信心/掌控感的减少，并且与抑郁症状、对家庭沟通的满意度差以及身体功能下降有关。现有针对 MCI 患者和护理人员的干预措施通常集中于单一问题，例如记忆或身体活动，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，以防止过早脱离和风险对于抑郁症状。每日增强有意义的活动 (DEMA) 干预采用家庭二元、基于优势和积极的健康方法，以现有二元技能和价值观为基础，完成有意义的活动参与，以满足有效干预措施的优先需求，防止过早脱离和抑郁MCI 患者的症状。 DEMA 建立在我们之前的描述性工作和老年学理论、人类休闲模型以及问题解决疗法的组成部分的基础上。我们的初步调查结果表明，干预措施和措施是可以接受的，并向参与者征求了改善交付的建议。本试点研究的目的是 1) 评估修订后的 DEMA 干预措施的可行性和满意度； 2) 通过纳入对照组来估计干预措施的效果大小。 MCI-护理人员双人组（n = 36 组）将被随机分配到 DEMA 或信息支持组；每个小组将接受 6 次每两周一次的会议（2 次面对面会议和 4 次电话会议），由训练有素的干预者主持。 MCI 患者和护理人员结果的数据将在干预前、干预后立即（两周）以及项目评估后 3 个月收集。描述性统计分析将用于评估 DEMA 或信息支持小组的满意度和感知，一般线性混合模型将用于估计干预措施对近端和远端结果的影响大小。研究结果将为后续 R01 的设计提供信息，以：1）在纵向随机临床试验中测试 DEMA 对 MCI 患者-护理人员二人组的功效； 2) 探索实施的成本/收益。如果发现有效，DEMA 有可能减缓从 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。