Decreasing Alzheimer's Disease and Related Dementias after Delirium-Exercise and Cognitive Training (DDD-ECT)

谵妄运动和认知训练 (DDD-ECT) 后可减少阿尔茨海默氏病和相关痴呆症

• 批准号: 9919490
• 负责人: Babar A Khan
• 金额: $ 68.9万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9919490
• 关键词: Achievement; Acute; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; Astrocytes; Biological Markers; Brain-Derived Neurotrophic Factor; Chronic; Cognitive; Cognitive Therapy; Critical Illness; Delirium; Dementia; Educational Intervention; Effectiveness; Elderly; Exercise; Exercise Therapy; Functional disorder; Generalized Anxiety Disorder; Glial Fibrillary Acidic Protein; Goals; Health; Home environment; Hospitals; IL8 gene; Impaired cognition; Indiana; Inflammation; Insulin-Like Growth Factor I; Intensive Care Units; Interleukin-1; Interleukin-6; Internet; Intervention; Left; Length; Length of Stay; Link; Measures; Medical; Modeling; Neurobiology; Neuropsychology; Outcome; Outcome Study; Participant; Pathway interactions; Patients; Physical Exercise; Physical Performance; Quality of life; Questionnaires; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Recovery; Research; Research Infrastructure; Risk; Scientist; Serum; Step Tests; Survival Rate; Survivors; TNF gene; Testing; Time; Training; Training Programs; Universities; Vascular Endothelial Growth Factors; Videoconferences; Work; anxiety symptoms; attentional control; base; biobank; brain dysfunction; care costs; clinical Diagnosis; cognitive development; cognitive function; cognitive training; cost; depressive symptoms; disability; exercise program; exercise training; experience; follow-up; group intervention; human old age (65+); improved; indexing; informal caregiver; mood symptom; mortality; neurotrophic factor; novel; primary outcome; programs; psychologic; randomized controlled design; restoration; stem

PROJECT ABSTRACT Every year, more than two million older Americans (aged 65 and older) suffer from an episode of delirium during their intensive care unit (ICU) stay. Advances in the management of critical illness have improved critical illness survival rates especially among older adults. However, as many as 70% of ICU older survivors who had an episode of delirium are left with newly acquired cognitive impairment that can have disabling long- term consequences for both patients and their informal caregivers. Currently, there are no effective and scalable recovery models to remediate or treat ICU acquired cognitive impairment and its deleterious effects on quality of life and independence of this growing segment of older ICU survivors. Over the past five years, interdisciplinary team of scientists at Indiana University Center for Aging Research developed a novel, home-based cognitive and physical exercise program to reduce the societal impact of cognitive impairment. The team is proposing to conduct a randomized controlled trial (RCT) called “Decreasing Alzheimer's Disease and Related Dementias after Delirium-Exercise and Cognitive Training (DDD-ECT)” to evaluate the efficacy of 12 weeks of combined physical exercise and cognitive training intervention on the primary outcome of cognitive function among older ICU survivors in central Indiana who had an episode of delirium during their ICU stay. Importantly, we propose to deliver these interventions via a facilitator-led, small group format using internet-enabled, multiparty-videoconference delivered directly into the participants' homes. The trial has the following aims: 1. Determine the effect of the combined physical exercise and cognitive training on the cognitive function of older ICU survivors at 3 and 6-months follow-up. 2. Determine the effect of the combined physical exercise and cognitive training on physical performance, anxiety and depressive symptoms, and quality of life of older ICU survivors at 3 and 6-months follow-up. 3. To examine the mechanisms of action of combined training. Achievement of the aforementioned aims will provide an efficacious therapy to improve cognitive outcomes among ICU survivors along with highlighting the involved neurobiological pathways. The findings will aid in moving the field forward towards reducing the burden of Alzheimer's disease and related dementias.

项目摘要 每年，超过 200 万美国老年人（65 岁及以上）患有谵妄发作 在重症监护病房 (ICU) 住院期间，危重疾病的管理取得了进步。 重症患者的生存率尤其高，但 ICU 老年幸存者的生存率高达 70%。 曾经有过谵妄发作的人会留下新获得的认知障碍，这可能会导致长期残疾。 对患者及其非正式护理人员的长期后果。 目前，尚无有效且可扩展的恢复模型来补救或治疗 ICU 获得性认知障碍 老年 ICU 中这一不断增长的群体的损害及其对生活质量和独立性的有害影响 在过去的五年里，印第安纳大学老龄化中心的跨学科科学家团队。 研究开发了一种新颖的、以家庭为基础的认知和体育锻炼计划，以减少社会 该团队提议进行一项名为“认知障碍”的随机对照试验（RCT）。 “谵妄运动和认知训练后减少阿尔茨海默病和相关痴呆症 (DDD-ECT)”评估12周体育锻炼和认知训练相结合的效果 对印第安纳州中部 ICU 老年幸存者认知功能主要结局的干预 重要的是，他们在 ICU 住院期间出现过谵妄发作，我们建议通过以下方式提供这些干预措施： 由主持人主导的小组形式，使用支持互联网的多方视频会议直接传送到 参与者的家。 该试验的目的如下： 1.确定体育锻炼与认知训练相结合对认知功能的影响 老年 ICU 幸存者在 3 个月和 6 个月的随访中。 2.确定体育锻炼和认知训练相结合对身体表现的影响， 3 个月和 6 个月随访时 ICU 老年幸存者的焦虑和抑郁症状以及生活质量。 3.探讨组合训练的作用机制。 上述目标的实现将为改善认知结果提供有效的治疗 研究结果将有助于对 ICU 幸存者进行研究，并强调所涉及的神经生物学途径。 推动该领域朝着减轻阿尔茨海默病和相关痴呆症负担的方向发展。