Virtual Reality and Computerized Cognitive Intervention for Mild Cognitive Impairment in Heart Failure

虚拟现实和计算机认知干预治疗心力衰竭轻度认知障碍

基本信息

批准号：
10513843
负责人：
Miyeon Jung
金额：
$ 24.18万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-15 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10513843
关键词：
Address Adult Affect Aging Alleles Alzheimer&apos s disease related dementia American Apolipoprotein E Attention Award Biological Markers Biometry Brain-Derived Neurotrophic Factor Cardiology Caring Clinical Trials Cognition Cognitive Dementia Diagnosis Doctor of Philosophy Educational Intervention Educational workshop Elderly Enrollment Environment Evaluation Funding Future Generations Genetic Markers Goals Health Healthcare Heart failure Human Impaired cognition Individual Interdisciplinary Study Intervention Lead Leadership Left Longevity Longterm Follow-up Medication Management Memory Mentors Neurology Neuronal Plasticity Outcome Patients Persons Physical Exercise Population Public Health Quality of life Randomized Randomized Controlled Trials Research Research Personnel Research Project Grants Running Self Care Severities Solid Technology Testing Training Training Activity Treatment Efficacy United States Vulnerable Populations Work base cardiovascular nursing career development cognitive benefits cognitive function cognitive training computerized dementia risk depressive symptoms design disability effective intervention efficacious intervention experience follow-up functional independence head-to-head comparison health management health related quality of life high risk human old age (65+)improved instrumental activity of daily living interest intervention effect medical specialties meetings mild cognitive impairment mortality multidisciplinary normal aging novel older patient participant enrollment pilot trial post intervention primary outcome research study restoration skills standard of care theories treatment as usual virtual reality

项目摘要

PROJECT SUMMARY/ABSTRACT Heart failure (HF) and mild cognitive impairment (MCI) are prevalent among older adults in the U.S. Patients with HF are twice as likely to have MCI than people without HF. Cognitive impairment in HF is associated with significant decline in one’s ability to take care of one’s self and higher 12-month mortality. A small number of cognitive interventions have demonstrated preliminary efficacy in improving cognitive function in HF. However, this work suffers from some major limitations: 1) lack of focus on patients who already have cognitive impairments and at higher risk of dementia; 2) focus on single-component interventions; 3) lack of evaluation of responsiveness variables including genetic biomarkers; and 4) lack of long-term follow-up. Dr. Miyeon Jung, PhD, RN proposes to address this gap by conducting a randomized controlled pilot trial to estimate the preliminary efficacy of a virtual reality-based cognitive restoration (Vita) combined with a computerized cognitive training intervention (Com) relative to each intervention alone and standard of care among 172 older HF patients with MCI. The Specific aims of the project are to estimate the effects of the Vita and Com interventions individually and in combination to improve: 1) attention and memory (Aim 1); 2) HF self-care, instrumental activities of daily living, and health-related quality of life (Aim 2); and 3) dementia free survival (Aim 3) over 1 year. In addition, she will explore moderating factors that may influence intervention efficacy (i.e., baseline cognitive function, depressive symptoms, HF severity, and presence of apolipoprotein E ε4 and BDNF Met allele). Dr. Jung proposes career development/training activities to develop expertise in diagnosing MCI from normal cognition and dementia during this K76 award. Her multidisciplinary mentoring team consists of highly successful leaders in the fields of neurology and Alzheimer’s disease and related dementias (LG Apostolova, MD, MSc, primary mentor and dementia expert), cardiovascular nursing and HF (SJ Pressler, PhD, expert in cognition and health-related quality of life in HF; DK Moser, PhD, expert in HF self-care and aging), cardiology with HF specialty (I Gradus-Pizlo, MD), biostatistics with expertise in clinical trials (S Gao, PhD), and human-centered technology (RJ Holden, PhD). Dr. Jung will receive training via mentor-mentee interactions in group and individual settings, engaging in didactic coursework, workshops, and professional meetings, and conduct of the proposed research study. The planned training activities will support Dr. Jung to: 1) develop expertise in diagnosing cognitive impairment; 2) test preliminary efficacy of Vita+Com intervention among older adults with HF and MCI; 3) develop leadership skills to become a leader who runs multidisciplinary research teams and mentors future generations of researchers; and 4) become a successful R01-funded independent investigator. In summary, Dr. Jung will develop and test efficacious interventions to improve cognitive function among older adults with HF and MCI. Efficacious cognitive interventions will ultimately contribute to retaining the patients’ functional independence and promoting related quality of life.

项目概要/摘要心力衰竭 (HF) 和轻度认知障碍 (MCI) 在美国老年人中普遍存在。心力衰竭患者发生 MCI 的可能性是没有心力衰竭患者的两倍，心力衰竭与认知障碍相关。自我照顾能力显着下降，12 个月死亡率较高。认知干预已显示出改善心力衰竭认知功能的初步功效。这项工作存在一些主要局限性：1）缺乏对已经患有认知障碍的患者的关注患痴呆症的风险较高；2) 注重单一干预措施；3) 缺乏对反应性变量，包括遗传生物标志物；4) 缺乏长期随访。博士、注册护士建议通过进行随机对照试点试验来估计这一差距基于虚拟现实的认知恢复（Vita）结合计算机认知的初步效果培训干预 (Com) 相对于 172 名老年心力衰竭患者的单独干预和护理标准该项目的具体目标是评估 Vita 和 Com 干预措施的效果。单独和组合地改善： 1) 注意力和记忆力（目标 1）； HF 自我护理，工具性日常生活活动和健康相关的生活质量（目标 2）；以及 3）无痴呆生存率（目标 3）超过 1 此外，她还将探讨可能影响干预效果的调节因素（即基线）。认知功能、抑郁症状、心力衰竭严重程度以及载脂蛋白 E ε4 和 BDNF Met 等位基因的存在）。 Jung 博士提出职业发展/培训活动，以培养诊断 MCI 的专业知识她的多学科指导团队由以下人员组成：神经病学和阿尔茨海默氏病及相关痴呆症领域非常成功的领导者（LG Apostolova，医学博士，理学硕士，主要导师和痴呆症专家），心血管护理和心力衰竭（SJ Pressler，博士，心力衰竭认知和健康相关生活质量专家；DK Moser 博士，心力衰竭自我护理和衰老专家），具有心力衰竭专业的心脏病学（I Gradus-Pizlo，医学博士）、具有临床试验专业知识的生物统计学（S 高，博士），以及以人为本的技术（RJ Holden 博士）将通过导师与学员的互动接受培训。小组和个人环境，参与教学课程、研讨会和专业会议，以及进行拟议的研究。计划的培训活动将支持荣格博士：1）发展诊断认知障碍的专业知识；2）测试Vita+Com干预对老年人的初步效果患有 HF 和 MCI 的成年人；3) 培养领导技能，成为开展多学科研究的领导者团队并指导下一代研究人员；4) 成为 R01 资助的成功独立人士总之，荣格博士将开发和测试有效的干预措施以改善认知功能。在患有 HF 和 MCI 的老年人中，有效的认知干预最终将有助于保持患者的功能独立性并提高相关的生活质量。