ARMCADA - Advancing Reliable Measurement in Cognitive Aging and Decision-making Ability

ARMCADA - 推进认知老化和决策能力的可靠测量

• 批准号: 10663728
• 负责人: RICHARD GERSHON
• 金额: $ 128万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10663728
• 关键词: Age; Age-associated memory impairment; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Area; Behavioral; Caregivers; Cellular Phone; Cognitive; Cognitive aging; Competence; Consent; Contracts; Decision Making; Detection; Development; Dimensions; Early identification; Education; Elder Abuse; Elderly; Family; Funding; Goals; Impaired cognition; Impairment; Independent Living; Infrastructure; Institution; Intervention; Legal; Measurement; Measures; Medical; Minority; Modeling; Neurobehavioral Manifestations; Neurodegenerative Disorders; Neurologic; Neurosciences; Outcome Measure; Participant; Patients; Performance; Pilot Projects; Procedures; Public Domains; Quality of life; Reporting; Research; Research Personnel; Review Literature; Sampling; Science; Series; Standardization; Surveys; Systems Development; Taxonomy; Time; United States National Institutes of Health; United States Preventative Services Task Force; Universities; Validation; aging population; cognitive ability; decision-making capacity; design; early screening; efficacy evaluation; electronic health record system; experience; financial decision making; functional outcomes; health disparity; healthy aging; psychosocial; screening; skills; theories

With age comes increasing emphasis on making highly consequential, long term and varied decisions, ranging from medical to financial to legal, and beyond. These decisions underlie the basic competencies for independent living. Cognitive impairment often hinders basic decision-making capacities, significantly impacting quality of life. Deficits in decision-making capacity sadly often lead to harmful consequences including financial loss, incapacity to consent to medical procedures, and even vulnerability for elder abuse. There is growing evidence that early screening of decision-making capacity can be an important indicator of early age-related cognitive impairment related to Alzheimer’s disease and Alzheimer’s disease-related dementias (AD/ADRD). Yet, despite a 2020 United States Preventive Services Task Force report pointing to the importance of early assessment and detection of such functional outcomes for older adults, caregivers, and families, cognitive impairment screening typically does not include systematic and comprehensive assessment of decision-making capacity. We will establish the Advancing Reliable Measurement in Cognitive Aging and Decision-making Ability (ARMCADA) research network and integrate efforts to adapt, develop, validate and norm measures to assess decision-making functionality in an aging population. Our Northwestern University team has extensive experience in developing national research networks for the purpose of assessment system development, validation and distribution, including the original NIH Neuroscience Blueprint contract to create the NIH Toolbox for Assessment of Neurological and Behavioral Function® (NIHTB). We will leverage this expertise to complete three specific aims: The proposed project will 1) Create the ARMCADA research network with the goal of advancing a theoretical taxonomy of decision-making skills for successful aging; 2) Identify, synthesize, create, and validate new measures of decision-making in an aging sample representative of the entire range of decision-making capacity levels and older adults from minority backgrounds; 3) Facilitate scalable nationwide public dissemination of these measures, including integration into Electronic Health Record systems, to benefit the early identification of older adults with cognitive impairment and evaluate the efficacy of potential interventions aimed to mitigate cognitive decline commonly associated with AD/ADRD.

随着年龄的增长，人们越来越重视做出高度重要、长期和多样化的决定，从医疗到财务到法律等，这些决定是独立生活的基本能力的基础。认知障碍往往会阻碍基本的决策能力，从而严重影响质量。不幸的是，决策能力的缺陷往往会导致有害的后果，包括经济损失、无法同意医疗程序，甚至容易遭受虐待。越来越多的证据表明，早期筛查决策能力可能是一个重要指标。早期的与阿尔茨海默病和阿尔茨海默病相关的痴呆 (AD/ADRD) 相关的年龄相关认知障碍 然而，尽管 2020 年美国预防服务工作组报告指出了早期评估和检测老年人的此类功能结果的重要性，对于照顾者和家庭来说，认知障碍筛查通常不包括对决策能力的系统和全面的评估。 我们将建立推进认知老化和决策能力的可靠测量（ARMCADA）研究网络，并整合努力来适应、开发、验证和规范评估人口老龄化决策功能的措施。我们的西北大学团队拥有丰富的经验。旨在开发、验证和分发评估系统的国家研究网络，包括创建 NIH 神经和行为功能评估工具箱 (NIHTB) 的原始 NIH 神经科学蓝图合同，我们将利用这些专业知识来完成三个具体目标： 拟议项目将 1) 创建 ARMCADA 研究网络，目标是推进成功老龄化决策技能的理论分类；2) 识别、综合、创建和验证代表老龄化样本的新决策指标； 3) 促进在全国范围内广泛传播这些措施，包括纳入电子健康记录系统，以利于早期识别患有认知障碍的老年人并评估其效果；潜力的旨在减轻通常与 AD/ADRD 相关的认知能力下降的活动。