Smartphone-Based Solutions for Prospective Memory in Mild Cognitive Impairment and Dementia

基于智能手机的轻度认知障碍和痴呆症未来记忆解决方案

• 批准号: 10712097
• 负责人: Jared F Benge
• 金额: $ 76.69万
• 依托单位: BAYLOR UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10712097
• 关键词: Address; Adherence; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Anterior; Appointment; Behavior Therapy; Calendar; Caring; Catchment Area; Cellular Phone; Clinic; Clinical; Cognitive; Communities; Compensation; Data; Dementia; Disadvantaged; Disparity population; Elderly; Enrollment; Ensure; Equity; Ethnic Population; Event; Family; Foundations; Friends; Future; Goals; Health Personnel; Hippocampus; Impaired cognition; Impairment; Individual; Inequity; Intervention; Intervention Studies; Interview; Lead; Medicine; Memory; Memory impairment; Outcome; Paper; Participant; Patient Selection; Patients; Performance; Persons; Pharmaceutical Preparations; Pilot Projects; Population; Positioning Attribute; Prefrontal Cortex; Procedures; Quality of life; Randomized; Randomized, Controlled Trials; Reminder Systems; Reporting; Research; Rural; Sample Size; Sampling; Self Efficacy; Site; Stress; Support System; System; Technology; Testing; Time; Training; Underrepresented Populations; Work; acceptability and feasibility; active control; aging and technology; care recipients; caregiving; cognitive change; cognitive training; daily functioning; digital; disadvantaged background; efficacy testing; family burden; follow-up; improved; informant; loved ones; low socioeconomic status; medication compliance; member; mild cognitive impairment; patient oriented; pilot trial; preservation; prospective memory; racial population; recruit; social; socioeconomics; success; Address; Adherence; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Anterior; Appointment; Behavior Therapy; Calendar; Caring; Catchment Area; Cellular Phone; Clinic; Clinical; Cognitive; Communities; Compensation; Data; Dementia; Disadvantaged; Disparity population; Elderly; Enrollment; Ensure; Equity; Ethnic Population; Event; Family; Foundations; Friends; Future; Goals; Health Personnel; Hippocampus; Impaired cognition; Impairment; Individual; Inequity; Intervention; Intervention Studies; Interview; Lead; Medicine; Memory; Memory impairment; Outcome; Paper; Participant; Patient Selection; Patients; Performance; Persons; Pharmaceutical Preparations; Pilot Projects; Population; Positioning Attribute; Prefrontal Cortex; Procedures; Quality of life; Randomized; Randomized, Controlled Trials; Reminder Systems; Reporting; Research; Rural; Sample Size; Sampling; Self Efficacy; Site; Stress; Support System; System; Technology; Testing; Time; Training; Underrepresented Populations; Work; acceptability and feasibility; active control; aging and technology; care recipients; caregiving; cognitive change; cognitive training; daily functioning; digital; disadvantaged background; efficacy testing; family burden; follow-up; improved; informant; loved ones; low socioeconomic status; medication compliance; member; mild cognitive impairment; patient oriented; pilot trial; preservation; prospective memory; racial population; recruit; social; socioeconomics; success

Abstract: Alzheimer’s disease and related dementias lead to marked declines in daily functioning, independence, and quality of life. One of the earliest cognitive changes in these conditions is impairment in prospective memory, or the ability to remember future intentions such as taking medications at a given time. Prior intervention studies that targeted prospective memory used mnemonic strategies or cognitive training, but these approaches resulted in modest gains in clinical populations. By contrast, our Stage I pilot trial indicated that smartphone-based memory aids (reminder apps) can be used by persons with mild cognitive impairment and mild dementia to improve both subjective and objective prospective memory performance. Having established feasibility and acceptability in the Stage I pilot study, we will now test for efficacy, durability, and generalizability of benefits across diverse samples in a Stage II randomized controlled trial. We will recruit 200 participants with mild cognitive impairment or mild dementia, half of whom will be from digitally-disadvantaged backgrounds (low socioeconomic status, rural, or historically underrepresented groups). These populations are well- captured by our clinical catchment areas. Participants will complete baseline assessments and then be randomly assigned to a smartphone reminder app intervention or an active control condition that uses a paper- based memory support system. Across a 4-week intervention period, participants will complete both patient- selected and experimenter-assigned prospective memory assessments and receive booster training sessions to promote self-efficacy with the intervention/control system. We will assess durability of effects at 3-month and 6-month follow-up sessions. It is unknown whether smartphone-based or paper-based approaches will be better at supporting prospective memory across 6 months in older adults with cognitive impairment and digital disadvantages. However, based on pilot data, we anticipate that the reminder app will be especially beneficial to prospective memory because it provides automated reminders, allows care partners to “push” reminders and events, and it includes daily alerts to use the app. As a secondary aim, we will simultaneously enroll family or friend study partners to collect informant ratings, track how much study partners assist the participants, and determine whether improving prospective memory in patients improves quality of life in study partners (e.g., by reducing the double to-do list burden of remembering for themselves and for care recipients). As a third aim, we will integrate quantitative and qualitative data to identify barriers and facilitators to smartphone interventions in digitally-disadvantaged individuals who have historically been underrepresented in technology and dementia research. This research will advance understanding of technology usage in older adults, inform whether smartphone-based reminder apps are effective and durable relative to established paper-based approaches for prospective memory, and provide the foundation for personalized cognitive medicine interventions.

抽象的： 阿尔茨海默氏病和相关痴呆症导致日常功能，独立性和 生活质量。这些条件下最早的认知变化之一是预期记忆中的损害， 或能够记住未来意图的能力，例如在给定时间服药。事先干预 针对前瞻性记忆的研究使用了助记符策略或认知培训，但是这些 方法导致临床人群的适度增长。相比之下，我们的阶段I试点试验表明 基于智能手机的记忆辅助工具（提醒应用程序）可以由轻度认知障碍的人使用 轻度痴呆以改善主观和客观的前瞻性记忆表现。建立了 在我试点研究的阶段的可行性和可接受性，我们现在将测试效率，耐用性和概括性 在II期随机对照试验中，潜水员样品的好处。我们将招募200名参与者 具有轻度的认知障碍或轻度痴呆，其中一半来自数字化的背景 （社会经济地位低，粗糙或历史上代表性不足的群体）。这些人口很好 由我们的临床集水区捕获。参与者将完成基线评估，然后 随机分配到智能手机提醒应用程序干预或使用纸张的主动控制条件 - 基于内存支持系统。在一个为期4周的干预期内，参与者将完成两个患者 - 选定和专家分配的预期记忆评估并接受助推器培训课程 通过干预/控制系统促进自我效果。我们将在3个月和 6个月的后续课程。尚不清楚基于智能手机的方法还是基于纸质手机的方法 在患有认知障碍和数字的老年人中，可以更好地支持6个月的前瞻性记忆 缺点。但是，根据试点数据，我们预计提醒应用程序将特别有益 出现潜在的记忆，因为它提供了自动提醒，允许护理合作伙伴“推动”提醒 和事件，其中包括每天使用该应用程序的警报。作为次要目标，我们将简单地注册家庭 或朋友学习合作伙伴以收集线人评级，跟踪学习伙伴的帮助，以及 确定改善患者的前瞻性记忆是否改善研究伙伴的生活质量（例如， 减少自己和护理接收者的记忆的双重待办事项清单）。作为第三个目标， 我们将整合定量和定性数据，以确定智能手机干预措施的障碍和促进因子 在数字化的弱势群体中，历史上的技术和痴呆症的人数不足 研究。这项研究将提高对老年人技术使用的了解，告知是否是否 相对于既定的基于纸张的方法 预期的记忆，并为个性化的认知医学干预奠定了基础。