Dual-Task Training Exercise to Reduce Falls in Older Adults with Mild Cognitive Impairment

双任务训练可减少患有轻度认知障碍的老年人跌倒的情况

• 批准号: 10578178
• 负责人: FUZHONG LI
• 金额: $ 79.28万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10578178
• 关键词: Activities of Daily Living; Address; Age-associated memory impairment; Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Attention; Balance training; Clinical; Clinical Practice Guideline; Clinical Trials; Cognitive; Communities; Country; Coupled; Data; Educational Intervention; Elderly; Equilibrium; Exercise; Exercise Therapy; Exhibits; Fall prevention; Gait; Goals; Health; Healthcare; Impaired cognition; Impairment; Incidence; Intervention; Knowledge; Mediating; Methodology; Modeling; Motor; Movement; Musculoskeletal Equilibrium; Outcome; Participant; Performance; Persons; Physical Exercise; Physical Performance; Population; Populations at Risk; Prevention Guidelines; Public Health; Randomized, Controlled Trials; Recommendation; Research; Risk; Risk Factors; Single-Blind Study; Stretching; Tai Ji; Testing; Therapeutic; Therapeutic Intervention; Time; Training; Treatment Efficacy; United States; Walking; Work; aging population; arm; care burden; clinical practice; cognitive ability; cognitive enhancement; cognitive function; cognitive performance; cognitive task; community setting; comparative efficacy; design; eHealth; efficacy evaluation; equilibration disorder; evidence based guidelines; executive function; exercise intervention; experience; fall injury; fall risk; falls; follow-up; improved; innovation; insight; instructor; intervention delivery; mild cognitive impairment; mind/body; multitask; novel; patient engagement; post intervention; preventive intervention; primary outcome; programs; response; secondary outcome; targeted treatment; virtual

PROJECT SUMMARY/ABSTRACT Non-pharmacological interventions, such as physical exercise or movement therapies, to prevent falls in older adults with mild cognitive impairment (MCI) have not been effective. Our long-term goal is to establish a safe and efficacious mind-body exercise intervention that can be made widely available in community settings and for clinical practice to prevent falls in a rapidly growing, at-risk population of community-dwelling older adults with MCI. The objective of this proposal is to evaluate a novel intervention—dual-task Tai Ji Quan: Moving for Better Balance (Dual-TJQMBB)—that is specifically tailored for older adults with MCI to prevent falls. The rationale underlying this proposal is that by integrating cognitive exercises with physical (tai ji quan) movements we address the impaired balance and concomitant attention (dual-tasking) deficits associated with the increased risk of falling in this population. The central hypothesis is that our therapeutically tailored and dual-task augmented tai ji quan training approach will be more efficacious than traditional tai ji quan training in preventing falls. The central hypothesis, with its premise established from our prior work and promising pilot data, will be tested by pursuing our Primary Aim in which we will determine the efficacy of a 6-month Dual- TJQMBB intervention in reducing the incidence of falls among older adults with MCI. We will address our Primary Aim using an innovative e-health (online) intervention delivery approach with a 3-arm, single-blind, randomized controlled trial involving a test of the comparative efficacy of the two tai ji quan fall prevention interventions (Dual-TJQMBB, standard TJQMBB) relative to a stretching control. We hypothesize that, by month 6, participants assigned to the Dual-TJQMBB intervention will show a significant reduction in the incidence of falls (primary outcome) and improvement in dual-task walking and physical and cognitive performances (secondary outcomes) compared to those assigned to the stretching control. The project has two secondary aims: (1) to determine how well the benefits of our Dual-TJQMBB intervention persist over a 6- month post-intervention follow-up, and (2) to examine whether the impact of Dual-TJQMBB training on reducing the incidence of falls is mediated by change in dual-task walking performance. Our proposed research is significant because it will fill a vital gap in clinical practice by providing efficacy evidence about a tailored fall prevention intervention that combines tai ji quan with cognitive task training, for the first time, for older adults with MCI who are at risk of falling and continuing cognitive decline. If the evidence supports the Dual-TJQMBB hypothesis, the proposed study can (a) make a rapid impact on clinical practice guidelines in the field of fall prevention and (b) have a widespread positive impact very quickly because it can be coupled with the standard TJQMBB program, which has been broadly disseminated across the country.

项目摘要/摘要 非药理学干预措施，例如体育锻炼或运动疗法，以防止年龄较大 轻度认知障碍（MCI）的成年人尚未有效。我们的长期目标是建立一个安全 有效的心身运动干预措施，可以在社区环境中广泛使用， 为了临床实践，以防止在迅速增长的社区老年人中迅速增长的人口 与MCI。该提案的目的是评估一种新颖的干预措施 - 戴上的tai ji quan：移动 更好的平衡（双TJQMBB） - 专门针对MCI的老年人量身定制，以防止下降。这 该提议的基本原理是，通过将认知练习与身体（太极拳）相结合 我们解决了损害的平衡和伴随的关注（双任务）定义与 该人群下降的风险增加。中心假设是我们的治疗量身定制和 双重任务增强的太极拳训练方法将比传统的太极拳训练更有效 防止跌倒。中央假设的前提是我们先前的工作和承诺飞行员的前提 数据将通过追求我们的主要目标来测试，我们将确定6个月双 - TJQMBB干预减少了MCI老年人跌倒的事件。我们将解决我们的 使用创新的电子卫生（在线）干预交付方法的主要目标，使用3臂，单盲 随机对照试验，涉及两种太极拳预防的比较效率测试 干预措施（双TJQMBB，标准TJQMBB）相对于拉伸控制。我们假设这是 第6个月，分配给双TJQMBB干预的参与者将显着减少 跌倒（主要结果）的发生率和双重任务步行以及身体和认知的改善 与分配给拉伸控制的表演（次要结果）相比。该项目有两个 次要目的：（1）确定我们的双TJQMBB干预效果的效果如何持续到6-- 干预后的一个月随访，以及（2）检查双TJQMB培训对 减少瀑布的事件是由双重任务步行性能的变化介导的。我们提出的 研究之所以重要，是因为它将通过提供有关临床实践的重要空白。 量身定制的秋季预防干预措施将太极拳与认知任务培训相结合，首次 患有MCI的老年人有跌倒并持续认知下降的风险。如果证据支持 拟议的研究可以（a）对临床实践指南产生快速影响 预防秋季和（b）的领域很快就具有宽度的积极影响，因为它可以耦合 随着标准TJQMBB计划，该计划已在全国范围内广泛传播。