A Pilot of Memory Support System for Older Chinese Americans with Mild Cognitive Impairment

针对患有轻度认知障碍的老年华裔美国人的记忆支持系统试点

• 批准号: 10728571
• 负责人: Clara Li
• 金额: $ 56.11万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10728571
• 关键词: Adherence; Adult; Age; Alzheimer disease prevention; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Anxiety; Asian Americans; Assessment tool; Calendar; Caregiver Burden; Caregivers; Chinese; Chinese American; Chronic; Clinical; Clinical Research; Clinical Trials; Cognition; Cognitive; Collaborations; Communities; Control Groups; Data; Dementia; Development; Early Intervention; Early treatment; Education; Effectiveness; Elderly; English Language; Enrollment; Ethnic Population; Exclusion; Feedback; Focus Groups; Goals; Impaired cognition; Independent Living; Individual; Intervention; Language; Learning; Life; Limited English Proficiency; Linguistics; Measures; Memory; Mental Depression; Moods; Neurobehavioral Manifestations; Not Hispanic or Latino; Older Population; Participant; Persons; Pharmacological Treatment; Population; Prevention; Prevention trial; Quality of life; Race; Randomized, Controlled Trials; Registries; Reporting; Research; Research Methodology; Risk; Sample Size; Sampling; Self Efficacy; Serious Adverse Event; Site; Support System; Symptoms; System; Testing; Thinking; Training; Translating; Translations; Writing; associated symptom; bilingualism; clinical translation; cognitive testing; cohort; community based participatory research; daily functioning; design; efficacy evaluation; ethnic diversity; evidence base; experience; follow-up; functional decline; functional disability; improved; instrumental activity of daily living; mild cognitive impairment; neuropsychiatric symptom; non-demented; preservation; primary outcome; programs; randomized trial; recruit; retention rate; satisfaction; success; symptom treatment; treatment adherence

Project Summary The older Chinese American population has been rising for the last few decades, with the risk of Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias (AD/ADRD) also increasing. Despite the pressing need to increase racial/ethnic diversity in clinical trial participation in the US, older Chinese Americans remain historically underrepresented and understudied in AD/ADRD research due to a lack of culturally and linguistically appropriate study materials and assessment tools. Using Chinese language translations of clinical measures and cognitive tests, the study PI (Li) successfully enrolled over 200 older Chinese Americans in clinical research at the Alzheimer’s Disease Research Center (ADRC) at Mount Sinai. The sample, with over 80% non-demented older adults, provides a window of opportunity for early intervention and treatment of AD/ADRD. Since a majority of older Chinese Americans are foreign born with limited to no English proficiency, they are frequently excluded from clinical trial participation as English language proficiency is one of the inclusionary criteria. The Memory Support System (MSS) from the Healthy Action to Benefit Independence & Thinking® (HABIT) Program is a promising non-pharmacological intervention for Mild Cognitive Impairment (MCI). Prior data suggest the effectiveness of MSS on self-efficacy for memory, adapted functioning, quality of life, depression, and anxiety in the participants and their study partners, with an excellent retention rate. However, the MSS was primarily developed and used on non-Hispanic White, English-speaking adults. Additionally, little is known regarding the effectiveness of MSS on cognitive and neuropsychiatric symptoms associated with early AD/ADRD. Here, the study team proposes a 2-year study to translate and adapt the MSS materials and assessment tools from English into Mandarin and Cantonese - the most common spoken languages in the US after English and Spanish. This study will leverage Dr. Li’s expertise in research recruitment and enrollment of Chinese American older adults to answer the following questions: 1) Does Chinese language translation and cultural adaptation of MSS effectively engage and recruit Chinese Americans in clinical trials for AD/ADRD? (2) Can Chinese Americans with MCI and their study partners learn and use the MSS? (3) Is the MSS effective in mitigating early symptoms of AD/ADRD in older Chinese Americans? The team will collaborate with key community stakeholders to ensure that the materials and tests are culturally and linguistically appropriate for this population. Capitalizing on the older Chinese American cohort at the ADRC at Mount Sinai, the overarching goal is to extend the MSS to older Chinese Americans with MCI by developing a linguistically and culturally appropriate adaption. Using 30 Mandarin- and 30 Cantonese-speaking older adults with MCI and their study partners, the primary outcomes are recruitment, retention, and completion rates to assess feasibility. The team will also examine the efficacy and utility of MSS in this sample. Findings from this study will provide pilot data to support a large-scale clinical trial with longer follow-up periods.

项目概要 过去几十年来，美国华裔老年人口不断增加，患阿尔茨海默氏症的风险增加 尽管迫切需要治疗，但疾病和阿尔茨海默病相关痴呆症 (AD/ADRD) 也在增加。 增加美国临床试验参与的种族/族裔多样性，年长的华裔美国人仍然历来如此 由于缺乏文化和语言方面的研究，AD/ADRD 研究中代表性不足且研究不足 适当的研究材料和评估工具使用临床测量的中文翻译。 和认知测试，该研究 PI（李）成功招募了 200 多名美国老年华裔参与临床研究 西奈山阿尔茨海默病研究中心 (ADRC) 的样本中，超过 80% 的人没有痴呆。 老年人，为大多数 AD/ADRD 的早期干预和治疗提供了机会。 的老年华裔美国人是在外国出生的，英语水平有限甚至没有，他们经常被排除在外 参与临床试验，因为英语语言能力是纳入标准之一。 Healthy Action to Benefit Independence & Thinking® (HABIT) 计划的支持系统 (MSS) 是一个 先前的数据表明，非药物干预对轻度认知障碍 (MCI) 有前景。 MSS 对记忆、适应功能、生活质量、抑郁和焦虑的自我效能的有效性 参与者及其研究伙伴，具有出色的保留率。然而，MSS 主要是。 此外，人们对非西班牙裔白人、讲英语的成年人知之甚少。 MSS 对与早期 AD/ADRD 相关的认知和神经精神症状的有效性。 研究小组提出一项为期 2 年的研究，翻译和改编英语的 MSS 材料和评估工具 普通话和粤语是继英语和西班牙语之后美国最常用的语言。 该研究将利用李博士在研究招募和招募华裔美国老年人方面的专业知识 回答以下问题： 1）MSS的中文翻译和文化适应是否有效 吸引和招募华裔美国人参与 AD/ADRD 临床试验吗？ (2) 患有 MCI 和 ADRD 的华裔美国人可以吗？ (3) MSS 是否能有效缓解 AD/ADRD 的早期症状 该团队将与主要社区利益相关者合作，以确保 材料和测试在文化和语言上适合该人群。 西奈山 ADRC 的华裔美国人群体，首要目标是将 MSS 扩展到老年人 患有 MCI 的华裔美国人通过制定语言和文化上适当的适应措施使用 30。 普通话和 30 名患有 MCI 的说粤语的老年人及其研究伙伴，主要结果是 该团队还将检查有效性和完成率。 MSS 在该样本中的效用 本研究的结果将为支持大规模临床试验提供试点数据。 具有更长的随访期。