PROMIS Profile Measures in Older Adults - Identifying Cognitive Thresholds for Reliable and Valid Responses

老年人的 PROMIS 概况测量 - 确定可靠和有效反应的认知阈值

基本信息

批准号：
10757177
负责人：
ANN L GRUBER-BALDINI
金额：
$ 38.62万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10757177
关键词：
Administrative Supplement African American African American population Age Aged, 80 and over Alzheimer&apos s disease related dementia Awareness Baltimore COVID-19 pandemic Chronic Clinic Clinical Cognition Cognitive Cognitive deficits Data Data Reporting Elderly Enrollment Ensure Funding Goals Grant Health Health Status Impaired cognition Individual Information Systems Investigation Maryland Measurement Measures Medical Modeling Outcome Outcome Measure Outpatients Parents Participant Patient Outcomes Assessments Patient Self-Report Patients Persons Population Psychometrics Research Research Personnel Resources Sampling Site Study Subject Subgroup Symptoms Telemedicine Testing Time Translations Travel United States National Institutes of Health Universities Validation Validity and Reliability Visit age group aged case-by-case basis clinical practice cognitive function cognitive interview cognitive testing computerized coronavirus disease cost disability improved outcome mental state metacognition mild cognitive impairment older patient operation pandemic disease patient response psychological distress racial diversity reading comprehension recruit remote assessment research study response screening success tool

项目摘要

Summary The National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS®) measures were developed to provide highly precise and valid measures of patient-reported outcomes, establish a common metric across chronic health conditions, and enable computerized adaptive testing. The PROMIS measures have not been widely tested in the older adult population, especially those aged 80 and older nor among those with Mild Cognitive Impairment (MCI), and Alzheimer’s and Related Dementias (ADRD). The reliability and validity of responses provided by those with MCI and ADRD on PROMIS measures is unknown, as is the threshold on cognitive screening tests where self-reported outcomes data is no longer representative of underlying health status. The Specific Aim of the overall study is to validate the PROMIS Profile measures in older adults and to identify the threshold where cognitive impairment invalidates these measures. We will test the utility of the PROMIS Profile measures (29-, 43-, and 57-item versions) among older adults with varying levels of cognitive impairment to find thresholds (cut-points) where patient-reported data can no longer be reliably or validly attained. Cognitive levels will be assessed with the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). A total of 438 subjects will be enrolled from outpatient practices ensuring equal numbers of subjects, ages 65-79 and 80+ years, as well as a spectrum of cognitive function from normal cognition to MCI to ADRD. Qualitative cognitive interviews in 38 older adults examined patient understanding of individual items and capacity to provide valid information. Quantitative investigation of thresholds of cognition will be assessed using the PROMIS profile measures in an additional sample of 400 older adults to identify the cognitive threshold where responses become inconsistent, unreliable, and invalid. The first administrative supplement expanded the brief cognitive assessments (MMSE, MoCA) with a) the more sensitive NIH Toolbox Cognition Battery, b) a reading comprehension measure, and c) the PROMIS Applied Cognition Abilities and Concerns measure to assess metacognition (awareness of cognitive deficits). This second administrative supplement will provide additional resources to collect more data on people over age 80 and those with greater cognitive impairment. These groups were very challenging to enroll during the COVID-19 pandemic due to greater difficulty with telemedicine during the shutdown, and greater barriers in travelling to the office when in-person visits restarted. It will also enable expansion of our recruitment to additional clinic settings to recruit more African Americans, and those with cognitive impairment related to more diverse medical conditions. This study will result in practical data for immediate translation to clinical practice and for further research on the capacity of older adults with varying levels of cognitive impairment to provide accurate responses on measures of disability and psychological distress.

概括美国国立卫生研究院 (NIH) 患者报告结果测量信息系统 (PROMIS®) 测量的开发是为了提供高度精确和有效的患者报告测量结果，建立针对慢性健康状况的通用指标，并实现计算机化自适应 PROMIS 措施尚未在老年人群中进行广泛测试，尤其是老年人群。 80 岁及以上或患有轻度认知障碍 (MCI)、阿尔茨海默病及相关疾病的人痴呆症 (ADRD)。MCI 和 ADRD 患者提供的回答的可靠性和有效性。 PROMIS 措施尚不清楚，认知筛查测试的阈值也是未知的，其中自我报告的结果数据不再代表潜在的健康状况。整个研究的具体目的是验证。 PROMIS Profile 测量老年人并确定认知障碍的阈值我们将测试 PROMIS 配置文件措施（29、43 和 57 项）的实用性。版本）在具有不同程度认知障碍的老年人中找到阈值（切点）患者报告的数据将无法再可靠或有效地获得认知水平将被评估。蒙特利尔认知评估（MoCA）和简易精神状态检查（MMSE）总计 438。受试者将从门诊诊所招募，确保年龄 65-79 岁和 80 岁以上的受试者数量相同年，以及从正常认知到 MCI 到 ADRD 的一系列认知功能。对 38 名老年人的访谈考察了患者对个别项目的理解以及提供有效信息的能力认知阈值的定量调查将使用 PROMIS 配置文件进行评估。对另外 400 名老年人样本进行测量，以确定响应的认知阈值第一个行政补充扩大了简短的认知。使用 a) 更灵敏的 NIH Toolbox Cognition Battery，b) 读数进行评估（MMSE、MoCA）理解测量，以及 c) PROMIS 应用认知能力和关注点测量来评估元认知（认知缺陷的意识）。额外资源来收集有关 80 岁以上人群和认知障碍较严重人群的更多数据。在 COVID-19 大流行期间，这些群体的注册非常具有挑战性，因为在关闭期间的远程医疗，以及亲自拜访时前往办公室的更大障碍它还将使我们能够将招募范围扩大到更多的诊所，以招募更多的非洲人。美国人以及那些患有与更多样化的医疗状况相关的认知障碍的人。产生实用数据，可立即转化为临床实践并进一步研究具有不同程度认知障碍的老年人对残疾测量提供准确的反应和心理困扰。