Preventing cognitive decline in older African Americans with mild cognitive impairment: design and methods of a randomized clinical trial.
Preventing cognitive decline in older African Americans with mild cognitive impairment: design and methods of a randomized clinical trial.
复制标题
预防患有轻度认知障碍的老年非裔美国人的认知能力下降：随机临床试验的设计和方法。
DOI：
10.1016/j.cct.2012.02.016
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发表时间：
2012
影响因子：
2.2
通讯作者：
Leiby,BenjaminE
中科院分区：
文献类型：
--
作者：
Rovner,BarryW;Casten,RobinJ;Hegel,MarkT;Leiby,BenjaminE
轻度认知障碍（MCI）影响25%的老年非裔美国人，并预测阿尔茨海默病的进展。大量的流行病学文献表明，认知、身体和/或社会活动可以预防认知能力下降。我们描述了一项随机临床试验的方法，以测试行为激活的有效性，以防止认知能力下降的老年非洲裔美国人与遗忘多域亚型MCI。社区卫生工作者在2- 3个月内提供6次初始家庭治疗，然后在24个月的临床试验期间使用与老年非裔美国人文化相关的语言，材料和概念进行6次后续家庭加强治疗。我们从教堂、老年中心和医疗诊所招募了200名受试者，随机分配到行为激活或支持疗法组，控制注意力。主要结局是在基线和第3、12、18和24个月时通过霍普金斯言语学习测试修订版测量的情景记忆。次要结果是一般和特定领域的神经心理功能，日常生活活动，抑郁和生活质量。最近MCI和阿尔茨海默病药物治疗的临床试验的负面结果表明，行为干预可能提供一种替代的治疗方法，以保持在老龄化社会的认知。
Mild Cognitive Impairment (MCI) affects 25% of older African Americans and predicts progression to Alzheimer's disease. An extensive epidemiologic literature suggests that cognitive, physical, and/or social activities may prevent cognitive decline. We describe the methods of a randomized clinical trial to test the efficacy of Behavior Activation to prevent cognitive decline in older African Americans with the amnestic multiple domain subtype of MCI. Community Health Workers deliver 6 initial in-home treatment sessions over 2–3months and then 6 subsequent in-home booster sessions using language, materials, and concepts that are culturally relevant to older African Americans during this 24month clinical trial. We are randomizing 200 subjects who are recruited from churches, senior centers, and medical clinics to Behavior Activation or Supportive Therapy, which controls for attention. The primary outcome is episodic memory as measured by the Hopkins Verbal Learning Test—Revised at baseline and at months 3, 12, 18, and 24. The secondary outcomes are general and domain-specific neuropsychological function, activities of daily living, depression, and quality-of-life. The negative results of recent clinical trials of drug treatments for MCI and Alzheimer's disease suggest that behavioral interventions may provide an alternative treatment approach to preserve cognition in an aging society.