Compensation Training and Lifestyle Modifications to promote healthy aging in persons at risk for Alzheimer's disease: a digital application supported intervention

补偿培训和生活方式改变以促进阿尔茨海默病风险人群的健康老龄化：数字应用支持的干预措施

• 批准号: 10324579
• 负责人: MAUREEN SCHMITTER-EDGECOMBE
• 金额: $ 74.44万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-15 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10324579
• 关键词: Activities of Daily Living; Adherence; Adoption; Age; Alzheimer' s Disease; Alzheimer' s disease risk; Behavior; Behavior Therapy; Behavior monitoring; Behavioral; Brain; Calendar; Caregiver Burden; Characteristics; Cognition; Cognitive; Collection; Competence; Control Groups; Data; Data Collection; Development; Disease; Education; Educational Intervention; Educational Materials; Elderly; Encapsulated; Ethnic Origin; Exercise; Exhibits; Feedback; Financial compensation; Future; Goals; Health; Health Care Costs; Health Status; Health behavior; Impaired cognition; Individual; Interdisciplinary Study; Intervention; Interview; Knowledge; Lead; Life Style; Life Style Modification; Machine Learning; Maintenance; Measures; Medical; Memory; Methods; Mission; Monitor; Motivation; Neuronal Plasticity; Neuropsychology; Outcome; Participant; Pattern; Personal Satisfaction; Persons; Physical Function; Physical activity; Pilot Projects; Population Heterogeneity; Prevalence; Public Health; Quality of life; Race; Randomized; Randomized Controlled Trials; Research; Research Design; Self Determination; Socioeconomic Status; Structure; Symptoms; System; Tablets; Technology; Testing; Time; Training; Translations; Treatment Effectiveness; Treatment Efficacy; Treatment outcome; United States National Institutes of Health; Work; aging population; base; brain health; cost; daily functioning; dementia risk; design; digital; disability; efficacy evaluation; evidence base; executive function; follow-up; functional disability; functional independence; health care delivery; health literacy; healthy aging; healthy lifestyle; improved; innovation; insight; instrumental activity of daily living; lifestyle intervention; machine learning algorithm; mild cognitive impairment; modifiable risk; novel; outcome prediction; post intervention; prevent; preventive intervention; primary outcome; racial and ethnic; resilience; secondary outcome; sex; stress management; success; support tools; technology development; theories; therapy development; tool; treatment adherence; treatment responders; uptake; user-friendly

The prevalence of Alzheimer's Disease and other disorders (ADRDs) is now a public health crisis. In the absence of effective medical treatment, there is a critical need for behavioral interventions to prevent or delay symptom onset. Multidomain interventions simultaneously targeting multiple modifiable risks for ADRD have shown promise, but additional innovative approaches that could be highly accessible by capitalizing on user- friendly digital applications to support and strengthen behavior modification are needed. Training in the use of compensatory aids (e.g., calendars and note taking systems) can improve daily independence. These same compensatory tools can be employed to facilitate the adoption of lifestyle changes that support brain health (e.g., exercise, cognitive engagement, stress management) through management of goal-setting, behavioral monitoring, tracking and feedback. The current project will test a 6-month intervention that provides training in both compensatory aids and lifestyle modification. A comprehensive suite of digital tools encapsulated in the Digital Memory Notebook (DMN), an easy to use, interactive application, will be used to facilitate behavioral change and enhance participant motivation. Further, the DMN allows collection of real-time data to track intervention adherence. The DMN has been successfully applied to improving compensation among individuals with mild cognitive impairment. The proposed work capitalizes on a critical window for building resilience by targeting individuals at risk for ADRD due to a subjective cognitive concern (SCC) but who remain cognitively normal. We will conduct a randomized controlled trial (RCT) among ethnoracially diverse older adults with SCC to compare our digital app supported compensation training and lifestyle modification intervention to an education only control group that will not use the DMN or be provided with guidance on how to implement the educational material into their daily lives. Specific aims of the project include: 1) evaluate intervention efficacy on primary outcomes (global cognition and everyday function); secondary outcomes focus on well-being, cognitive domains (memory and executive function), activities of daily living (IADLs), physical function, compensation, and health behaviors; 2) evaluate characteristics of treatment responders; 3) evaluate adherence and identify the effective components of the target intervention using a mixed-method approach; and 4) design machine learning algorithms that use patterns of change in real-time DMN data metrics to identify incipient declines in treatment adherence and changes in health status. The intervention under study is novel because it applies training in compensation to support lifestyle modifications and everyday functioning using a digital app that also monitors adherence to each component of the intervention in real-time. The project is expected to expand understanding of factors that may impact adherence to and outcomes of a preventative intervention leading to optimization of a scalable intervention to reduce dementia risk applicable to diverse populations.

阿尔茨海默氏病和其他疾病（ADRDS）的患病率现在是一种公共卫生危机。在 缺乏有效的医学治疗，至关重要的行为干预措施以预防或延迟 症状发作。多域干预措施同时针对ADRD的多个可修改风险 显示出承诺，但是通过资本化用户可以高度访问的其他创新方法 - 需要友好的数字应用以支持和加强行为修改。培训使用 补偿性辅助工具（例如，日历和记录系统）可以改善每日独立性。这些一样 可以使用补偿工具来促进采用生活方式的改变，以支持大脑健康 （例如，锻炼，认知参与，压力管理）通过管理目标，行为 监视，跟踪和反馈。当前项目将测试6个月的干预措施，提供培训 在补偿性辅助工具和生活方式修改中。封装在 数字存储笔记本（DMN），一种易于使用的交互式应用程序，将用于促进行为 改变并增强参与者的动力。此外，DMN允许收集实时数据 干预依从性。 DMN已成功应用于改善薪酬 患有轻度认知障碍的人。拟议的工作在建造关键窗口上大写 由于主观认知问题（SCC）而导致有ADRD风险的个人，但仍在 认知正常。我们将在民族多样化的老年人中进行随机对照试验（RCT） 具有SCC的成年人比较我们的数字应用程序支持的薪酬培训和生活方式修改 干预仅教育对照组，该组将不使用DMN或提供有关指导的指导 如何将教育材料实施到他们的日常生活中。该项目的具体目的包括：1） 评估对主要结果（全球认知和日常功能）的干预功效；次要 结果专注于幸福感，认知领域（记忆和执行功能），日常生活的活动 （IADL），身体机能，补偿和健康行为； 2）评估治疗的特征 响应者； 3）评估使用A的依从性并确定目标干预的有效组成部分 混合方法方法； 4）设计机器学习算法的实时使用变化模式 DMN数据指标以确定治疗依从性和健康状况变化的初期下降。这 研究中的干预措施是新颖的，因为它对赔偿进行培训以支持生活方式修改 以及使用数字应用程序的日常运作，该应用也可以监视遵守对 实时干预。预计该项目将扩大对可能影响的因素的理解 遵守预防性干预的结果，导致优化可扩展干预措施 降低适用于不同人群的痴呆症风险。