权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Prospective memory impairment in Parkinson disease-related cognitive decline: Intervention and mechanisms

帕金森病相关认知能力下降的前瞻性记忆障碍：干预措施和机制

基本信息

批准号：
10404667
负责人：
ERIN R FOSTER
金额：
$ 45.69万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-15 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10404667
关键词：
Address Alzheimer&apos s disease related dementia Attention Attenuated Behavior Therapy Behavioral Behavioral Mechanisms Biological Brain Brain Injuries Clinical Cognition Cognitive Cognitive deficits Data Dementia Dopamine Educational Intervention Educational process of instructing Employment Evaluation Expectancy Fostering Functional disorder Future Goals Health Care Costs Health behavior Impaired cognition Impairment Independent Living Intention Intervention Intervention Studies Laboratories Lateral Life Longitudinal cohort Magnetic Resonance Imaging Medical Memory Memory impairment Mental Depression Monitor Motivation Motor Neurologic Operative Surgical Procedures Parents Parkinson Disease Parkinson&apos s Dementia Participant Pattern Performance Persons Pharmaceutical Preparations Pharmacological Treatment Population Populations at Risk Prediction of Response to Therapy Process Psychological Transfer Quality of life Randomized Randomized Controlled Trials Regression Analysis Reporting Research Research Personnel Research Priority Rest Retrieval Risk Single-Blind Study Standardization Stroke Testing Training Training Programs Work behavior test cognitive function cognitive impairment in Parkinson&apos s cognitive process cognitive rehabilitation cognitive task computerized daily functioning data infrastructure design disability efficacy testing executive function functional decline functional disability functional outcomes improved informant mild cognitive impairment mortality multilevel analysis neural correlate neurobiological mechanism neuroimaging neuromechanism novel predicting response primary endpoint programmed cell death protein 1 prospective memory relating to nervous system repetitive task practice response secondary endpoint social relationships treatment response trial comparing

项目摘要

Erin R. Foster R01 AG065214-01A1 Prospective memory impairment in Parkinson disease-related cognitive decline: Intervention and mechanisms PROJECT SUMMARY/ABSTRACT Parkinson disease dementia (PDD) – one of the Alzheimer’s Disease Related Dementias (ADRD) – is associated with increased disability, mortality and healthcare costs among people with PD. The long term goal of this research is to reduce disability and delay the onset of the ADRD PDD by enabling people at risk for PDD to cope with cognitive decline to maintain daily function. Existing medical (e.g. surgical, pharmacological) treatments for PD do not prevent or treat cognitive impairment, so behavioral interventions that mitigate its negative functional consequences and potentially delay or slow PDD are a top research priority. Unfortunately, the widely-used process training approach to cognitive intervention (repetitive practice of tasks designed to challenge and improve particular cognitive functions) has been unsuccessful in improving daily function and quality of life in this population. To overcome this limitation, the investigators take a strategy training approach, teaching targeted strategies that people can use in their everyday lives to circumvent cognitive deficits and accomplish daily tasks. Strategy training is a practice standard for cognitive rehabilitation in brain injury and stroke, but its application to PDD is novel. Moreover, the strategy training intervention developed for this study explicitly focuses on generalization of training to daily function, an aspect that is critically lacking from many typical strategy training approaches and from PD-related cognitive intervention research to date. This project addresses prospective memory, or the ability to remember to execute delayed intentions at the appropriate moment in the future. Good prospective memory is essential for independent living (e.g. paying bills, turning the stove off), employment, social relationships, and compliance with important health behaviors (e.g. taking medications). People at risk for PDD have prospective memory deficits that relate to worse daily function and quality of life. Therefore, prospective memory impairment is a relevant cognitive problem to address in this population. The primary objective of the current project is to determine the efficacy of mechanistically-targeted strategy training on prospective memory among people at risk for PDD (those with PD-related mild cognitive impairment; PD-MCI). It is a single-blind randomized controlled trial comparing the effects of strategy training to the traditional process training approach on objective laboratory prospective memory performance (Aim 1) and reported everyday prospective memory function (Aim 2). Additional objectives are to investigate neural mechanisms of prospective memory impairment in PD-MCI (Aim 3) and neural and behavioral predictors of prospective memory training response (Aim 4). This project leverages participants, data and infrastructure from an existing longitudinal cohort of PD, PD-MCI, PDD and control participants to evaluate short-term and long-term training effects, neurobiological mechanisms, and predictors of treatment response. This work will meet the pressing need for effective cognitive interventions that delay functional impairment associated with the ADRD PDD and will positively impact function and quality of life in this population.

艾琳·R·福斯特 R01 AG065214-01A1 帕金森病相关认知能力下降的前瞻性记忆障碍：干预措施和机制项目概要/摘要帕金森病痴呆 (PDD) 是阿尔茨海默病相关痴呆 (ADRD) 的一种，与帕金森病患者的残疾、死亡率和医疗费用增加有关。这项研究的长期目标是让有 PDD 风险的人能够应对认知能力下降以维持日常功能，从而减少残疾并延迟 ADRD PDD 的发作。现有的帕金森病医疗（例如手术、药物）治疗方法不能预防或治疗认知障碍，因此减轻其负面功能后果并可能延迟或减缓帕金森病的行为干预是首要研究重点。不幸的是，广泛使用的认知干预过程训练方法（旨在挑战和改善特定认知功能的任务的重复练习）未能成功改善该人群的日常功能和生活质量。为了克服这一限制，研究人员采取了策略培训方法，教授人们可以在日常生活中使用的有针对性的策略，以规避认知缺陷并完成日常任务。策略训练是脑损伤和中风认知康复的实践标准，但其在 PDD 中的应用是新颖的。此外，本研究开发的策略训练干预明确侧重于将训练推广到日常功能，这是迄今为止许多典型策略训练方法和 PD 相关认知干预研究中严重缺乏的一个方面。该项目旨在解决前瞻性记忆，或者记住在未来适当的时刻执行延迟意图的能力。良好的前瞻性记忆对于独立生活（例如支付账单、关掉炉子）、就业、社会关系以及遵守重要的健康行为（例如服药）至关重要。患有 PDD 风险的人存在前瞻性记忆缺陷，这与较差的日常功能和生活质量有关。因此，前瞻性记忆障碍是该人群需要解决的一个相关认知问题。当前项目的主要目标是确定机械针对性策略训练对 PDD 风险人群（患有 PD 相关轻度认知障碍的人；PD-MCI）的前瞻性记忆的效果。这是一项单盲随机对照试验，比较策略训练与传统过程训练方法对客观实验室前瞻性记忆表现（目标 1）和报告的日常前瞻性记忆功能（目标 2）的影响。其他目标是研究 PD-MCI 中预期记忆损伤的神经机制（目标 3）以及预期记忆训练反应的神经和行为预测因子（目标 4）。该项目利用来自 PD、PD-MCI、PDD 和对照参与者的现有纵向队列的参与者、数据和基础设施来评估短期和长期训练效果、神经生物学机制和治疗反应的预测因子。这项工作将满足对有效认知干预的迫切需求，以延缓与 ADRD PDD 相关的功能障碍，并将对该人群的功能和生活质量产生积极影响。