The Impact of Cognition on Rehabilitative Treatment for Slow Gait Speed

认知对慢步速康复治疗的影响

• 批准号: 10557853
• 负责人: Elisa Ogawa
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10557853
• 关键词: Activities of Daily Living; Address; Adherence; Age; Aging; Attention; Award; Behavioral; Boston; Caring; Cessation of life; Characteristics; Cladribine; Clinical; Clinical Trials; Cognition; Cognitive; Cognitive deficits; Communities; Coupled; Data; Dementia; Elderly; Environment; Executive Dysfunction; Exercise; Foundations; Future; Gait; Gait speed; Goals; Grant; Healthcare Systems; Hospitalization; Impaired cognition; Impairment; Individual; K-Series Research Career Programs; Knowledge; Learning; Memory; Mentors; Mentorship; Morbidity - disease rate; Neurobiology; Neuropsychological Tests; Neuropsychology; New England; Outcome; Participant; Pathology; Patients; Performance; Phase; Physician Executives; Positioning Attribute; Prevalence; Quasi-experiment; Rehabilitation therapy; Research; Research Design; Research Methodology; Research Project Grants; Research Support; Research Training; Role; Self Efficacy; Therapeutic exercise; Time; Training; Training and Education; Treatment outcome; United States National Institutes of Health; Veterans; Walking; Work; Writing; bean; career; cognitive ability; cognitive benefits; compliance behavior; design; disability; evidence base; executive function; experience; functional decline; functional disability; functional status; hands on research; improved; improved mobility; individualized medicine; innovation; insight; medical schools; multidisciplinary; novel; personalized approach; professor; programs; rehabilitation research; rehabilitation science; rehabilitative care; response; secondary analysis; skills; treatment adherence; treatment optimization; treatment response; walking speed

Slow walking and cognitive impairment are prevalent among aging Veterans and are independent predictors for subsequent hospitalization, disability, and death. Recent scientific evidence suggests that walking and cognition are interrelated whereby their declines may share a common underlying neurobiological pathology. Thus, treating slow walking speed may not only improve mobility but also cognition. Live Long Walk Strong (LLWS) is a new innovative rehabilitative care program targeting Veterans (≥50yrs) with slow walking speed. LLWS treatment primarily focuses on mobility problems. However, it is estimated that 40% of LLWS participants have manifested cognitive deficits; thus, it is uncertain whether current LLWS treatment is designed to optimally serve the unique characteristics of Veterans who have cognitive problems. For example, we do not know whether Veterans with cognitive challenges will adhere to the rehabilitative program. Likewise, we are unsure whether the treatment response will be the same across cognitive status. Therefore, the study objective is to understand the treatment adherence, compliance, and response among older Veterans with and without cognitive problems participating in the LLWS clinical trial. The present study will 1) provide insight into whether LLWS treatment needs to be modified to increase compliance and adherence, 2) examine the association between baseline cognitive status and change in gait speed after LLWS treatment, and 3) discover the influence of LLWS treatment on cognition. The long-term goal of this proposed Career Development Award (CDA-1) is to advance research and educational training in order for the PI to establish an independent line of research developing personalized rehabilitative treatment to maintain safe mobility and cognition among aging Veterans with varying functional abilities. The PI previously was the study coordinator of a NIH supported R21 exercise treatment study and later conducted her own feasibility and quasi-experimental studies. Currently, she is mentored by Jonathan Bean, MD, MPH, a professor of PM&R at Harvard Medical School and Director of New England GRECC at VA Boston Healthcare System. The short-term goals of this CDA-1 are to acquire experience in 1) rehabilitation science, 2) mobility assessment and treatment, 3) neuropsychological assessment and analysis, 4) personalized rehabilitation treatment (geriatric care principles), and 5) research methods and grant writing skills to establish a strong foundation for a VA-research career. The PI will use the combination of didactic coursework provided from a rich academic research environment, hands-on research training, and mentorships from a team of experts who can offer extensive knowledge and support her research. The proposed research is significant and innovative as it provides information about how to tailor innovative rehabilitative care to better suit the individual needs of Veterans.

缓慢行走和认知障碍在老年退伍军人中普遍存在，是独立的预测因素