PROBLEM SOLVING/PHYSICAL INTERVENTIONS AND AGING

描述（改编自研究者摘要）： 美国的老年人 在过去的几十年里， 攀登随着这一点的出现，人们对确定帮助衰老的方法越来越感兴趣 成年人保持他们的健康，功能独立性和整体素质， 生活本提案的主要目标是评价一项随机对照研究。 一项旨在改善情绪健康的干预临床试验， 增加健康行为，提高解决问题的能力。这 干预措施将在成功的两个决定因素中提供技能培训 老化：解决问题和体育锻炼。二百四十八 75岁以上的社区居民将被随机分配到四个社区之一， 2 × 2析因设计中的处理条件：问题解决（PS） 仅运动（EX）、PS+EX和运动护理控制（UCC）。受试者将 从一群老年人中招募，这些老年人是基于社区的 HMO已经有了大量的数据。主要结局指标 包括老年抑郁量表（用于评估抑郁和情绪 SF-36（用于评估健康和功能）和日常生活 问题解决测试（用于评估解决问题的能力）。次要结局 这些措施将评估抑郁症和情绪健康，身体健康， 护理和死亡率。将在以下时间收集结局指标： 入组研究（基线）、3个月（治疗后）和4个月时 在2年的随访过程中，据推测，PS 和EX条件将有效地改善情绪健康， 身体健康私人秘书处将有效改善解决问题的能力; PS+EX的组合将比单独干预更有效 改善所有领域。还假设这些影响将是 维持2年以上，PS、EX和PS+EX中的受试者将在以下方面得到改善： 残疾和独立性的措施，健康利用和成本。

DESCRIPTION (adapted from investigator's abstract): The proportion of individuals in the United States who are living into old age had risen dramatically in the past several decades and is expected to continue its upward climb. With this has come a growing interest in identifying ways to help aging adults maintain their health, functional independence, and overall quality of life. The primary goal of this proposal is to evaluate a randomized controlled clinical trial of an intervention designed to improve emotional well-being, increase health behaviors, and enhance problem-solving skills. This intervention will provide skills training in two determinants of successful aging: problem solving and physical exercise. Two hundred forty-eight community-residing adults over age 75 will be randomly assigned to one of four treatment conditions in a two-by-two factorial design: Problem-solving (PS) only, Exercise (EX) only, PS+EX, and Usual Care Control (UCC). Subjects will be recruited from a cohort of older adults who are members of a community-based HMO on whom extensive data are already available. Primary outcome measures include the Geriatric Depression Scale (for assessing depression and emotional well-being), the SF-36 (for assessing health and function), and the Everyday Problem-Solving Test (for assessing problem-solving skills). Secondary outcome measures will assess depression and emotional well-being, physical health, cost of care, and mortality. Outcome measures will be collected at the time of enrollment into the study (baseline), at 3 months (post-treatment), and four times over the course of the 2-year follow-up. It is hypothesized that the PS and EX conditions will be effective in improving emotional well-being and physical health. PS will be effective in improving problem-solving; and the combination of PS+EX will be more effective than the individual interventions in improving all areas. It is also hypothesized that these effects will be maintained over 2 years, and that subjects in PS, EX, and PS+EX will improve on measures of disability and independence, health utilization and cost.