MAINTENANCE AND ENHANCEMENT OF COGNITIVE ADLS

正常的衰老与认知功能的丧失有关。 在 实验室研究表明，老年人的认知功能可以通过 加强记忆力和流动智力的训练。 但不 明确这些干预措施是否能提高执行能力 日常生活活动（ADL），需要流体智力， 认知ADL（Cognitive ADL） 这一点尤为重要，因为损失 认知ADL与住院率增加密切相关， 其他医疗保健利用率提高。 长期目标是 建议是找到保持或增强老年人能力的方法 成年人进行认知ADL。 具体目标是：1） 识别和招募有认知能力下降风险的老年人 功能; 2）设计和实施认知干预，以改善 记忆和流体智力; 3）评估的有效性， 维持或改善认知ADL的干预; 4）使用基线 特征，以确定最能响应 干预;和5）进行特定地点的影响研究， 对卫生服务使用和费用的干预。 老年人没有 认知ADL受损，但有丧失这些功能的风险， 将通过严格和有效的筛选确定 方法论 在知情同意后，他们将被随机分配到对照组， 干预组。 干预组将接受培训 在记忆和流体智力每周超过6周和助推器会议 每6个月一次共18个月 此外，在家里要做的练习 将每周提供一次，持续六周，然后每月提供一次，持续18个月。 对照受试者将接受以下培训的平等接触： 自信技巧 两组患者都将接受为期两年的随访 在第2、6、12、14、16、18、19、1 18和24个月。 控制和干预的区别 将在调整基线特征后分析各组。 卫生资源的利用和费用将通过 Regenstrief医疗记录系统和访谈。

Normal aging is associated with loss of cognitive function. In laboratory studies, cognitive function in the elderly can be improved by training to enhance memory and fluid intelligence. However, it is not clear if these interventions lead to improved ability to perform activities of daily living (ADLs) which require fluid intelligence and memory (cognitive ADLs). This is especially important because the loss of cognitive ADLs is closely related to increased hospitalization and other increased health care utilization. The long-term objective of this proposal is to find methods to maintain or enhanced the ability of older adults to perform cognitive ADLs. The specific objectives are to: 1) identify and enroll elderly adults at risk for decline in cognitive function; 2) design and implement a cognitive intervention to improve memory and fluid intelligence; 3) evaluate the effectiveness of the intervention on maintaining or improving cognitive ADLs; 4) use baseline characteristics to identify individuals most responsive to the intervention; and 5) conduct a site-specific study of the effect of the intervention on health services use and costs. Older adults without impairment in cognitive ADLs, yet at risk for loss in these functions, will be identified through a rigorous and efficient screening methodology. After informed consent, they will be randomized to control and intervention groups. The intervention group will receive training in memory and fluid intelligence weekly over 6 weeks and booster sessions every 6 months for 18 months. In addition, exercises to be done at home will be provided weekly for six weeks and then monthly to 18 months. Control subjects will receive equal contacts with training in assertiveness techniques. Both groups will be followed for two years with assessments of cognitive function and cognitive ADLs at 2, 6, 12, 18, and 24 months. The difference between control and intervention groups will be analyzed after adjusting for baseline characteristics. Health resource utilization and costs will be tracked through the Regenstrief Medical Record System and interview.