MAINTENANCE AND ENHANCEMENT OF COGNITIVE ADLS

正常衰老与认知功能的丧失有关。在……里面 实验室研究，老年人的认知功能可以通过以下方式改善 训练以增强记忆力和流畅的智力。然而，它并不是 明确这些干预措施是否会提高执行能力 日常生活活动(ADL)需要液态智力和 记忆(认知ADL)。这一点尤其重要，因为 认知性ADL的增加与住院和 其他增加的卫生保健利用率。这样做的长期目标是 建议是想办法保持或增强老年人的能力 成年人进行认知性ADL。具体目标是：1) 确定并登记有认知能力下降风险的老年人 功能；2)设计并实施认知干预，以提高 记忆和流体智力；3)评估 维持或改善认知ADL的干预；4)使用基线 特征，以识别对 干预措施；以及5)开展针对现场的研究，以了解 对卫生服务利用和费用的干预。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查来确定 方法论。在知情同意后，他们将被随机分配到对照组 和干预组。干预组将接受培训 在超过6周的记忆和流体智力课程和助推器课程中 每6个月一次，共18个月。此外，练习要在家里进行。 将在六周内每周提供一次，然后每月至18个月提供。 对照受试者将在培训期间获得平等的接触 自信技巧。这两组人都将接受为期两年的跟踪 用认知功能和认知ADL在2，6，12， 18又24个月。控制和干预之间的区别 在对基线特征进行调整后，将对组进行分析。 卫生资源利用情况和成本将通过 Regenstrief病历系统和面谈。

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.