Feasibility Study: Attention Measures in Persons with Alzheimer's Disease

描述(申请人提供)：这项研究将确定使用重复简单反应时测量来研究睡眠中断对阿尔茨海默病患者警觉注意力的影响的可行性。睡眠障碍是阿尔茨海默病的一个显著临床特征，严重影响AD患者及其照顾者的生活质量。在健康人中，对睡眠干扰的研究显示了睡眠干扰的负面影响，以及改善睡眠对运动功能、情绪和警觉注意力的积极影响。警觉注意力受损是非常重要的，因为完整的警觉注意力是人类功能的核心。警觉地注意、快速选择和响应最显著的输入刺激进行处理的能力对于安全和有效的人类行为是必不可少的。警觉注意力受损对阿尔茨海默病患者尤其重要，因为无法保持警觉注意力可能会导致或恶化记忆问题。尽管睡眠干扰对警觉注意力的影响已经在健康人中进行了广泛的研究，但关于其对阿尔茨海默病患者影响的有力证据是有限的。据首席调查员(PI)所知，还没有人研究睡眠中断对阿尔茨海默病患者警觉注意力的影响。然而，在我们研究睡眠中断对阿尔茨海默病患者警觉注意力的影响之前，我们必须确保我们有有效和可靠的警觉注意力措施。在健康人群中，重复的简单反应时测量(心理运动警戒任务[PVT])已被成功地用于研究睡眠中断对警戒注意力的影响。PVT由Dinges和Powell(1986)开发，是一种标准化的实验室工具，已被健康人群中的睡眠研究人员广泛使用。PVT是一种简单的小型手持设备，可以对其进行编程，以提供视觉或声音的多个未准备好的反应时间测试。每次审判持续10分钟。虽然反应时范式已经被用来评估轻度AD患者的警觉注意，但我们不知道AD患者是否可以完成多次重复测量，或者所获得的结果是否可能是错误的。例如，注意力的变化可能会错误地反映出考试时动机低落或焦虑。因此，本研究的主要目的是：1.确定在AD患者中使用频繁重复(Q 2小时)的警戒注意(PVT)措施的可行性。第二个具体目标是：2.确定PVT测试在6个时间段的敏感度，以衡量AD患者警觉注意力的变化。3.确定持续时间小于10分钟的PVT试验的灵敏度。本申请是根据学术研究促进奖(R15)公告(PA-06-042)提交的。这项拟议的研究将确定使用重复简单反应时间测量来研究睡眠中断对阿尔茨海默病患者警觉注意力的影响的可行性。这项可行性研究涉及目标2.1：神经功能和感觉条件的研究，如国家护理研究所研究使命声明和战略计划中概述的那样。

DESCRIPTION (provided by applicant): This study will establish the feasibility of using repeated simple reaction time measures to study the effect of sleep disruption on vigilant attention in persons with AD. Sleep disruption is a prominent clinical feature of AD that significantly impacts quality of life for persons with AD and their caregivers. In healthy people, studies of sleep disruption show the negative effects of sleep disruption and the positive effects of improved sleep on motor function, mood, and vigilant attention. Impaired vigilant attention is highly significant because intact vigilant attention is central to human function. The ability to vigilantly attend to, quickly select and respond to the most salient incoming stimuli for processing is essential for safe and effective human performance. Impaired vigilant attention is particularly important for persons with AD because the inability to maintain vigilant attention may cause or worsen memory complaints. Although the impact of sleep disruption on vigilant attention has been studied extensively in healthy people the availability of strong evidence concerning its effect on persons with AD is limited. To the Principal Investigator's (PI) knowledge, no one has studied the effect of sleep disruption on vigilant attention in persons with AD. However, before we can study the effect of sleep disruption on vigilant attention in persons with AD, we must ensure that we have valid and reliable measures of vigilant attention. In healthy populations repeated simple reaction time measures (The Psychomotor Vigilance Task [PVT]) have successfully been used to study the effect of sleep disruption on vigilant attention. The PVT was developed by Dinges and Powell (1986) as a standardized laboratory tool and has been used extensively by sleep researchers in healthy populations. The PVT is a simple small handheld device that can be programmed to deliver either a visual or audible multiple unprepared reaction time tests. Each trial lasts 10 minutes. Although the reaction time paradigm has been used to assess vigilant attention in persons with mild AD in a cross sectional design, we do not know if persons with AD can complete multiple repeated measures or if the results obtained might be erroneous. For example, changes in attention may erroneously reflect depressed motivation or anxiety with the testing situation. Therefore, the primary specific aim for this study is: 1. Determine the feasibility of using frequently repeated (q 2 hour) measures of vigilant attention (PVT) in persons with AD. The secondary specific aims are: 2. Determine the sensitivity of PVT tests across 6 time periods to measure changes in vigilant attention in persons with AD. 3. Determine the sensitivity of PVT tests of less than 10 minutes duration. This application is submitted under the Academic Research Enhancement Award (R15) Announcement (PA- 06-042). The proposed study will establish the feasibility of using repeated simple reaction time measures to study the effect of sleep disruption on vigilant attention in persons with Alzheimer's disease. This feasibility study addresses Goal 2.1: Research in neurofunction and sensory conditions, as outlined in the National Institute on Nursing Research Mission Statement and Strategic Plan.