Daily Functioning, Cognition, and Caregiver Burden in MCI Patients

MCI 患者的日常功能、认知和护理负担

• 批准号: 8098222
• 负责人: Laleh Jill Razani
• 金额: $ 10.77万
• 依托单位: CALIFORNIA STATE UNIVERSITY NORTHRIDGE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8098222
• 关键词: Activities of Daily Living; Address; Affect; Alzheimer' s Disease; Area; Attention; Awareness; Caregiver Burden; Caregivers; Clinical; Cognition; Cognitive; Cognitive deficits; Complex; Data; Data Collection; Databases; Dementia; Development; Diagnosis; Diagnostic; Diagnostics Research; Disease; Economics; Educational process of instructing; Elderly; Emotional; Exhibits; Exposure to; Family; Feeling; Frontotemporal Dementia; Functional disorder; Funding; Funding Mechanisms; Future; Grant; Hispanics; Impaired cognition; Impairment; Individual; Institution; Intervention; Judgment; Knowledge; Laboratories; Lead; Literature; Manuscripts; Measures; Memory; Memory impairment; Mentorship; Minority; Nature; Neuropsychological Tests; Patients; Pattern; Peer Review; Performance; Preparation; Publications; Publishing; Questionnaires; Recruitment Activity; Relative (related person); Reporting; Research; Research Personnel; Severities; Staging; Stress; Students; Testing; Time; United States National Institutes of Health; Vascular Dementia; abstracting; base; care burden; cognitive function; daily functioning; disability; ethnic minority population; experience; follow-up; functional decline; functional disability; informant; information processing; instrument; instrumental activity of daily living; interest; longitudinal design; mild neurocognitive impairment; neuropsychological; normal aging; processing speed; professor; programs; psychologic; psychological distress; public health relevance; social; treatment planning

DESCRIPTION (provided by applicant): Individuals at the very early stages of dementia (most often Alzheimer's disease) are referred to as having mild cognitive impairment (MCI). However, concrete clinical diagnostic criteria have not yet been established because cognitive and daily functional impairments are not yet well characterized in individuals with MCI. The current research criteria states that individuals with MCI must exhibit memory impairment beyond that of normal aging and maintain relatively preserved daily functional abilities (Petersen, 2004). Yet, recent research indicates that MCI patients are likely to experience subtle functional impairments (Farias et al., 2009; Pernesczky et al., 2006a). The problem is that most of the studies assessing daily functioning have used either cognitive rating forms or self- or informant-rated instrumental activities of daily living which can lead to biased results (Albert et al., 1999; Wadley et al., 2003; Razani et al., 2007). Additionally, very little attention has been paid to caregiver's of MCI individuals, given that there is an assumption that individuals with MCI do not require assistance in their daily activities. Thus, the aims of the present study are. 1) to characterize daily functioning in MCI individuals using a performance-based measure and to examine how neuropsychological impairment affects functional ability in MCI patients relative to those with diagnosed dementia, 2) to characterize how neuropsychological and functional impairments affect caregivers of MCI individuals, and 3) to assess whether the rate of cognitive decline can predict the rate of functional decline in MCI individuals and the rate of increased burden for their caregivers. Forty individuals with MCI (using the current research diagnostic criteria for MCI) will be recruited and administered a clinical neuropsychological test battery that includes tests of memory, attention, abstract reasoning, and information processing speed, as well as a performance-based functional task. The performance of the MCI individuals will be compared to a database of individuals with dementia (Alzhiemer's disease, Frontotemporal dementia, and Vascular dementia) and normal controls. Additionally, next-of-kin caregivers will be administered a set of questionnaires in order to assess the level of burden and psychological distress experienced. Patients and caregivers will be administered tests at baseline and 1-year follow-up periods. The functional abilities of the groups will be compared, the degree to which neuropsychological test scores predict daily functioning will be examined, and finally decline in cognitive and functional abilities over a 1-year period will be assessed. The results will better characterize degree, type and severity of deficits experienced by MCI individuals and their caregivers, which will assist with refining the diagnostic criteria for MCI and lead to better treatment planning for patients and their families. PUBLIC HEALTH RELEVANCE: Currently, there are no formal clinical diagnostic criteria for individuals experiencing mild cognitive impairment and very little is known about the daily functional abilities of such individuals. Also, little is known about the burden of care experienced by their next-of-kin. Gaining this information can assist with refining diagnostic criteria and aid with treatment planning.

描述(由申请人提供)：痴呆症(最常见的是阿尔茨海默病)非常早期的个人被称为轻度认知障碍(MCI)。然而，具体的临床诊断标准尚未建立，因为认知和日常功能障碍在MCI患者中还没有很好的特征。目前的研究标准规定，MCI患者必须表现出超过正常衰老的记忆障碍，并保持相对保存的日常功能能力(Petersen，2004)。然而，最近的研究表明，MCI患者可能会经历轻微的功能障碍(Farias等人，2009；Pernesczky等人，2006a)。问题是，大多数评估日常功能的研究要么使用认知评定表，要么使用自我或线人评估的日常生活工具活动，这可能导致有偏见的结果(Albert等人，1999；Wadley等人，2003；Razani等人，2007)。此外，很少关注MCI患者的照顾者，因为有一种假设是MCI患者在日常活动中不需要帮助。因此，本研究的目的是。1)使用基于表现的测量来表征MCI个体的日常功能，并检验神经心理障碍如何影响MCI患者相对于诊断为痴呆者的功能能力；2)表征神经心理和功能障碍如何影响MCI个体的照顾者；以及3)评估认知减退率是否可以预测MCI个体的功能减退率及其照顾者的负担加重的比率。40名MCI患者(使用目前MCI的研究诊断标准)将被招募并进行临床神经心理测试，包括记忆、注意力、抽象推理和信息处理速度的测试，以及基于表现的功能任务。MCI患者的表现将与痴呆症患者(阿尔茨海默病、额颞叶痴呆症和血管性痴呆症)和正常对照组的数据库进行比较。此外，近亲照顾者将接受一套问卷调查，以评估所经历的负担和心理痛苦程度。患者和照顾者将在基线和一年的随访期进行测试。将比较这些组的功能能力，检查神经心理测试分数预测日常功能的程度，最后将评估一年内认知和功能能力的下降。结果将更好地描述MCI患者及其照顾者所经历的缺陷的程度、类型和严重程度，这将有助于完善MCI的诊断标准，并导致为患者及其家人制定更好的治疗计划。 公共卫生相关性：目前，对于患有轻度认知障碍的个人，还没有正式的临床诊断标准，对这些人的日常功能能力知之甚少。此外，人们对他们的近亲经历的护理负担知之甚少。获得这些信息有助于完善诊断标准，并有助于治疗计划。