The Hearthside Book Club: Pioneering Dementia-Level-Appropriate Reading Materials

描述(由申请人提供)：据估计，目前有530万美国人患有阿尔茨海默病(AD)，预计AD病例将以惊人的速度上升(AD；阿尔茨海默病协会，2010年)。因此，可以帮助治疗和/或规避与疾病相关的挑战性行为的产品、方法和/或培训具有市场潜力。一种已被证明有效的办法涉及使用蒙特梭利活动方案拟订(MAP；Camp，1999a；Camp，印刷中)。MAP由一套开发和促进痴呆症患者参与活动的原则组成。在这项研究中，我们将开发一个新的基于蒙特梭利的活动：炉边图书俱乐部故事，这将是有史以来第一个痴呆症级别的适当阅读材料。将选出20个许多老年人都熟悉和感兴趣的话题。对于每个主题，将创建故事/论文的三个不同版本。为痴呆症早期患者编写的《A级阅读材料》将长达30页，并将在9年级编写；为痴呆症中期患者开发的《AA-级别阅读材料》将长达20页，将在6年级水平编写；最后，为痴呆症晚期患者编写的《AAA-级别故事》将长达10页，将在3年级水平编写。本研究将创作60个故事(三个阅读水平的20个主题)。一半的HEarth side Book Club bTM小册子(在所有阅读级别中平均分配)将包含图片。45名患有痴呆症的老年人将参加这项研究。他们将被分配到三组中的一组：早期组(简易精神状态检查(MMSE)得分18+)，中期组(MMSE 11-17)，或晚期组(MMSE 5-10)。参加HEarth side Book ClubTM课程的人的参与度/影响将与参与者在基线活动(如宾果游戏、时事、锻炼等)中的参与度/影响进行比较。此外，还将使用为痴呆症患者设计的阅读圆桌会议(R)小册子，将炉石图书俱乐部TM课程与小组课程参与者的参与度/影响进行比较，但它们没有针对不同程度的痴呆症进行调整。近期结果测量将包括在小组阅读活动中观察到的参与度和情感、沟通和行为。远期结局测量将评估焦虑、抑郁和生活质量。将在参加阅读圆桌会议(R)会议两周后以及在参加水平匹配的阅读材料会议之后，在基线上采取措施。该项目的具体目标如下：(1)开发专门为不同程度痴呆症患者量身定做的阅读材料(有图片和没有图片)；(2)确定与痴呆症程度相匹配的文本材料是否与不同程度痴呆症的近端和远端结果有关；(3)确定是否包含图片与不同程度痴呆症的近端和远端结果显著相关。 公共卫生相关性：据估计，目前有530万美国人患有阿尔茨海默病(AD)，预计AD病例将以惊人的速度上升。阿尔茨海默病除了影响患者外，也是一个公共卫生问题，因为照顾痴呆症患者所需的巨额费用，以及给痴呆症患者的照顾者带来的精神和身体压力。因此，迫切需要能够吸引和刺激痴呆症患者的产品和计划，同时减轻照顾者的压力。通过为不同程度的痴呆症患者编写专门的阅读材料，拟议的项目将有助于满足这一需求。

DESCRIPTION (provided by applicant): An estimated 5.3 million Americans are currently suffering from Alzheimer's disease (AD), and AD cases are expected to rise at an alarming rate (AD; Alzheimer's Association, 2010). Therefore, market potential exists for products, approaches, and/or training that can help treat and/or circumvent the challenging behaviors associated with the condition. One approach that has been shown to be effective involves the use of Montessori Activity Programming (MAP; Camp, 1999a; Camp, in press). MAP consists of a set of principles for developing and facilitating activities for engaging persons with dementia. In this study, we will develop a new Montessori-based activity: Hearthside Book ClubTM stories, which will be the first-ever dementia-level appropriate reading materials. Twenty topics will be chosen which are familiar and interesting to many older adults. For each topic, three different versions of the story/essay will be created. Developed for persons in the early stages of dementia, "A-Grade Level Reading Materials" will be 30 pages in length and be written at an 9th grade level; "AA-Grade Level Reading Materials", developed for persons in the Middle Stages of dementia, will be 20 pages in length and will be written at the 6th grade level; finally, "AAA-Grade Level Stories", created for persons in the Late Stages of Dementia, will be 10 pages in length, and will be written at the 3rd grade level. A total of 60 stories will be created for this study (20 topics at three reading levels). Half of the Hearthside Book ClubTM booklets (split equally among all reading levels) will contain pictures. Forty-five older adults with dementia will take part in the study. They will be assigned to one of three groups: the Early Stage Group (Mini-Mental Status Exam (MMSE) score of 18+), the Middle Stage Group (MMSE 11- 17), or the Late Stage Group (MMSE 5-10). The engagement/affect of persons taking part in Hearthside Book ClubTM sessions will be compared against the engagement/affect of participants in baseline activities (e.g., bingo, current events, exercise, etc.) Hearthstone Book ClubTM sessions will also be compared against the engagement/affect of participants in small-group sessions using Reading Roundtable(R) booklets, which are designed for persons with dementia, but they are not adjusted for varying levels of dementia. Proximal outcome measures will involve engagement and affect, communications, and behaviors observed during small group reading activities. Distal outcome measures will assess agitation, depression, and quality of life. Measures will be taken at baseline, after two weeks of taking part in Reading Roundtable(R) sessions, and after taking part in level-matched reading materials sessions. The Specific Aims of this project are as follows: (1) to develop reading materials (with and without pictures) tailored specifically to persons with varying levels of dementia; (2) to determine if matching text materials to levels of dementia is related to proximal and distal outcomes across levels of dementia; (3) to determine if the inclusion of pictures significantly relates to proximal and distal outcomes across levels of dementia. PUBLIC HEALTH RELEVANCE: An estimated 5.3 million Americans are currently suffering from Alzheimer's disease (AD), and AD cases are expected to rise at an alarming rate. Besides affecting the person with the condition, AD also presents a public health concern, due to the significant cost required to care for persons with dementia and due to the mental and physical stress placed upon caregivers of persons with dementia. So, there is an urgent need for products and programs that will engage and stimulate persons with dementia, while at the same time reducing the stress on caregivers. Through the development of special reading materials for persons of varying levels of dementia, the proposed project will help meet this need.