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

描述（由申请人提供）：目前估计有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）。因此，市场潜力存在于产品，方法和/或培训，可以帮助治疗和/或规避与疾病相关的挑战性行为。一种已被证明是有效的方法涉及使用蒙台梭利活动规划（MAP;坎普，1999年a;坎普，出版中）。MAP包括一套原则，用于制定和促进痴呆症患者参与的活动。在这项研究中，我们将开发一个新的蒙台梭利为基础的活动：炉边读书俱乐部TM的故事，这将是有史以来第一次痴呆症水平适当的阅读材料。将选择20个主题，这些主题是许多老年人熟悉和感兴趣的。对于每个主题，将创建三个不同版本的故事/文章。为痴呆症早期患者开发的“A级水平阅读材料”将长达30页，以9年级水平编写;为痴呆症中期患者开发的“AA级水平阅读材料”将长达20页，以6年级水平编写;最后，“AAA级水平的故事”，为老年痴呆症晚期的人创造的，将是10页长，将在三年级水平写。本研究共创建60个故事（三个阅读水平的20个主题）。Hearthside Book ClubTM小册子的一半（在所有阅读级别中平均分配）将包含图片。45名老年痴呆症患者将参加这项研究。他们将被分配到三个组之一：早期组（简易精神状态检查（MMSE）评分为18+），中期组（MMSE 11- 17）或晚期组（MMSE 5-10）。参加Hearthside Book ClubTM会议的人员的参与/影响将与基线活动参与者的参与/影响进行比较（例如，宾果游戏、时事、锻炼等）炉石图书俱乐部TM会议也将与参与者的参与/影响进行比较，在小组会议使用阅读圆桌（R）小册子，这是专为痴呆症患者，但他们没有调整不同程度的痴呆症。近端结果测量将涉及参与和影响，沟通，以及在小组阅读活动中观察到的行为。远端结局指标将评估激越、抑郁和生活质量。将在基线、参加阅读圆桌会议（R）两周后以及参加水平匹配的阅读材料会议后进行测量。本项目的具体目标如下：（1）开发阅读材料（2）确定将文本材料与痴呆水平相匹配是否与痴呆水平的近端和远端结果相关;（3）确定是否包含图片显著相关的近端和远端的结果，在不同程度的痴呆。 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。除了影响患有这种疾病的人之外，AD还引起了公共卫生问题，这是由于照顾痴呆症患者所需的大量费用以及对痴呆症患者的照顾者造成的精神和身体压力。因此，迫切需要能够吸引和刺激痴呆症患者的产品和计划，同时减轻护理人员的压力。通过为不同程度的痴呆症患者编制特殊阅读材料，拟议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.