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），并且预计AD病例将以惊人的速度增长（AD; Alzheimer's Association, 2010）。因此，帮助治疗和/或规避与该病症相关的挑战性行为的产品、方法和/或培训存在市场潜力。一种已被证明有效的方法是使用蒙台梭利活动规划（MAP; Camp, 1999a; Camp, in press）。MAP包括一套制定和促进痴呆症患者参与活动的原则。在这项研究中，我们将开发一种新的基于蒙特梭利的活动：Hearthside Book ClubTM故事，这将是有史以来第一个适合痴呆症水平的阅读材料。将选择20个主题，这些主题对许多老年人来说是熟悉和有趣的。对于每个主题，将创建三个不同版本的故事/文章。“a级阅读材料”为早期痴呆症患者开发，长度为30页，写作水平为9年级；“aa级阅读材料”，为痴呆症中期患者开发，长度为20页，将按照六年级水平编写；最后，“aaa级故事”，为老年痴呆症晚期患者创作，长度为10页，将以3年级水平写作。本研究将共创作60篇故事（20个主题，三个阅读水平）。一半的Hearthside Book ClubTM小册子（在所有阅读水平中平均分配）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中的一个：早期组（迷你精神状态测试（MMSE）分数为18+），中期组（MMSE 11- 17）或晚期组（MMSE 5-10）。参加炉石图书俱乐部tm会议的人的参与/影响将与基线活动（如宾果游戏、时事、锻炼等）参与者的参与/影响进行比较。炉石图书俱乐部tm会议也将与使用阅读圆桌(R)小册子的小组会议参与者的参与/影响进行比较，这些小册子是为痴呆症患者设计的，但它们没有针对不同程度的痴呆症进行调整。近端结果测量包括在小组阅读活动中观察到的参与和影响、交流和行为。远端预后指标将评估躁动、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采取措施。该项目的具体目标如下：(1)开发适合不同程度痴呆症患者的阅读材料（有和没有图片）；(2)确定文本材料与痴呆水平的匹配是否与痴呆水平的近端和远端结果相关；(3)确定图片的纳入是否与近端和远端痴呆水平的预后显著相关。

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.