Cognitive Behavioral Therapy for Arthritis Pain and Insomnia in Older Adults

描述（由申请人提供）：这是1 R01 AG031126的竞争性修订（补充）申请，老年人关节炎疼痛和失眠的认知行为疗法，m.v. Vitiello联系主要研究者。这项资助的随机对照试验父母研究的目的是评估针对疼痛和睡眠障碍的行为干预、单独针对疼痛的行为干预和注意力控制的行为干预，是否会显著改善患有骨性关节炎和失眠的老年人的疼痛和睡眠相关症状、功能结局和医疗保健利用。在治疗前、治疗后以及9个月和18个月随访时进行家长研究评估。许多文献报道将疼痛和睡眠障碍与认知功能受损联系起来；当这些情况同时发生时，对老年人的影响尤其加剧。因此，一种可能减轻疼痛和改善睡眠的干预措施也可能具有理想的认知增强效果，尤其是对认知能力

DESCRIPTION (provided by applicant): This is a competing revision (supplement) application for 1 R01 AG031126, Cognitive Behavioral Therapy for Arthritis Pain and Insomnia in Older Adults, M. V. Vitiello Contact Principal Investigator. The aim of the funded randomized controlled trial parent study is to assess whether a behavioral intervention that targets both pain and sleep disturbance vs. one that targets pain alone vs. an attention-control, will substantially improve pain- and sleep-related symptoms, functional outcome, and health care utilization in a large sample of older adults with co-morbid osteoarthritis and insomnia. Parent study assessments are made pretreatment, post-treatment and at 9 and 18 month follow-ups. Numerous reports in the literature link pain and sleep disturbance to compromised cognitive function; an effect that is particularly exacerbated for older adults when these conditions co-occur. Therefore, an intervention which is likely to reduce pain and improve sleep will likely have a desirable cognition-enhancing effect as well, particularly for cognitive abilities most susceptible to the influences of these conditions. Funds are requested to support the addition of a cognitive assessment to the 9 and 18 month follow-up assessments of the parent study and the analysis of the cognitive data. This will allow us to examine the potential acute and long term cognitive benefits associated with two behavioral interventions vs. a control in older adults with co-morbid osteoarthritis and insomnia. PUBLIC HEALTH RELEVANCE: Osteoarthritis (OA) pain debilitates half of all older adults, most of whom also experience significant sleep disturbance. The parent project seeks to determine whether a cognitive-behavioral treatment targeting both pain and co-morbid sleep disturbance in older adults with painful OA results in substantially greater reductions in pain and improvements in sleep and functional outcomes compared a cognitive-behavioral treatment targeting pain alone, or an attention-control condition. This competing revision(supplement) seeks to add a cognitive assessment to the outcome measures of the parent study since an intervention which is likely to reduce pain and improve sleep will likely have a desirable cognition-enhancing effect as well. Given the recent limitations on pharmacologic options for effective management of OA pain, this project has major implications for improving management of both pain and co-morbid sleep disturbance in the rapidly growing population of older Americans suffering from OA.