The Moderating Influence of Personality on Cognitive Stimulation Outcomes in Pers

描述(由申请人提供)：痴呆症导致的认知能力下降对许多老年人的健康和福祉是一个严重的威胁。由于痴呆症的渐进性，它不可避免地会导致生活质量的毁灭性下降。以认知为重点的行为干预以补偿大脑机制为目标，以改善认知表现，已经在这一人群中进行了测试，结果令人振奋；研究人员尚未解决为什么一些人比另一些人更适合。这项拟议的研究将通过调查人格对认知加速下降高危痴呆症患者以认知为重点的干预的调节作用，扩展有关认知重点干预的科学知识。本研究的具体目的如下：1)检验人格特质对认知功能(注意、记忆、定向、执行功能和抽象思维)五个领域认知功能突变期干预与改善之间的调节作用；2)检验认知突变期人格特质对认知刺激干预的调节作用。这项研究将利用目前参与随机临床试验的样本的一部分来测试个性化认知刺激活动的有效性。受试者是从宾夕法尼亚州的五家疗养院招募的，这些疗养院提供急性后护理服务，用于住院后的康复。那些在两年期间注册的人，或估计总共120门科目，将被纳入拟议的研究。所有受试者都要接受轻度至中度痴呆症以及精神错乱的筛查，精神错乱是一种以注意力不集中为特征的急性混乱状态。在已经具有认知能力的脆弱人群中的严重困惑为观察康复过程中干预的效果，包括缓和因素的影响提供了一个机会主义的模型。符合条件的受试者被随机分为治疗组和对照组。干预措施包括各种个性化的认知刺激娱乐活动，每天提供30分钟，最多30天；对照组接受常规护理。拟议研究的首席调查员将使用NEO五因素调查表的告密者版本收集人格评估数据，这是一种基于人格五因素模型的成熟和常用的工具。两组每天都会测量五个目标领域的认知功能。干预的参与度将以工作时间和参与程度来衡量。数据分析将采用线性混合效应模型。每一个 这五种人格特征将被独立测试，以获得统计上显著的缓和 对认知功能的每个领域的影响，以及在干预中对参与的缓和效应。该模型还将考虑多种人格特质之间的相互作用。现有的研究还没有调查个体特征对认知衰退个体的认知刺激活动治疗效果的潜在调节影响。拟议的研究将解决这一关键差距，并有助于为专门针对认知的干预研究奠定坚实的基础。

DESCRIPTION (provided by applicant): Cognitive decline due to dementia is a significant threat to the health and well-being of many older adults. As a consequence of its progressive nature, dementia inevitably leads to devastating declines in quality of life. Cognition- focused behavioral interventions which target compensatory brain mechanisms in order to improve cognitive performance have been tested in this population with promising results; researchers have yet to address why some individuals are better candidates than others. The proposed research will extend scientific knowledge regarding cognition-focused interventions by investigating the moderating effect of personality on a cognition-focused intervention in individuals with dementia at high risk for accelerated cognitive decline. The specific aims of the proposed study are as follows: 1) To test the moderating effect of personality traits on the relationship between a cognitive stimulation intervention and improvement in five domains of cognitive function (attention, memory, orientation, executive functioning, and abstract thinking) during a period of abrupt cognitive decline; and, 2) To test the moderating effect of personality traits on engagement in the intervention during a period of abrupt cognitive decline. This research will utilize a portion of the sample currently participating in a randomized clinical tria testing the effectiveness of individualized cognitively stimulating activities. Subjects are recruied from five nursing homes in Pennsylvania with post-acute care services for rehabilitation following hospitalization. Those enrolled during a two year period, or an estimated 120 total subjects, will be included in the proposed study. All subjects are screened for the presence of mild to moderate dementia as well as the presence of delirium, a state of acute confusion characterized by inattention. Acute confusion in an already cognitively vulnerable population provides an opportunistic model for viewing the effects of the intervention, including the influence of moderating factors, during the course of rehabilitation. Eligible subjects are randomized to treatment and control groups. The intervention consists of a variety of individually tailored cognitively stimulating recreational activities which are delivered for 30 minutes a day for up to 30 days; the control group receives usual care. The Principle Investigator of the proposed study will collect personality assessment data using the informant version of the NEO Five Factor Inventory, a well-established and commonly used instrument based on the five factor model of personality. Cognitive function in the five targeted domains will be measured each day in both groups. Engagement in the intervention will be measured as both time on task and level of participation. A linear mixed-effects model will be applied for data analysis. Each of the five personality traits will be tested independently for a statistically significant moderating effect on each domain of cognitive functioning, as well as separately for a moderating effect on engagement in the intervention. Interactions between multiple personality traits will also be considered within the model. Existing research has not investigated the potential moderating influence of individual characteristics on the treatment effect of cognitive stimulating activitiesin individuals experiencing cognitive decline. The proposed research will address that critical gap and help build a strong foundation for tailored cognition-focused intervention research.