Web-Based ACTIVE Memory Training Intervention for Older Adults

描述（由申请人提供）：本提案响应PA-11-124转化研究，以帮助老年人在社区中保持健康和独立性（R21），并寻求支持，以测试基于证据的ACTIVE（独立和重要老年人高级认知训练）记忆训练干预的网络版本，供社区组织使用，以促进老年人的记忆健康和健身。记忆丧失是社区老年人的一个主要公共卫生问题，通常与失去独立性、需要正式护理和机构化有关。虽然有越来越多的证据表明，在ACTIVE中使用的小团体，培训师主导的，基于纸和笔的课程导致显着的认知增益和日常功能的一些改善，他们提供的练习机会很少，在他们的能力有限，以达到老年人的人口不断增长，并不容易传播，由于管理成本高。建议使用在线交互式技术进行这种认知训练，被认为上级最初的ACTIVE试验和大多数以前的训练研究中使用的有限方法。我们建议现场测试一个名为ACTIVE Memory Works（AMW）的在线程序，以帮助老年用户提高性能，监测记忆和认知的变化，并评估其对日常功能活动的影响。基于网络的AMW实验干预将：通过纳入自动化数据收集和分析，与纸笔形式相比，大大降低了管理成本;提供自动化评分和报告;根据个人进展增加对上下文敏感的辅导的参与;并提供评估更大样本的类别和样本的记忆任务的机会;并增加用户指导的实践。这产生了具有以下关键特征的总体设计：1）基线评估和随机分配到10个疗程的实验干预组，10个疗程的实验干预加4个疗程的加强组，或等待列表对照条件，以及2）立即后测试和6个月的随访测试。在线格式的使用将使广泛传播成为可能，这对于开始改变老年人的生活是必要的，这些老年人有兴趣在面临与年龄有关的记忆障碍时监测和保持他们的记忆表现、认知活力和生活质量，并开始降低机构化的成本。一些社区组织已经准备好并能够参与。

DESCRIPTION (provided by applicant): This proposal responds to PA-11-124 Translational Research to Help Older Adults Maintain Their Health and Independence in the Community (R21) and seeks support to test a web-based version of the evidence-based ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) memory training intervention for use by community organizations to promote memory health and fitness among the elderly. Memory loss is a major public health problem among community-living older adults, and is often associated with loss of independence, need for formal care, and institutionalization. Although there is growing evidence that small-group, trainer-led, paper-and-pencil based classes used in ACTIVE lead to significant cognitive gains and some improvement in everyday function, they offer few practice opportunities outside of class time, are limited in their ability to reach the growing population of older adults, and are not easily disseminated due to high costs of administration. The proposed use of online, interactive technology for this cognitive training is conceived as superior to the limited approach used in the original ACTIVE trial and in most previous training research. We propose to field test an online program called ACTIVE Memory Works (AMW) to help older adult users increase performance and monitor changes in memory and cognition and assess their effects on daily functional activities. The web- based AMW experimental intervention will: greatly reduce administrative costs compared with the paper-and- pencil form by incorporating automated data collection and analysis; provide automated scoring and reporting; increase engagement with context-sensitive coaching based on individual progress; and provide opportunities to evaluate a larger sample of categories and exemplars for memory tasks; and increase user-directed practice. This yields an overall design with the following key features: 1) a baseline assessment and randomization to a 10-session experimental intervention group, a 10-session experimental intervention plus 4-session booster group, or to a wait-list control condition, and 2) an immediate post-test and 6-month follow-up test. The use of the online format will make possible the widespread dissemination necessary to begin to make a difference in the lives of older adults interested in monitoring and maintaining their memory performance, cognitive vitality, and quality of life in the face of age-related memory impairments and begin to reduce the costs of institutionalization. Several community organizations are ready and able to participate.