Maintaining Cognitive Health in Aging Veterans

描述(由申请人提供)： 从1980年到1990年，65岁以上退伍军人的比例从11%上升到26%，预计到2030年将上升到50%以上(Hisnanik，1994)。由于老年退伍军人的数量不断增加，退伍军人健康管理局主要关注的是老年退伍军人的健康问题。对痴呆症的恐惧在老年人中很常见(Commisseris，Pond，&Jollees，1998；Corner&Bond，2004)，以前很少被关注的轻微记忆丧失可能被误解为痴呆症的开始阶段(Commissaris等人，1994)。尽管正常的认知老化与病理性衰老不同，但正常的年龄相关变化的影响需要干预，因为它可能导致情绪困扰和功能困难，影响职业、娱乐和社交追求(Royall等人，2004,2005；Dodge等人，2008)，主观认知障碍，其定义是在神经心理测试中没有客观证据下降的情况下注意到的认知变化，可能是痴呆症的最早先兆(Reisberg等人，2010)。虽然随着年龄的增长，认知变化是可以预期的，但越来越多的文献表明，随着年龄的增长，可改变的生活方式因素可以影响生活的功能能力和质量(Depp，Vahia，&Just，2010；LaRue，2010)。此外，认知训练可能会改善老年人的认知和功能(Unverzagt等人，2009年；Papp等人，2009年；Lustig等人，2009年)。不幸的是，许多老年人缺乏关于认知老化和导致成功认知老化的因素的知识，这限制了他们做出改变以提高成功认知老化几率的能力(Anderson等人，2009年)。最近，参与促进老年人福利的主要机构认识到传播与大脑健康有关的信息的必要性，包括国家神经疾病和中风研究所、心理健康和老龄化研究所(认知和情绪健康项目，Hendrie等人，2006年)以及疾病控制和预防中心和阿尔茨海默氏症协会(健康大脑倡议，2007年)。目前的研究建立在之前关于老年人认知干预工作的基础上，通过调查多成分干预，包括关于认知衰老的心理教育，呈现有助于成功认知衰老的生活方式因素，以及广泛的认知技能培训。使用随机对照试验设计，72名退伍军人将被分配到 干预组(36例)或非治疗对照组(36例)。退伍军人将接受基线评估，用于在干预后立即以及在3个月和6个月随访时进行比较。结果包括认知老化的知识，心理健康的测量，以及认知和功能能力的指标。

DESCRIPTION (provided by applicant): The proportion of Veterans over age 65 has risen from 11% to 26% from 1980 to 1990, and is estimated to rise to over 50% by 2030 (Hisnanik, 1994). Due to the growing number of older Veterans, health issues specific to the aging Veteran population is a primary concern for the Veterans Health Administration. Fear of developing dementia is common among older adults (Commisseris, Ponds, & Jollees, 1998; Corner & Bond, 2004) and minor memory lapses that were previously of little concern may be misinterpreted as signaling the beginning stages of dementia (Commissaris et al., 1994). Although normal cognitive aging is not the same as pathological aging, the impact of normal age-related changes warrants intervention since it can cause emotional distress and functional difficulties impacting occupational, recreational, and social pursuits (Royall et al., 2004, 2005; Dodge et al., 2008) and subjective cognitive impairment, defined as a noticed cognitive change without objective evidence of decline on neuropsychological testing may be the earliest precursor for dementia (Reisberg, et al., 2010). While cognitive changes can be expected as we age, there is a growing body of literature demonstrating that modifiable lifestyle factors can influence functional ability and quality of lif as one ages (Depp, Vahia, & Jeste, 2010; LaRue, 2010). In addition, cognitive training may result in improvements in cognition and functioning in older adults (Unverzagt et al., 2009; Papp et al., 2009; Lustig et al., 2009). Unfortunately, many older adults lack knowledge about cognitive aging and the factors that contribute to successful cognitive aging, which limits their ability to make changes that can improve the odds of successful cognitive aging (Anderson et al., 2009). The need to disseminate information related to brain health has recently been recognized by key agencies involved in promoting the welfare of older adults, including the National Institutes of Neurological Disorders and Stroke, Mental Health, and Aging (the Cognitive and Emotional Health Project; Hendrie et al., 2006) as well as the Centers for Disease Control and Prevention and the Alzheimer's Association (the Healthy Brain Initiative; 2007). The current study builds upon previous work on cognitive intervention in older adults by investigating a multi-component intervention which includes psychoeducation about cognitive aging, presentation of lifestyle factors that contribute to successful cognitive aging, and broad cognitiv skills training. Using a randomized controlled trial design, 72 Veterans will be assigned to either the intervention group (36) or a no treatment control group (36). Veterans will undergo baseline assessment, which will be used for comparison immediately following the intervention and at 3 and 6 month follow- up. Outcomes include knowledge of cognitive aging, measures of psychological wellness, and indicators of cognitive and functional ability.