A novel computer-based functional skills assessment and training program

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Abstract People with cognitive impairments such as those with dementia or Mild Cognitive Impairment (MCI), often experience difficulty performing everyday routine activities, particularly those involving technology as it generally involves new learning. Further, normative age-related changes in cognition often lead to performance deficits on previously learned skills and also impede new learning, such as learning to use new technology systems, which are ubiquitous in today's technology driven world. This is of great concern given the aging of the population, the increasing number of older adults with cognitive impairments, and the continual deployment of new technologies in everyday contexts. Currently, there is a vast interest in developing tools to detect the earliest manifestations of cognitive and functional decline and in developing efficacious pharmacological and non-pharmacological interventions for those who are experiencing or at risk for cognitive and functional problems. The proposed Phase 1 study will refine and evaluate a novel integrated computer-based functional skills assessment and training (FST) program that provides training on everyday tasks critical to independent living (e.g., financial and medication management). The tasks in the program are veridical representations of everyday activities and real world systems and the training is tailored to the unique needs of an individual via the assessment component. The sample will include 75 non-impaired older adults and 75 adults with MCI, who will be randomly assigned to the FST condition, a cognitive rehabilitation training (CRT) condition or a combined FST/CRT condition. This design will allow us to examine the specificity of effects and examine the benefits of direct functional skill training relative to CRT on functional skills (FS) and cognitive outcomes and to determine if CRT provides a priming effect that further enhances the benefits of FST. Outcome measures will include objective measures of cognitive and functional abilities, self and informant reports of everyday task performance, and measures of self-efficacy and the acceptability and usability of the program. We will also gather data on the maintenance of training gains over time. The overall objective of the proposed Phase 1 study is to develop an integrated commercially available technology-based functional skills assessment and training program that can be deployed on a variety of technology platforms such as tablets or PCs and used in a variety of settings (e.g., clinical settings, home environments) with diverse adult populations. Ultimately our long term goal is to develop a product that can help prevent and treat functional declines and maintain the cognitive health and functional independence of older adults.