Interventions to Attenuate Cognitive Decline

项目总结 已经开发了不同的认知干预方法来减轻下降(例如，认知参与- 训练或刺激)，但还不清楚哪种方法是有效的。目前也不清楚何时， 从正常认知老化到轻度认知障碍(MCI--之前的过渡阶段 痴呆症发作)，最有效的方法是干预。至关重要的是，有效认知的潜在机制-- 发明还不为人所知；这是这一领域取得进展的关键障碍。迫切需要找出有效的 遏制痴呆症日益流行的方法。总体目标是应用最好的认知 旨在减轻认知和功能衰退并遏制痴呆症流行的干预措施。长期目标 是促进老年人保持健康和独立。[这项随机临床试验将取消- 终止一种新的认知介入干预方法(高强度钢琴训练)的有效性。 相比于认知刺激(这将是一种严格的、主动的控制)]。从理论上讲，中央银行 假说是，增强中枢听觉处理(CAP)的干预措施是一种强有力的纵向预测因素 MCI和痴呆症，将改善认知。音乐培训越来越被认为是一种可行的手段，以达到- 与年龄相关的认知功能减退。先前的研究和我们的初步数据表明，高强度的钢琴训练- ING可增强CAP，可能比认知刺激更有效。[相关研究表明SU- 接受过正规音乐训练的成年人的周边CAP、执行功能和其他认知能力与 非音乐家。我们在三个试点随机试验中的结果表明，钢琴训练可以提高老年人的 CAP和行政职能，包括MCI的职能]。这项研究的具体目的是考察其对经济增长的影响。 高强度钢琴训练相对于认知刺激(主动控制)改善CAP、认知和 患有和不患有MCI的老年人的日常功能。钢琴训练的有效性将被确立 并将考察MCI状态的调节作用。这项拟议的研究进一步旨在阐明联合国与联合国的关系。 通过探索训练收益的中介，揭示有效认知干预方法的机制。 研究结果将是确定有效的干预方法来减弱与年龄相关的认知 并对其功能衰退机制进行了阐述。我们认为，拟议的研究具有创新性，因为 钢琴训练增强老年人认知的第一阶段II随机试验。此外，这项研究是 通过纳入患有和不患有MCI的老年人并评估对日常功能的影响来实现创新 性能。最重要的是，为了推动这一领域的发展，我们将使用调解分析来阐明潜在的 干预效果的机制。这些贡献将是巨大的，促进了我们对 认知干预会导致认知和功能的改变。结果将有助于改进设计和改进产品。 实施有效的干预措施，以减缓认知衰退和遏制痴呆症的流行， 从而改善公共健康。

PROJECT SUMMARY Different cognitive intervention approaches have been developed to attenuate decline (e.g., cognitive engage- ment, training, or stimulation), but it is not clear which approaches are efficacious. It is also not clear when, along the continuum of normal cognitive aging to mild cognitive impairment (MCI-a transitional stage before dementia onset), it is most effective to intervene. Crucially, the underlying mechanisms of effective cognitive in- terventions are not known; a critical barrier to progress in this field. There is an urgent need to identify effective approaches to curb the increasing prevalence of dementia. The overall objective is to apply the best cognitive interventions to attenuate cognitive and functional decline and curb dementia prevalence. The long-term goals are to promote maintained health and independence among older adults. [This randomized clinical trial will de- termine the efficacy of a novel cognitive engagement intervention approach (intense piano training) as com- pared to cognitive stimulation (which will serve as a stringent, active control)]. Grounded in theory, the central hypothesis is that interventions enhancing central auditory processing (CAP), a strong, longitudinal predictor of MCI and dementia, will improve cognition. Music training is increasingly recognized as a feasible means to at- tenuate age-related cognitive decline. Prior research and our preliminary data suggest that intense piano train- ing may enhance CAP and is likely more effective than cognitive stimulation. [Correlational studies indicate su- perior CAP, executive function, and other cognitive abilities for adults with formal music training compared to non-musicians. Our results across three pilot randomized trials show that piano training improves older adults' CAP and executive function, including those with MCI]. The specific aims of the study are to examine the effi- cacy of intense piano training relative to cognitive stimulation (active controls) to improve CAP, cognition, and everyday function among older adults with and without MCI. The efficacy of piano training will be established and moderating effects of MCI status will be examined. The proposed study further aims to elucidate the un- derlying mechanisms of effective cognitive intervention approaches by exploring mediators of training gains. Study outcomes will be identification of effective intervention approaches to attenuate age-related cognitive and functional decline and elucidation of the mechanisms. The proposed study is innovative, in our opinion, as the first phase II randomized trial of piano training to enhance older adults' cognition. Moreover, this study is innovative by including older individuals with and without MCI and assessing effects on everyday functional performance. Most importantly, to advance this field, we will use mediation analyses to elucidate the underlying mechanisms of intervention effects. The contributions will be significant, advancing our understanding of how cognitive interventions produce cognitive and functional change. Results will facilitate improved design and im- plementation of effective interventions to attenuate cognitive decline and curb the prevalence of dementia, thereby improving public health.