Meaningful Activity Intervention for Individuals With Early-Stage Dementia: Involving the End User in Intervention Design

对早期痴呆症患者进行有意义的活动干预：让最终用户参与干预设计

• 批准号: 9918836
• 负责人: Natalie Grace Regier
• 金额: $ 17.21万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9918836
• 关键词: Address; Affect; Aggressive behavior; Agitation; Alzheimer' s Disease; Awareness; Biological Markers; Boredom; Caregivers; Characteristics; Clinic; Clinical Investigator; Cognition; Communities; Degenerative Disorder; Dementia; Development; Disease; Disease Progression; Distress; Elderly; Emotions; Exclusion; Failure; Feedback; Focus Groups; Frequencies; Home environment; Individual; Intervention; Intervention Studies; Lead; Link; Literature; Location; Loneliness; Long-Term Care; Measures; Medical center; Memory; Mentored Patient-Oriented Research Career Development Award; Neurologic; Outcome; Participant; Personal Satisfaction; Persons; Pilot Projects; Plant Roots; Play; Population; Prevalence; Protocols documentation; Public Health; Randomized Controlled Trials; Research; Research Personnel; Role; Sensory Deprivation; Series; Services; Severities; Targeted Research; Testing; Therapeutic Intervention; Training; Treatment Efficacy; Universities; Work; adverse outcome; base; career; catalyst; dementia care; depressive symptoms; design; expectation; improved; informant; interest; knowledge base; neuropsychiatric symptom; novel; open label; preservation; prototype; randomized trial; recruit; social; symptom management; symptomatology; therapy design; therapy development; treatment planning

Abstract The aim of this NIA Mentored Patient-Oriented Research Career Development Award application is to support my career objective to become an independent clinical investigator specializing in the design and implementation of non-pharmacological interventions for persons with dementia. Throughout the literature, the majority of intervention studies have targeted persons with at least moderate dementia and have not involved the person with dementia in the construction of the intervention(s). In preliminary studies on which I served as a co-investigator, tailored interventions demonstrated beneficial impact on neuropsychiatric symptoms of dementia but did not significantly impact measures of well- being (i.e., depressive symptomatology). Thus, it is important to examine whether intervention implementation at an earlier stage of dementia and greater involvement of persons with dementia in the intervention design lead to better immediate and long-term outcomes. I propose a training plan that will facilitate the development of a protocol for the collaborative creation of a tailored activity plan. This training plan will also allow me to gain the necessary knowledge base to conduct a larger, randomized controlled trial that incorporates neurological biomarkers of dementia. The proposed five-year research plan represents a novel and critical contribution to the field by developing the first service user- led meaningful activity intervention for persons with early-stage dementia. The specific aims of the proposed research are to: (1) identify delivery characteristics of an activity intervention for persons with dementia at the early stage, (2) evaluate the feasibility, acceptability, and initial potential benefits of this protocol, and (3) evaluate the feasibility of the revised protocol and examine its effects on outcomes. An exploratory aim is to evaluate whether the activities are used independently of the intervention (i.e., sustainable). A total of 60 community-dwelling older adults with early dementia (≥60 years) will be recruited to participate in the pilot study. These participants will be drawn from the Johns Hopkins University Maximizing Independence (MIND) at Home study, the Johns Hopkins Bayview Medical Center Memory Clinic, and community-based social agencies such as the Alzheimer’s Association. The expectation is that the findings from this project will ultimately advance the field of dementia care through analysis of the long-term benefits of implementing activities early-on and the benefits to persons with dementia of participating in intervention design.

摘要 这个NIA指导的以患者为导向的研究职业发展奖的目的 申请是为了支持我的职业目标，成为一名独立的临床研究者 专门设计和实施非药物干预， 痴呆症患者。纵观文献，大多数干预研究 目标人群至少患有中度痴呆症，并且没有涉及患有 在干预措施的建设中的痴呆症。在我参与的初步研究中， 作为共同研究者，量身定制的干预措施对 神经精神症状的痴呆，但没有显着影响措施的良好， 是（即，抑郁症）。因此，重要的是要检查是否 在老年痴呆症的早期阶段实施干预措施， 痴呆症患者在干预设计导致更好的即时和长期 结果。我提出了一项培训计划，将有助于制定一项议定书， 协作创建定制的活动计划。这个训练计划也会让我 进行更大规模的随机对照试验所需的知识基础， 结合了痴呆症的神经生物标志物。五年研究计划 通过开发第一个服务用户- 对早期痴呆症患者进行有意义的活动干预。具体目标 建议的研究是：（1）确定一个活动的交付特性 对痴呆症患者进行早期干预，（2）评估可行性， 可接受性和本方案的初始潜在受益，以及（3）评价 修订后的议定书，并审查其对结果的影响。一个探索性的目标是评估 活动是否独立于干预使用（即，可持续）。了60余 将招募患有早期痴呆症（≥60岁）的社区居住老年人， 参与试点研究。这些参与者将来自约翰霍普金斯大学 约翰霍普金斯湾景大学最大化独立性（MIND）研究 医疗中心记忆诊所，以及社区为基础的社会机构，如 老年痴呆症协会。我们期望这个项目的结果最终能 通过分析老年痴呆症的长期益处， 开展早期活动，以及痴呆症患者参加 干预设计