Promoting Physical Activity to Improve Cognitive Function in Older Adults Undergoing Hematopoietic Cell Transplantation (HCT)

促进身体活动以改善接受造血细胞移植 (HCT) 的老年人的认知功能

基本信息

批准号：
10298917
负责人：
Thuy Koll
金额：
$ 19.02万
依托单位：
UNIVERSITY OF NEBRASKA MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-30 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10298917
关键词：
Address Adoption Adult Affect Age Age-Years Attention Behavioral Sciences Brain Cancer Survivor Cancer Survivorship Chronic Clinical Cognition Cognition Disorders Cognitive aging Collaborations Communities Community Health Data Dissemination and Implementation Distress Effectiveness Elderly Evaluation Exercise Exercise Test Feedback Future Geriatrics Guidelines Health Hematologic Neoplasms Hospitalization Immune system Immunosuppression Impaired cognition Individual Inflammation Infusion procedures Intervention Interview K-Series Research Career Programs Knowledge Leadership Life Light Malignant Neoplasms Measures Memory Mentors Mentorship Methods Modeling Neuropsychological Tests Oncology Outcome Pathway interactions Patient Care Patients Perception Performance Physical Function Physical activity Population Positioning Attribute Process Quality of life Radiation therapy Reach, Effectiveness, Adoption, Implementation, and Maintenance Research Research Personnel Risk Role Severities Structure Survivors Target Populations Testing Toxic effect Training Translations Transplant Recipients Transplantation Vulnerable Populations Work active control base cancer therapy cardiorespiratory fitness chemotherapy clinical practice clinical trial implementation cognitive benefits cognitive change cognitive function collaborative approach design disability effectiveness evaluation effectiveness implementation design effectiveness implementation study effectiveness research evidence base executive function exercise intervention exercise training experience functional outcomes hematopoietic cell transplantation high risk implementation determinants implementation intervention implementation research implementation science implementation strategy improved innovation member novel older patient preservation prevent primary outcome programs secondary outcome sedentary activity skills stem cells translational study trial design

项目摘要

PROJECT SUMMARY Cancer and treatment-related cognitive changes cause distress, hinder resumption of normal routine and roles, and worsen quality of life. Hematopoietic cell transplantation (HCT) is a potentially life-prolonging treatment for patients with hematological malignancies. HCT differs from the delivery of chemotherapy in other cancer settings due to the intensity of chemotherapy and severity of toxicity. Previously reserved for younger patients, in the past decade a growing number of adults 60 years of age and older have received this intense treatment. Our preliminary data shows that post-HCT, 35% of older patients experience significant cognitive impairment compared to 19% pre-HCT. Physical activity improves cognitive function in older adults and survivors of other cancers. While untested in older adults undergoing HCT, we hypothesize that increasing physical activity can also improve cognitive function in this vulnerable population. The objective of this proposal is to adapt and test an evidence-based physical activity intervention, The Community Health Activities Model Program for Seniors II (CHAMPS II), in the HCT setting to improve cognitive function for adults 60 years and older. This program is effective in increasing physical activity for sedentary community-dwelling older adults with multiple chronic health conditions. We will iteratively adapt and implement CHAMPS-II in three waves. During each wave, 2-4 patient/care-partner dyads will participate in a multi-phase, light- to moderate-intensity physical activity program. We will use a Type 1 hybrid effectiveness-implementation design to determine the preliminary effectiveness of the adapted intervention to improve cognitive function compared to an active control condition (N = 34 per group). This novel trial design spans the effectiveness and implementation research to accelerate the translation of physical activity interventions into practice for older adults with cancer. The translation of physical activity interventions into clinical practice remains challenging within cancer survivorship, despite promising evidence of efficacy in improving functional outcomes and quality of life. To become an independent researcher who develops, implements, and disseminates interventions that prevent cognitive decline and improve functional outcomes for older patients with cancer, Dr. Koll requires additional training and experience in: 1) physical activity promotion and principles of exercise training; 2) design and conduct of hybrid effectiveness-implementation clinical trials; and 3) leadership and project management skills needed to execute translational studies requiring collaboration between researchers and clinicians. An outstanding team of mentors and advisors support this proposal with expertise in geriatrics (Fisher), behavioral and implementation science (Estabrooks), clinical exercise trials in older adult and cancer populations (Ehlers), geriatric oncology (Wildes), cognitive disorders and cognitive aging (Murman), and mixed methods (Jones). The training and research plan will position Dr. Koll to become one of the few geriatricians with expertise in cognition and cognition-enhancing interventions in older adults with cancer.

项目摘要癌症和与治疗相关的认知变化会导致困扰，阻碍正常常规和角色的恢复，并恶化生活质量。造血细胞移植（HCT）是一种潜在的生命疗法血液学恶性肿瘤的患者。 HCT与在其他癌症环境中化学疗法的递送不同由于化疗的强度和毒性的严重程度。以前保留给年轻患者，过去十年越来越多的60岁及以上的成年人接受了这种强烈的治疗。我们的初步数据表明，HCT后35％的老年患者遭受严重的认知障碍与HCT前相比19％。体育锻炼改善了老年人的认知功能和其他的幸存者癌症。虽然在接受HCT的老年人中未经测试，但我们假设体育锻炼的增加可以还提高了这个脆弱人群的认知功能。该提案的目的是调整和测试基于证据的体育活动干预措施，《社区健康活动模型ii》 II （Champs II），在HCT设置中，以改善60岁以上的成年人的认知功能。这个程序是有效增加具有多个慢性健康的久坐社区居住的老年人的体育锻炼状况。我们将在三波中迭代地适应和实施Champs-II。在每个波中，2-4 患者/护理人员二元组将参加多相，轻度至中等强度的体育锻炼计划。我们将使用1型混合有效性 - 实现设计来确定与主动对照条件相比，适应性的干预措施可改善认知功能（每组n = 34）。这种新颖的试验设计涵盖了加速翻译的有效性和实施研究癌症老年人的体育锻炼干预措施。体育锻炼的翻译尽管有希望的证据表明改善功能结果和生活质量的功效。成为一名独立研究人员发展，实施和传播干预措施，以防止认知能力下降并提高功能癌症老年患者的结果，科尔博士需要额外的培训和经验：1）体育锻炼晋升和运动训练原则； 2）设计和进行混合有效性实施临床试验； 3）执行翻译研究所需的领导和项目管理技能研究人员与临床医生之间的合作。一个杰出的导师和顾问团队支持这一点具有老年医学专业知识（Fisher），行为和实施科学（Estabrooks）的建议，临床老年人和癌症种群（EHLERS），老年肿瘤学（WILDES），认知障碍和认知衰老（穆尔曼）和混合方法（琼斯）。培训和研究计划将把科尔博士定位为成为少数在认知和认知增强干预措施方面具有专业知识的老年医生之一成人癌症。