The Adherence Promotion with Person-centered Technology (APPT) Project: Promoting Adherence to Enhance the Early Detection and Treatment of Cognitive Decline

以人为本的技术 (APPT) 项目的依从性促进：促进依从性以加强认知衰退的早期发现和治疗

基本信息

批准号：
10829509
负责人：
Walter Richard Boot
金额：
$ 1.7万
依托单位：
FLORIDA STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-01 至 2025-03-31
项目状态：
未结题

项目摘要

Many older adults experience declines in cognitive ability that can be substantial, including mild cognitive impairment and Alzheimer’s disease and AD-related dementia. Population aging, coupled with age-related cognitive impairment, including Alzheimer’s disease and other dementias, represents an unprecedented challenge. Early detection of cognitive impairment is a crucial goal. This would allow individuals at risk for mild cognitive impairment and/or AD/ADRD to adopt lifestyle changes to minimize decrements and the risk for acquired cognitive impairment. However, the massive potential of cognitive training and longitudinal assessment to detect and prevent age-related cognitive impairment and dementia are unlikely to be realized unless individuals are willing and able to engage with these protocols for an extended period of time. Adherence to cognitive assessment and training is often poor. Addressing the gap between potential and realized benefits of early detection and prevention of cognitive impairment is an urgent goal as the population ages. The aims of the Adherence Promotion with Person-centered Technology (APPT) project are to promote early detection and treatment of age-related cognitive impairment and dementia by 1) enhancing adherence to cognitive intervention and assessment protocols, 2) improving understanding of barriers to long-term adherence, and 3) assisting in the development of algorithms for predicting and preventing adherence failures. Projects aim to investigate these issues within samples of older adults with and without cognitive impairment. Two randomized controlled trials will test an adaptive, tailored, and integrated technology support system predicted to boost adherence to cognitive protocols, over and above a simpler scheduling and reminder system over 6 months. Studies will provide valuable and generalizable insight into not only the benefits of adherence support, but also the individual difference factors that shape protocol adherence (e.g., attitudes, cognitive ability, dementia status, health status, personality, technology proficiency). Data will inform the process of identifying individuals who would benefit from additional support, and predicting and preventing extended adherence failures before they happen. By increasing adherence, these studies will help improve early detection and treatment of cognitive impairment, which will ultimately extend older adults' functional independence, improving their lives and the lives of their families, and reducing care and support resources needed to address lost independence like that associated with Alzheimer’s disease and AD-related dementia. Further, intervention studies for dementia and Alzheimer’s disease can be made more efficient through tools for identifying individuals likely to experience decline before substantial cognitive impairment has occurred. Results have implications that extend far beyond cognitive impairment; the methods and mechanisms uncovered have broad implications for technology-mediated assessment and protocols to enhance health and well-being in general. The project consists of two large randomized controlled trials and smaller needs assessment and usability studies that will guide their development and deployment.

许多老年人的认知能力会下降，这可能是实质性的，包括轻度认知障碍以及阿尔茨海默氏病和与广告相关的痴呆症。人口衰老，再加上与年龄有关的认知障碍，包括阿尔茨海默氏病和其他痴呆症，这是一个前所未有的挑战。早期发现认知障碍是一个关键目标。这将使有危险中有轻度认知障碍和/或AD/ADRD的个人采用生活方式的改变，以最大程度地减少减少和获得认知障碍的风险。但是，除非个人愿意并有能力在很长一段时间内与这些方案互动，否则不太可能实现认知训练和纵向评估的巨大潜力。遵守认知评估和培训通常很差。随着人口年龄的增长，解决早期发现和预防认知障碍的潜在和实现的好处之间的差距和预防认知障碍之间的差距是一个紧迫的目标。以人为中心的技术（APPT）项目的依从性促进的目的是促进与年龄相关的认知障碍和痴呆症的早期检测和治疗1）提高对认知干预和评估方案的依从性，2）提高对长期依从性的障碍的理解，以及3）有助于预测和预测失败。项目旨在在患有和没有认知障碍的老年人样本中调查这些问题。两项随机对照试验将测试一个自适应，量身定制和集成的技术支持系统，预计将在6个月内提高遵守认知方案的依从性，超过更简单的计划和提醒系统。研究将提供宝贵而可普遍的见解，不仅对依从性支持的益处，还可以提供塑造协议依从性的个体差异因素（例如参加，认知能力，痴呆症状况，健康状况，人格，人格，技术能力）。数据将为识别将从额外支持中受益的个人，并在发生之前预测和预测扩展依从性失败的过程。通过提高依从性，这些研究将有助于改善对认知障碍的早期检测和治疗，这最终将扩大老年人的功能独立性，改善其家庭的生活和家庭生活，并减少与阿尔茨海默氏病相关的失去独立性所需的护理和支持资源。此外，可以通过在发生重大认知障碍之前识别一些人会经历下降的人来使痴呆症和阿尔茨海默氏病的干预研究更加有效。结果的含义远远超出了认知障碍。发现的方法和机制对技术介导的评估和协议具有广泛的影响，以增强健康和福祉。该项目由两个大型随机对照试验和较小的需求评估和可用性研究组成，可以指导其发展和部署。