Computerized Cognitive Training to Improve Cognition in Diabetic Elderly Veterans

计算机认知训练可提高患有糖尿病的老年退伍军人的认知能力

• 批准号: 9812757
• 负责人: Jeremy M. Silverman
• 金额: --
• 依托单位: JAMES J PETERS VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2020-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9812757
• 关键词: Adherence; Affect; Age; Alzheimer' s Disease; Area; Attention; BRAIN initiative; Behavior; Behavioral; Blood; Blood Pressure; Brain; Centers for Disease Control and Prevention (U.S.); Characteristics; Clinical; Cognition; Cognitive; Data; Dementia; Demographic Impact; Diabetes Mellitus; Disease; Education; Educational Intervention; Elderly; Epidemiology; Ethnic Origin; Evaluation; Evaluation Research; Family; Family history of; Foundations; Glycosylated hemoglobin A; Health; Health Benefit; Hour; Impaired cognition; Impairment; Incidence; Individual; Intervention; Investigation; Life Style; Measurement; Memory; Mental Depression; Methods; Minor; Modeling; Monitor; Multimedia; Outcome; Participant; Patient Self-Report; Persons; Pharmaceutical Preparations; Population; Prevention; Prevention strategy; Psyche structure; Randomized; Randomized Controlled Trials; Recording of previous events; Records; Research; Risk; Self Management; Senile Plaques; Services; Site; Structure; Time; Training; Training Programs; Veterans; active control; behavioral outcome; blood pressure regulation; clinical implementation; cognitive benefits; cognitive function; cognitive training; computerized; cost; dementia risk; design; diabetic; diabetic patient; drug discovery; executive function; flexibility; glycemic control; health literacy; high risk; improved; innovation; instructor; instrumental activity of daily living; intervention effect; lifestyle factors; lifestyle intervention; medication compliance; middle age; mild cognitive impairment; neurogenesis; neuropathology; non-demented; non-diabetic; novel; prevent; primary outcome; programs; recruit; residence; response

DESCRIPTION (provided by applicant): Project Background: Diabetes mellitus (DM) has consistently been associated with increased risk for cognitive decline, mild cognitive impairment, and dementia in the elderly. Even minor cognitive impairments in nondemented individuals dramatically affect disease self-management. This, in turn, is associated with poor glycemic and blood pressure control in diabetes, which by themselves increase the risk of dementia, provoking a reinforcing cycle of disease. Thus, it is imperative to find interventions to delay or prevent cognitive compromise in diabetic patients, that can be relatively easily and rapidly implemented, and that are not cost prohibitive. This is especially true in the VA, in view of the high incidence of both diabetes and dementia in our growing population of elderly Veterans. Epidemiologic evidence suggests modifiable life-style factors, including cognitive activity, may prevent or delay the onset of cognitive decline. Computerized cognitive training (CCT) is an intervention that has shown promising results in the improvement of cognitive functioning, more consistently in non-demented elderly, with additional benefits from booster training sessions. To date, studies of CCT have typically only examined cognitive outcomes, and only shortly after the intervention. The proposed CCT program, Personal Coach from Cognifit, is designed to improve cognition of elderly persons by targeting their weak cognitive functions, using a personally tailored training plan. The proposed study will provide the first evaluation of the effects of CCT on DM self-management behavior and clinical outcomes, in addition to cognition. Project Objectives: Aim 1A: To determine whether the CCT, relative to the active control games program, improves cognition (memory and executive functions/attention), DM-related behavior (DM self-management and medication adherence), and clinical outcomes (glycemic and blood pressure control), 6 and 12 months after the intervention. Aim 1B: To demonstrate efficacy by improvement in behavioral outcomes (DM self-management and medication adherence) 6 months after the intervention. Aim 2: To document the effects of CCT on the successive changes in memory and executive functions/attention, DM self-management and medication adherence, and glycemic and blood pressure control. Aim 3: To explore the impact of demographic (age, education, ethnicity, site) and health (ADL/IADL, health literacy, depression, dementia family history, lifestyle factors) characteristics, on the intervention effects. Project Methods: Non-demented DM elderly from the James J. Peters (Bronx, NY) and Ann Arbor (MI) VAMCs will be randomized to CCT or games intervention and perform the respective program 3 times/week, for 20 minutes, during eight weeks. Four months after the intervention, subjects will receive a 1-week booster training. Subjects will be assessed at baseline; and immediately, 6 months, and 12 months after the intervention. At each time point, assessments will be cognitive function, DM self-management, and blood pressure; blood will be drawn for HbA1c measurement. VA records will be used to monitor medication adherence. Longitudinal mixed model analyses will assess the effects of the intervention on change in outcomes over time. Path analyses will evaluate the inter-relationships among changes in cognition, DM self- management, and clinical outcomes for each intervention at 6 and 12 months.

描述（由申请人提供）：