Assessing and Improving the Durability of Compensatory Cognitive Training for Older Veterans (AID-CCT)

认知能力下降是衰老和神经精神疾病的常见后果，可导致痴呆症 和日常功能活动的损害，这反过来又可能促使机构安置和丧失 独立退伍军人认知能力下降的风险增加，退伍军人事务部现在正在为他们提供医疗保健。 大量老年退伍军人报告了重大的认知投诉，日常生活困难， 功能，以及对即将发生的痴呆症的担忧。旨在扭转或减轻艾滋病毒/艾滋病后果的治疗 迫切需要下降。我们的研究团队先前已经开发并验证了以下方案： 补偿性认知训练（CCT）干预措施，训练与以下方面相关的认知策略和习惯： 注意力、学习/记忆和执行功能，以改善真实的世界中的日常功能。尽管 明确的，立即的，基于CCT的认知和日常功能的收益，退伍军人有多种原因， 认知障碍，CCT的长期持久性仍然存在问题。此外，虽然系统 综述和荟萃分析表明，加强干预会议可以帮助维持治疗收益，这些 尚未开发用于CCT。 建议的综合发展区提供了一个黄金机会，以评估持续关连交易的长期耐用性，并发展 并对加强治疗的效果进行试点测试。具体目的是：1）评价CCT在24个月时的耐久性 在认知表现、基于表现的功能能力、主观功能和质量方面 2）开发一系列CCT强化干预模块，重点关注认知和日常生活方面 功能，以及3）进行CCT加强干预的试点随机对照试验（RCT），以建立 可行性和可接受性。我们将招募55岁或以上的退伍军人，他们以前参加过VA Merit 轻度认知障碍老年退伍军人CCT研究[CSRD：I 01 CX 001592; PI：Twamley]。 杰奎琳·梅耶博士目前是VA圣地亚哥医疗保健系统的博士后研究员。 她的长期职业目标是成为一名独立的，VA资助的研究人员，专注于改善认知健康 为老年人服务。培训目标以认知康复概念和研究为中心 实践，针对有认知障碍的老年退伍军人的RCT，先进的纵向技术，以及 专业发展。拟议的研究补充了这些目标，与导师团队，其中包括 老龄化、认知康复、干预和RCT设计方面的专家，以及先进的统计方法。 项目结果将是至关重要的候选人的使命，以推进认知康复科学和交付 通过CCT为退伍军人提供长期、持续的福利。结果将告知后CDA研究目标， 与未来的CCT参与者广泛实施助推器。

Cognitive decline is a common consequence of aging and neuropsychiatric conditions that can lead to dementia and impairment in everyday functional activities, which may in turn prompt institutional placement and loss of independence. Veterans are at increased risk of cognitive decline, and the VA is now providing health care to surging numbers of older Veterans who report significant cognitive complaints, difficulties with everyday functioning, and concerns about impending dementia. Treatments to reverse or reduce the consequences of decline are urgently needed. Our study team has previously developed and validated protocols for Compensatory Cognitive Training (CCT) interventions that train cognitive strategies and habits relevant to attention, learning/memory, and executive functioning to improve everyday functioning in the real world. Despite clear, immediate, CCT-based gains in cognitive and everyday functioning in Veterans with multiple causes of cognitive impairment, questions remain about the long-term durability of CCT. Additionally, while systematic reviews and meta-analyses indicate that booster intervention sessions can help maintain treatment gains, these have not yet been developed for CCT. The proposed CDA provides a golden opportunity to evaluate both the long-term durability of CCT and to develop and pilot test the effects of booster treatment. Specific aims are 1) to evaluate the durability of CCT at 24 months in the areas of cognitive performance, performance-based functional capacity, subjective functioning, and quality of life, 2) to develop a series of CCT booster intervention modules focused on aspects of cognition and everyday function, and 3) to conduct a pilot randomized controlled trial (RCT) of the CCT booster intervention to establish feasibility and acceptability. We will recruit Veterans aged 55 or older who previously participated in a VA Merit study of CCT for older Veterans with Mild Cognitive Impairment [CSRD: I01CX001592; PI: Twamley]. The candidate, Dr. Jacqueline Maye, is currently a Postdoctoral Fellow at the VA San Diego Healthcare System. Her long-term career goal is to be an independent, VA-funded investigator focused on improving cognitive health and function for older Veterans. Training objectives center on cognitive rehabilitation concepts and research practices, RCTs for older Veterans with cognitive impairments, advanced longitudinal techniques, and professional development. The proposed study complements these goals, with a mentorship team that includes experts in aging, cognitive rehabilitation, intervention and RCT design, and advanced statistical methodology. Project findings will be critical to the candidate’s mission to advance cognitive rehabilitation science and deliver long-term, sustained benefits to Veterans through CCT. Results will inform post-CDA research goals to implement boosters widely with future CCT participants.