A Pilot of Memory Support System for Older Chinese Americans with Mild Cognitive Impairment

项目摘要 在过去的几十年里，美国华裔老年人口一直在增加，患老年痴呆症的风险也在增加。 疾病和阿尔茨海默病相关痴呆（AD/ADRD）也在增加。尽管迫切需要 增加美国临床试验参与的种族/民族多样性，老年华裔美国人仍然是历史上 在AD/ADRD研究中，由于缺乏文化和语言上的 适当的学习材料和评估工具。使用中文翻译的临床措施 和认知测试，研究PI（李）成功地招募了200多名老年华裔美国人参加临床研究 在西奈山的阿尔茨海默病研究中心（ADRC）。样本中，超过80%的非痴呆患者 老年人，为AD/ADRD的早期干预和治疗提供了一个机会窗口。由于大部分 的年长华裔美国人是在外国出生的，英语水平有限或没有，他们经常被排除在外， 由于英语水平是入选标准之一，因此，存储器 支持系统（MSS）的健康行动，以造福独立和思考（HABIT）计划是一个 有希望的轻度认知障碍（MCI）的非药物干预。先前的数据表明， MSS对记忆、适应功能、生活质量、抑郁和焦虑的自我效能的有效性 参与者和他们的研究伙伴，具有良好的留存率。然而，MSS主要是 开发并用于非西班牙裔白色，讲英语的成年人。此外，关于 MSS对与早期AD/ADRD相关的认知和神经精神症状的有效性这里 一个研究小组提出了一个为期2年的研究，翻译和适应MSS材料和评估工具，从英语 普通话和广东话--这是美国仅次于英语和西班牙语的最常用语言。这 这项研究将利用李博士在研究招募和招募华裔美国老年人方面的专业知识， 回答以下问题：1）MSS的中文翻译和文化适应是否有效 在AD/ADRD临床试验中招募和招募华裔美国人？(2)患有MCI的华裔美国人和 他们的学习伙伴学习和使用MSS？(3)MSS能否有效缓解AD/ADRD的早期症状 在年长的华裔美国人中该小组将与主要的社区利益相关者合作，以确保 教材和测试在文化和语言上适合这一人群。利用老年人 在西奈山ADRC的华裔美国人队列中，首要目标是将MSS扩展到老年人， 通过发展语言和文化上适当的适应，帮助患有MCI的华裔美国人。使用30 普通话和30名说粤语的MCI老年人及其研究伙伴，主要结果是 招聘、保留和完成率，以评估可行性。该小组还将检查疗效， 在这个例子中的MSS的效用。这项研究的结果将为支持大规模临床试验提供试点数据 随访时间更长。

Project Summary The older Chinese American population has been rising for the last few decades, with the risk of Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias (AD/ADRD) also increasing. Despite the pressing need to increase racial/ethnic diversity in clinical trial participation in the US, older Chinese Americans remain historically underrepresented and understudied in AD/ADRD research due to a lack of culturally and linguistically appropriate study materials and assessment tools. Using Chinese language translations of clinical measures and cognitive tests, the study PI (Li) successfully enrolled over 200 older Chinese Americans in clinical research at the Alzheimer’s Disease Research Center (ADRC) at Mount Sinai. The sample, with over 80% non-demented older adults, provides a window of opportunity for early intervention and treatment of AD/ADRD. Since a majority of older Chinese Americans are foreign born with limited to no English proficiency, they are frequently excluded from clinical trial participation as English language proficiency is one of the inclusionary criteria. The Memory Support System (MSS) from the Healthy Action to Benefit Independence & Thinking® (HABIT) Program is a promising non-pharmacological intervention for Mild Cognitive Impairment (MCI). Prior data suggest the effectiveness of MSS on self-efficacy for memory, adapted functioning, quality of life, depression, and anxiety in the participants and their study partners, with an excellent retention rate. However, the MSS was primarily developed and used on non-Hispanic White, English-speaking adults. Additionally, little is known regarding the effectiveness of MSS on cognitive and neuropsychiatric symptoms associated with early AD/ADRD. Here, the study team proposes a 2-year study to translate and adapt the MSS materials and assessment tools from English into Mandarin and Cantonese - the most common spoken languages in the US after English and Spanish. This study will leverage Dr. Li’s expertise in research recruitment and enrollment of Chinese American older adults to answer the following questions: 1) Does Chinese language translation and cultural adaptation of MSS effectively engage and recruit Chinese Americans in clinical trials for AD/ADRD? (2) Can Chinese Americans with MCI and their study partners learn and use the MSS? (3) Is the MSS effective in mitigating early symptoms of AD/ADRD in older Chinese Americans? The team will collaborate with key community stakeholders to ensure that the materials and tests are culturally and linguistically appropriate for this population. Capitalizing on the older Chinese American cohort at the ADRC at Mount Sinai, the overarching goal is to extend the MSS to older Chinese Americans with MCI by developing a linguistically and culturally appropriate adaption. Using 30 Mandarin- and 30 Cantonese-speaking older adults with MCI and their study partners, the primary outcomes are recruitment, retention, and completion rates to assess feasibility. The team will also examine the efficacy and utility of MSS in this sample. Findings from this study will provide pilot data to support a large-scale clinical trial with longer follow-up periods.