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

针对患有轻度认知障碍的老年华裔美国人的记忆支持系统试点

• 批准号: 10728571
• 负责人: Clara Li
• 金额: $ 56.11万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10728571
• 关键词: Adherence; Adult; Age; Alzheimer disease prevention; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Anxiety; Asian Americans; Assessment tool; Calendar; Caregiver Burden; Caregivers; Chinese; Chinese American; Chronic; Clinical; Clinical Research; Clinical Trials; Cognition; Cognitive; Collaborations; Communities; Control Groups; Data; Dementia; Development; Early Intervention; Early treatment; Education; Effectiveness; Elderly; English Language; Enrollment; Ethnic Population; Exclusion; Feedback; Focus Groups; Goals; Impaired cognition; Independent Living; Individual; Intervention; Language; Learning; Life; Limited English Proficiency; Linguistics; Measures; Memory; Mental Depression; Moods; Neurobehavioral Manifestations; Not Hispanic or Latino; Older Population; Participant; Persons; Pharmacological Treatment; Population; Prevention; Prevention trial; Quality of life; Race; Randomized, Controlled Trials; Registries; Reporting; Research; Research Methodology; Risk; Sample Size; Sampling; Self Efficacy; Serious Adverse Event; Site; Support System; Symptoms; System; Testing; Thinking; Training; Translating; Translations; Writing; associated symptom; bilingualism; clinical translation; cognitive testing; cohort; community based participatory research; daily functioning; design; efficacy evaluation; ethnic diversity; evidence base; experience; follow-up; functional decline; functional disability; improved; instrumental activity of daily living; mild cognitive impairment; neuropsychiatric symptom; non-demented; preservation; primary outcome; programs; randomized trial; recruit; retention rate; satisfaction; success; symptom treatment; treatment adherence

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.

项目摘要 在过去的几十年中 疾病和阿尔茨海默氏病与疾病相关的痴呆症（AD/ADRD）也在增加。尽管紧迫 增加种族/种族多样性在美国的临床试验参与中，在历史上仍然是年长的华裔美国人 由于缺乏文化和语言，在AD/ADRD研究中的代表性不足和理解 适当的学习材料和评估工具。使用临床测量的中文翻译 和认知测试，研究PI（LI）成功招募了200多名中国美国人的临床研究 在西奈山的阿尔茨海默氏病研究中心（ADRC）。样本，超过80％未痴呆 老年人为早期干预和AD/ADRD治疗提供了机会之窗。自多数 中国美国人的外国人天生有限，不受英语水平的限制，他们经常被排除在外 从临床试验参与中，作为英语水平是包容性标准之一。内存 支持系统（MSS）从健康行动中受益于独立性和思维®（习惯）计划是一个 有希望的非药理学干预措施对轻度认知障碍（MCI）。先前的数据表明 MSS对记忆，适应功能，生活质量，抑郁和动画的自我效能的有效性 参与者及其学习伙伴的保留率很高。但是，MSS是主要的 开发并用于非西班牙裔白人，讲英语的成年人。此外，关于 MSS对与早期/ADRD相关的认知和神经精神症状的有效性。在这里， 研究团队提案为期两年的研究，以翻译和调整英语的MSS材料和评估工具 进入普通话和广东话 - 美国最常见的语言是英语和西班牙语。这 研究将利用Li博士在研究招聘和入学的美国老年人的专业知识 回答以下问题：1）中文翻译和MSS的文化适应是否有效 参与和招募中国美国人参加广告/ADRD的临床试验？ （2）与MCI和MCI一起的中国美国人可以 他们的学习伙伴学习和使用MSS？ （3）MSS是有效缓解AD/ADRD早期症状的有效的 在中国年长的美国人中？团队将与关键社区利益相关者合作，以确保 材料和测试在文化和语言上适合该人群。利用较老的 西奈山ADRC的中国美式队列，总体目标是将MSS扩展到年长 与MCI的中国美国人通过在语言和文化上适当的适应来开发MCI。使用30 普通话和30个讲广东话的老年人与MCI及其学习伙伴，主要结果是 招聘，保留和完成率以评估可行性。团队还将检查效率和 该样本中MSS的实用性。这项研究的发现将提供试验数据以支持大规模临床试验 随访期更长。