Assessing Cognitive and Psychosocial Mechanisms of Useful Field of View Cognitive Training using Ecological Momentary Assessment

丧失独立性、认知能力下降和日常功能困难是非常令人担忧的领域， 老年人和他们的家人。从公共卫生的角度来看，使老年人能够 与养老院相比，他们在家中养老，每年将节省大约800亿美元。 有用的视野训练（UFOVt）是一种低成本，非侵入性的认知训练干预， 反复证明了可靠的转移效果，以维持认知，日常功能，健康， 最近，痴呆症的发病率降低了29%。重要的是，许多这些日常功能的影响， 在五到十年内保持，包括：保持驾驶机动性，故障车辆减少50% 日常生活的工具性活动（IADL）。虽然这显然是一个重要的， 有效的干预，介质，或机制，这一计划的基础是未知的。我们的整体 目的是评估日常生活中的认知和心理社会因素，这些因素导致了 UFOVt的日常功能。这项探索性的双盲试验将老年人随机分为20小时， UFOVt或20小时的活性对照组。我们会先评估认知和社会心理因素， 在日常生活中训练期间和训练后。然后，我们将比较这些因素，并评估它们如何影响 将UFOVt转移到日常功能中。我们的中心假设是，日常处理能力的提高 速度和注意力，高级认知功能的关键组成部分，将有最强的关系 日常功能的变化。这项探索性研究是第一次，将用于提供 与未来更大规模的随机对照试验相关的重要数据，该试验检查认知训练的介质 在一个有代表性的成年人样本中。这些信息将有助于今后更有效地开发 以家庭和社区为基础的干预措施，维持日常功能。

Loss of independence, cognitive decline, and difficulties in everyday function are areas of great concern for older adults and their families. From a public health perspective, successful efforts that enable older adults to age within their homes, as compared to nursing homes, will save an estimated $80 billion dollars per year. Useful Field of View training (UFOVt) is one low cost, noninvasive cognitive training intervention that has repeatedly demonstrated reliable transfer effects to maintained cognition, everyday function, health, and most recently, a 29% reduction in incident dementia. Importantly, many of these everyday function effects are maintained across five to ten years including: maintained driving mobility, 50% reduction in at-fault vehicle crashes, and maintained Instrumental Activities of Daily Living (IADL). Although clearly an important and effective intervention, the mediators, or mechanisms, underlying this program are unknown. Our overall objective is to assess the cognitive and psychosocial factors within daily life that account for the transfer of UFOVt to everyday function. This exploratory double-blind trial will randomize older adults to 20 hours of UFOVt or 20 hours of an active control group. We will assess cognitive and psychosocial factors before, during, and after training within daily life. We will then compare such factors and assess how they impact the transfer of UFOVt to everyday functioning. Our central hypothesis is that improvements in daily processing speed and attention, key components of higher order cognitive functions, will have the strongest relationship with everyday function changes. This exploratory study is the first of its kind and will be used to provide important data relevant to a future larger randomized controlled trial examining mediators of cognitive training in a representative sample of adults. This information will assist in the future development of more effective home- and community-based interventions that maintain everyday function.