Measurement and estimation of lucidity prevalence in persons with dementia and neurological disorders

痴呆和神经系统疾病患者清醒率的测量和估计

• 批准号: 10091724
• 负责人: Jose Alejandro Luchsinger
• 金额: $ 39.72万
• 依托单位: HEBREW HOME FOR THE AGED AT RIVERDALE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10091724
• 关键词: Activities of Daily Living; Address; Aging; Alzheimer' s Disease; Area; Assessment tool; Assisted Living Facilities; Basic Science; Beds; Care given by nurses; Caregivers; Case Study; Categories; Cessation of life; Characteristics; Clinical Trials; Collaborations; Coma; Communication; Complex; Consensus; Data; Dementia; Development; Diagnosis; Diagnostic; Disease; Doctor of Philosophy; Educational workshop; Epidemiology; Event; Family; Frequencies; Future; Geriatric Psychiatry; Geriatrics; Gerontology; Goals; Health care facility; Husband; Individual; Institutes; Intervention Studies; Interview; Knowledge; Link; Literature; Long-Term Care; Measurement; Measures; Medical; Methodology; Methods; Modification; Nature; Neurologic; Neurology; Neurons; Neurosciences; Nursing Homes; Participant; Patients; Persons; Phase; Pilot Projects; Population Study; Positioning Attribute; Prevalence; Procedures; Property; Psychology; Psychometrics; Qualitative Methods; Rain; Recovery; Reporting; Research; Retrospective Studies; Sampling; Signal Transduction; Synapses; adjudication; case finding; end of life; epidemiology study; interest; multidisciplinary; nervous system disorder; remediation; response; statistics; symposium; tool

The proposed project, “Measurement and estimation of lucidity prevalence in persons with dementia and neurological disorders” is in response to RFA-AG-20-017 “Lucidity in Dementia (R21/R33)”. Our goals are to develop further a measure of paradoxical lucidity and to use this measure to estimate the frequency and correlates of occurrences by interviewing nursing home staff with respect to incidents observed in residents during the past one-month and six-month periods. In addition, we will refine the definition of lucidity and develop further a case-adjudication method for lucidity “diagnosis”. We propose to study staff reports related to 300 residents of one long-term care facility during the R21 phase and 1500 residents from 12 facilities during the R33 phase. Front line nursing home staff is ideally suited to inform research in paradoxical lucidity, an understudied phenomenon; likely due to the transience of the incidents and the lack of scientific reporting channels. The literature extant focuses on anecdotal evidence and case reports. The proposed study addresses four objectives: 1) develop a measure to assess the occurrence of lucidity, 2) analyze the psychometric properties of the measure, 3) develop a consensus conference methodology to determine possible, probable and definite cases, and 4) conduct a local, population-based study of lucidity using direct interviews with nursing home staff. This study will contribute to remediation of the lack of measurement tools in the field and provide robust basic knowledge about the phenomenon of lucidity. The proposed study refines our case finding methodology used in prior epidemiological research in nursing homes to study underlying latent constructs that are the subject of early-stage research and require definitional clarity. The proposed team has expertise in measurement and statistics, gerontology, neuroscience, epidemiology, geriatric medicine and psychiatry (Alzheimer’s disease), psychology, qualitative methods, and congregate care nursing. The aims are: Aim 1-R21: Develop a measure to describe episodes of lucidity among individuals with dementia, neurological and other illnesses and identify individual and episodic characteristics associated with events; Aim 2-R21: Develop further a procedure for case conferencing of reported events, using data from a pilot sample of 300 staff reports linked to 300 unique residents with and without lucidity events residing in a large 750-bed long term care facility; Aim 3-R33: Conduct a retrospective study of lucidity events in 12 long-term care facilities to describe their characteristics in comparison to residents without an event; Aim 4-R33: Determine the prevalence and frequency of events by diagnostic categories; Aim 5-R33: Examine the predictors of lucidity and its subtypes. Findings could result in the development of a case-reporting methodology for use by front-line staff to identify episodes of lucidity and to characterize lucidity events to inform future research.

拟议的项目“测量和估计痴呆症患者和 神经系统疾病”是对RFA-AG-20-017的回应，“痴呆中的清醒性（R21/R33）”。我们的目标是 进一步发展一种矛盾的清晰度度量，并使用此措施来估计频率和 与居民观察到的事件相关的事件，通过采访护士家庭人员 在过去的一个月和六个月中。此外，我们将完善清晰度的定义和 进一步开发了一种审判方法，用于清除“诊断”。我们建议研究员工报告有关 在R21期间，有一个长期护理设施的300名居民和来自12个设施的1500名居民 在R33阶段。一线护士家庭工作人员非常适合为悖论清醒的研究提供信息， 一种理解的现象；可能是由于事件的暂时性和缺乏科学报告 频道。文献广泛的重点是轶事证据和案例报告。拟议的研究 解决四个目标：1）制定一项评估清醒发生的措施，2）分析 测量的心理测量特性，3）开发共识会议方法来确定 可能的，有问题和定义的情况，以及4）使用直接进行基于人群的本地研究的清晰度研究 对护士家庭工作人员的访谈。这项研究将有助于补救缺乏测量工具 该领域并提供有关清醒现象的强大基础知识。拟议的研究改进 我们的案例发现方法学用于护士家庭的流行病学研究，以研究基础 潜在构造是早期研究的主题，需要明确的清晰度。拟议的团队 在测量和统计学，老年学，神经科学，流行病学，老年医学和 精神病学（阿尔茨海默氏病），心理学，定性方法和聚集护理护士。目的是： AIM 1-R21：制定一种措施来描述痴呆症个体中清晰性的发作， 神经和其他疾病，并确定与事件相关的个人和情节特征； AIM 2-R21：进一步开发一种使用来自A 300名员工报告的飞行员样本与300名独特居民有关 大型750床长期护理设施； AIM 3-R33：对12个长期护理设施中的清醒事件进行回顾性研究以描述 与没有事件的居民相比，它们的特征； AIM 4-R33：通过诊断类别确定事件的患病率和频率； AIM 5-R33：检查清晰度及其亚型的预测因子。 调查结果可能导致开发案例报告的方法，以供一线员工使用以识别 清晰度的发作和表征清醒事件以告知未来研究。