Study protocol for the recreational stimulation for elders as a vehicle to resolve delirium superimposed on dementia (Reserve For DSD) trial.
Study protocol for the recreational stimulation for elders as a vehicle to resolve delirium superimposed on dementia (Reserve For DSD) trial.
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DOI：
10.1186/1745-6215-12-119
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发表时间：
2011-05-11
期刊：
影响因子：
2.5
通讯作者：
Boustani M
中科院分区：
文献类型：
--
作者：
Kolanowski AM;Fick DM;Litaker MS;Clare L;Leslie D;Boustani M
谵妄是一种混乱状态，其特征是认知功能急剧且波动性下降。谵妄在患有痴呆症的老年人中很常见且致命，通常被称为叠加痴呆症的谵妄（DSD）。治疗 DSD 的干预措施尚未成熟，因为其病因学机制尚不完全清楚。我们开发了一种基于理论的 DSD 干预措施，该干预措施源自有关认知储备的文献，并基于我们之前在痴呆症患者的谵妄、娱乐活动和认知刺激方面的跨学科工作。我们的初步工作表明，使用简单的认知刺激活动可以通过帮助集中注意力（谵妄的主要神经心理缺陷）来帮助解决谵妄问题。我们本次试验的主要目的是测试老年人娱乐刺激作为解决 DSD（RESERVE-DSD）问题的工具的功效。这项随机重复测量临床试验将招募参与者并在入院后急性护理时入组。我们将随机分配 256 名受试者进行干预 (RESERVE-DSD) 或对照（常规护理）。干预对象将接受为期 30 天的定制认知刺激娱乐活动，为期 30 分钟。我们假设接受 RESERVE-DSD 的受试者将： 谵妄的严重程度和持续时间降低；注意力、定向力、记忆力、抽象思维和执行功能都有更大的提高；与接受常规护理的 DSD 受试者相比，身体机能有更大的改善。我们还将评估干预效果的潜在调节因素（复杂心理活动的寿命和 APOE 状态）。我们的次要目标是描述与 RESERVE-DSD 相关的成本。我们基于理论的干预措施使用简单、廉价的娱乐活动来提供认知刺激，是创新的，因为据我们所知，它还没有被测试为 DSD 的治疗方法。这种针对 DSD 的新颖干预措施建立在我们之前的谵妄、娱乐活动和认知刺激研究的基础上，并得到了认知储备理论的支持。 ClinicalTrials.gov 标识符：NCT01267682
Delirium is a state of confusion characterized by an acute and fluctuating decline in cognitive functioning. Delirium is common and deadly in older adults with dementia, and is often referred to as delirium superimposed on dementia, or DSD. Interventions that treat DSD are not well-developed because the mechanisms involved in its etiology are not completely understood. We have developed a theory-based intervention for DSD that is derived from the literature on cognitive reserve and based on our prior interdisciplinary work on delirium, recreational activities, and cognitive stimulation in people with dementia. Our preliminary work indicate that use of simple, cognitively stimulating activities may help resolve delirium by helping to focus inattention, the primary neuropsychological deficit in delirium. Our primary aim in this trial is to test the efficacy of Recreational Stimulation for Elders as a Vehicle to resolve DSD (RESERVE- DSD). This randomized repeated measures clinical trial will involve participants being recruited and enrolled at the time of admission to post acute care. We will randomize 256 subjects to intervention (RESERVE-DSD) or control (usual care). Intervention subjects will receive 30-minute sessions of tailored cognitively stimulating recreational activities for up to 30 days. We hypothesize that subjects who receive RESERVE-DSD will have: decreased severity and duration of delirium; greater gains in attention, orientation, memory, abstract thinking, and executive functioning; and greater gains in physical function compared to subjects with DSD who receive usual care. We will also evaluate potential moderators of intervention efficacy (lifetime of complex mental activities and APOE status). Our secondary aim is to describe the costs associated with RESERVE-DSD. Our theory-based intervention, which uses simple, inexpensive recreational activities for delivering cognitive stimulation, is innovative because, to our knowledge it has not been tested as a treatment for DSD. This novel intervention for DSD builds on our prior delirium, recreational activity and cognitive stimulation research, and draws support from cognitive reserve theory. ClinicalTrials.gov identifier: NCT01267682
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影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
影响因子：
120.7
作者：
Ball, K;Berch, DB;Willis, SL
通讯作者：
Willis, SL
影响因子：
8.8
作者：
Ely, E. Wesley;Girard, Timothy D.;Laskowitz, Daniel T.
通讯作者：
Laskowitz, Daniel T.
影响因子：
2
作者：
Buckwalter, Kathleen C.;Grey, Margaret;Bowers, Barbara;McCarthy, Ann Marie;Gross, Deborah;Funk, Marjorie;Beck, Cornelia
通讯作者：
Beck, Cornelia
DOI：
10.1046/j.1532-5415.2003.51063.x
发表时间：
2003-02-01
影响因子：
6.3
作者：
Carnes, M;Howell, T;Knuppel, J
通讯作者：
Knuppel, J