Cognitive Training Gains and Mobility Outcomes in ACTIVE

描述(由申请人提供)：本申请建议对通过临床试验收集的数据集的行动能力结果衡量标准进行二次分析，该临床试验的标题是为独立和有活力的老年人(积极)提供高级认知培训。这项积极的试验是一项严格设计和进行的研究，解决了一个以前没有进行过大规模研究的重要问题，即训练对认知能力的影响是否会导致日常活动中功能的改善或保持。尽管有大量证据表明，许多基本的认知能力和过程与功能状态、护理需求和生活质量的衡量标准有关，但很少有研究探讨改善这些认知功能是否会对与独立生活相关的日常活动产生短期或长期影响。旨在推迟或防止需要使用养老院、家庭护理和短期医院的干预措施可以节省医疗费用，同时还可以确保老龄化人口的独立性和尊严。由于其规模和精心开发的严谨性，活跃的数据集为研究人员提供了大量进行二次分析的机会。这里提出的分析的目的是回答一系列问题，这些问题在最初的供资周期中没有得到解决，但本数据集可能会解决这些问题。具体地说，此应用程序旨在实现1) 确定主动筛查电池中的认知测量与一系列移动性结果测量(包括撞车风险、跌倒、生活空间等)之间的关联。在调整了人口统计学和其他相关的个人特征后，2)检验了三种认知干预措施对这些相同的流动性结果测量的影响，3)检查了流动性测量与其他次要结果之间的关系，如生活质量和卫生服务利用，以及4)评估干预有效性对流动性结果的中介作用。

DESCRIPTION (provided by applicant): This application proposes secondary analyses of the mobility outcome measures from the data set collected through the clinical trial entitled Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE). The ACTIVE trial was a rigorously designed and conducted study that addressed an important question not previously investigated on a large scale, i.e., whether training effects on cognitive abilities resulted in improved or maintained function in daily activities. Even though there is substantial evidence that many basic cognitive abilities and processes are related to measures of functional status, need for care, and quality of life, few studies have addressed whether improving such cognitive function might have short- or long-term effects on daily activities related to living independently. Interventions designed to delay or prevent the need for use of nursing homes, home care, and short stay hospitals can save health-care costs, while also ensuring the independence and dignity of the aging population. Because of its size and the carefully developed rigor, the ACTIVE datasets offer investigators a wealth of opportunities for secondary analyses. The purpose of the analyses proposed here is to answer a range of questions not addressed in the original funding cycle, but which may be addressed by this data set. Specifically, this application seeks to 1) Determine the associations between cognitive measures in the ACTIVE screening battery and a range of mobility outcome measures (including crash risks, falls, life space, etc.) after adjusting for demographic and other relevant personal characteristics, 2) Examine the impact of the three cognitive interventions on these same mobility outcome measures, 3) Examine the associations between mobility measures and other secondary outcomes such as quality of life and health service utilization, and 4) Evaluate the mediating role of intervention effectiveness on mobility outcomes.