Cognitive Behavioral Therapy for Arthritis Pain and Insomnia in Older Adults

描述(由申请人提供)：这是1 R01 AG031126，老年关节炎疼痛和失眠的认知行为疗法的竞争性修订(补充)申请，M.V.Vitiello联系首席调查员。这项资助的随机对照试验家长研究的目的是评估同时针对疼痛和睡眠障碍的行为干预与只针对疼痛的行为干预与只针对疼痛的行为干预与注意力控制相比，是否会显著改善患有骨关节炎和失眠的大量老年人的疼痛和睡眠相关症状、功能结果和医疗保健利用。在治疗前、治疗后以及在9个月和18个月的随访中进行父母学习评估。文献中的许多报告都将疼痛和睡眠障碍与认知功能受损联系在一起；当这些情况同时发生时，这种影响对老年人尤其严重。因此，可能减轻疼痛和改善睡眠的干预措施也可能具有理想的认知增强效果，尤其是对大多数人的认知能力。 易受这些条件影响的。请拨资金，以支持在家长研究的9个月和18个月后续评估以及对认知数据的分析中增加认知评估。这将使我们能够检验在患有骨关节炎和失眠的老年人中，两种行为干预与对照的潜在急性和长期认知益处。 公共卫生相关性：骨关节炎(OA)疼痛使一半的老年人虚弱，他们中的大多数人也经历了严重的睡眠障碍。母项目试图确定，与仅针对疼痛或注意力控制条件下的认知行为治疗相比，同时针对疼痛和合并睡眠障碍的老年患者的认知行为治疗是否显著减少了疼痛，改善了睡眠和功能结果。这一竞争性修订(补充)寻求在父母研究的结果衡量标准中增加认知评估，因为可能会减轻疼痛和改善睡眠的干预可能也会有理想的认知增强效果。鉴于最近在有效治疗骨性关节炎疼痛的药物选择方面的局限性，该项目具有重大意义 用于改善对快速增长的美国老年骨性关节炎患者的疼痛和共病睡眠障碍的管理。

DESCRIPTION (provided by applicant): This is a competing revision (supplement) application for 1 R01 AG031126, Cognitive Behavioral Therapy for Arthritis Pain and Insomnia in Older Adults, M. V. Vitiello Contact Principal Investigator. The aim of the funded randomized controlled trial parent study is to assess whether a behavioral intervention that targets both pain and sleep disturbance vs. one that targets pain alone vs. an attention-control, will substantially improve pain- and sleep-related symptoms, functional outcome, and health care utilization in a large sample of older adults with co-morbid osteoarthritis and insomnia. Parent study assessments are made pretreatment, post-treatment and at 9 and 18 month follow-ups. Numerous reports in the literature link pain and sleep disturbance to compromised cognitive function; an effect that is particularly exacerbated for older adults when these conditions co-occur. Therefore, an intervention which is likely to reduce pain and improve sleep will likely have a desirable cognition-enhancing effect as well, particularly for cognitive abilities most susceptible to the influences of these conditions. Funds are requested to support the addition of a cognitive assessment to the 9 and 18 month follow-up assessments of the parent study and the analysis of the cognitive data. This will allow us to examine the potential acute and long term cognitive benefits associated with two behavioral interventions vs. a control in older adults with co-morbid osteoarthritis and insomnia. PUBLIC HEALTH RELEVANCE: Osteoarthritis (OA) pain debilitates half of all older adults, most of whom also experience significant sleep disturbance. The parent project seeks to determine whether a cognitive-behavioral treatment targeting both pain and co-morbid sleep disturbance in older adults with painful OA results in substantially greater reductions in pain and improvements in sleep and functional outcomes compared a cognitive-behavioral treatment targeting pain alone, or an attention-control condition. This competing revision(supplement) seeks to add a cognitive assessment to the outcome measures of the parent study since an intervention which is likely to reduce pain and improve sleep will likely have a desirable cognition-enhancing effect as well. Given the recent limitations on pharmacologic options for effective management of OA pain, this project has major implications for improving management of both pain and co-morbid sleep disturbance in the rapidly growing population of older Americans suffering from OA.