Asparagus to Zucchini: A Nutrition Education System for Persons with Dementia

描述（由申请人提供）：在全球范围内，3560万人患有阿尔茨海默病（AD）（阿尔茨海默病国际，2010）。到2050年，预计1600万美国人（阿尔茨海默氏症协会，2011）和全世界1.154亿人（阿尔茨海默氏症国际，2010）将患有AD。阿尔茨海默病是最常见的痴呆类型，占所有痴呆病例的60%至80%（阿尔茨海默病协会，2011）。由于需要大量资源来解决与痴呆相关的问题行为，因此需要新的方法，干预和治疗来预防或减少这些行为的发生（Camp，Cohen-Mansfield和Capezuti，2002）。近年来，关于痴呆症的学习和社会互动已经有了重要的发现。例如，我们已经看到，痴呆症患者能够在有利的环境中学习新信息，表达知识和生活经验。痴呆症患者通常仍然渴望富有成效的、具有挑战性的活动，重要的是，在痴呆症诊断后，这种基本的人类需求尽可能长时间地得到满足。这项为期6个月的可行性研究将涉及创建芦笋到西葫芦（A2 Z），这是一个以农业科学为基础的课程，旨在利用剩余的优势，为痴呆症的所有阶段提供富有成效和有目的的活动。该课程将纳入基于蒙特梭利的痴呆症，园艺疗法和营养规划的原则。在整个研究过程中，我们将开发一个原型A2 Z工具包，其中将包括适应性的课堂材料和室内种植用品，我们将培训活动工作人员介绍课程，以指导参与者并鼓励积极参与 我们将参与者随机分配到参与A2 Z和时事（A2 Z/CE）的治疗组或仅参与时事（CE）的对照组。基线测量后，每周在同一时间进行两次观察，持续8周。在最初的8周后，第1组将单独参加CE，第2组将参加A2 Z/CE（交叉设计）。观察将持续第二个八周。测量的结果将包括参与和小组活动期间观察到的影响，记忆的编程内容和感知的目的性，描述性观察组动态和个人表达的满意度/不满意的编程内容。远端结局指标将侧重于生活质量，并将在基线和每个8周观察期后进行评估。据推测，与标准（CE）编程相比，A2 Z编程将导致更多的参与，积极的影响，感知的目的性，编程满意度和更好的生活质量结果。 公共卫生相关性：我们的目标是开发一个以农业为基础的教育计划（芦笋到西葫芦-A2 Z），用于长期护理设施和痴呆症患者的其他护理场所。具体而言，我们希望评估该计划对参与，影响和生活质量的影响。长期目标包括完善和扩展课程，培训早期至中度痴呆症患者的护理人员，为这些人提供教育和机会，让他们从事有意义和富有成效的园艺活动。

DESCRIPTION (provided by applicant): On a global scale, 35.6 million people are living with Alzheimer's disease (AD) (Alzheimer's disease International, 2010). By 2050, it has been projected that 16 million Americans (Alzheimer's Association, 2011) and 115.4 million persons worldwide (Alzheimer's disease International, 2010) will have AD. Alzheimer's disease, which is the most common type of dementia, makes up 60 to 80 percent of all cases of dementia (Alzheimer's Association, 2011). Because significant resources are required to address problematic behaviors associated with dementia, new approaches, interventions and treatments are needed to prevent or reduce the occurrence of these behaviors (Camp, Cohen-Mansfield, and Capezuti, 2002). In recent years, important discoveries have been made regarding learning and social interaction in dementia. For example, we have seen that persons with dementia are able to learn new information and express knowledge and life experiences in conducive settings. Individuals with dementia often still have the desire for productive, challenging activit, and it is important that this basic human need continues to be met as long as possible following a dementia diagnosis. This 6-month feasibility study will involve the creation of Asparagus to Zucchini (A2Z), an agricultural sciences-based curriculum designed to utilize remaining strengths and provide productive and purposeful activity for persons in all stages of dementia. This curriculum will incorporate principles of Montessori-based programming for dementia, Horticultural Therapy, and nutrition. Throughout the course of the study, we will develop a prototype A2Z kit, which will include adapted classroom materials and indoor growing supplies, we will train activities staff to present the curriculum to guide participants and encourage active engagement, and we will randomly assign participants to either a treatment group involving participation in A2Z and Current Events (A2Z/CE) or a control group involving participation in Current Events alone (CE). Following baseline measurement, two observations will be conducted each week, at the same time of day, for a period of eight weeks. After the initial eight-week period, Group 1 will take part in CE alone, and Group 2 will have A2Z/CE (a cross-over design). Observations will continue for a second eight-week period. Measured outcomes will include engagement and affect observed during group activities, memory for programming content and perceived purposefulness, descriptive observations of group dynamics and individual expressions of satisfaction/dissatisfaction with programming content. Distal outcome measures will focus on quality of life and will be assessed at baseline and following each 8-week observation period. It is hypothesized that A2Z programming will result in more engagement, positive effect, perceived purposefulness, satisfaction with programming, and better quality of life outcomes compared with standard (CE) programming. PUBLIC HEALTH RELEVANCE: Our aim is to develop an agriculture-based educational program (Asparagus to Zucchini - A2Z) for use in long-term care facilities and other care sites for persons with dementia. Specifically, we wish to assess the effects of this program on engagement, affect and quality of life. Long term goals include refining and extending a curriculum that will train caregivers of individuals with early to moderate stage dementia to educate and provide opportunities for these individuals to engage in meaningful and productive horticultural activities.