Web-Based ACTIVE Memory Training Intervention for Older Adults

描述（由申请人提供）：本提案响应PA-11-124“帮助老年人在社区中保持健康和独立的转化研究”（R21），寻求支持测试基于证据的ACTIVE（独立和重要老年人高级认知训练）记忆训练干预的网络版本，用于社区组织促进老年人的记忆健康和健身。记忆丧失是社区生活老年人的一个主要公共卫生问题，通常与独立性丧失、需要正规护理和住院有关。尽管越来越多的证据表明，在ACTIVE中使用的由教练领导的小团体、以纸和铅笔为基础的课程可以显著提高认知能力，并在一定程度上改善日常功能，但这些课程在课外提供的练习机会很少，对日益增长的老年人群体的影响有限，而且由于管理成本高，不易传播。建议使用在线、互动技术进行这种认知训练，被认为优于最初的ACTIVE试验和大多数以前的训练研究中使用的有限方法。我们建议实地测试一个名为ACTIVE Memory Works （AMW）的在线程序，以帮助老年用户提高性能，监测记忆和认知的变化，并评估其对日常功能活动的影响。基于网络的AMW实验干预将：通过结合自动数据收集和分析，与纸笔形式相比，大大降低管理成本；提供自动评分和报告；增加基于个人进步的情境敏感型指导的参与度；并为记忆任务提供评估更多类别和范例样本的机会；增加用户导向的实践。这产生了一个具有以下关键特征的总体设计：1)基线评估和随机分配到10个阶段的实验干预组，10个阶段的实验干预加4个阶段的强化组，或等待名单控制条件，2)立即进行后测试和6个月的随访测试。在线格式的使用将使必要的广泛传播成为可能，开始改变老年人的生活，对监测和维持他们的记忆表现、认知活力和生活质量感兴趣，面对与年龄有关的记忆障碍，并开始降低机构的成本。一些社区组织已经准备好并有能力参与。

DESCRIPTION (provided by applicant): This proposal responds to PA-11-124 Translational Research to Help Older Adults Maintain Their Health and Independence in the Community (R21) and seeks support to test a web-based version of the evidence-based ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) memory training intervention for use by community organizations to promote memory health and fitness among the elderly. Memory loss is a major public health problem among community-living older adults, and is often associated with loss of independence, need for formal care, and institutionalization. Although there is growing evidence that small-group, trainer-led, paper-and-pencil based classes used in ACTIVE lead to significant cognitive gains and some improvement in everyday function, they offer few practice opportunities outside of class time, are limited in their ability to reach the growing population of older adults, and are not easily disseminated due to high costs of administration. The proposed use of online, interactive technology for this cognitive training is conceived as superior to the limited approach used in the original ACTIVE trial and in most previous training research. We propose to field test an online program called ACTIVE Memory Works (AMW) to help older adult users increase performance and monitor changes in memory and cognition and assess their effects on daily functional activities. The web- based AMW experimental intervention will: greatly reduce administrative costs compared with the paper-and- pencil form by incorporating automated data collection and analysis; provide automated scoring and reporting; increase engagement with context-sensitive coaching based on individual progress; and provide opportunities to evaluate a larger sample of categories and exemplars for memory tasks; and increase user-directed practice. This yields an overall design with the following key features: 1) a baseline assessment and randomization to a 10-session experimental intervention group, a 10-session experimental intervention plus 4-session booster group, or to a wait-list control condition, and 2) an immediate post-test and 6-month follow-up test. The use of the online format will make possible the widespread dissemination necessary to begin to make a difference in the lives of older adults interested in monitoring and maintaining their memory performance, cognitive vitality, and quality of life in the face of age-related memory impairments and begin to reduce the costs of institutionalization. Several community organizations are ready and able to participate.