Web-Based ACTIVE Memory Training Intervention for Older Adults

说明(申请人提供)：本提案响应PA-11-124帮助老年人在社区保持健康和独立的翻译研究(R21)，并寻求支持测试基于证据的积极(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，供社区组织使用，以促进老年人的记忆健康和健身。记忆力丧失是社区老年人的一个主要公共卫生问题，通常与丧失独立性、需要正式护理和制度化有关。尽管越来越多的证据表明，在活动中使用小组、培训师主导、纸和铅笔的课程能够显著提高认知能力并改善日常功能，但它们在课外提供的练习机会很少，接触到日益增长的老年人的能力有限，而且由于高昂的管理成本，不易传播。拟议使用在线互动技术进行这种认知训练，被认为优于最初的积极试验和大多数以前的训练研究中使用的有限方法。我们建议现场测试一个名为主动记忆工作(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，并评估它们对日常功能活动的影响。基于网络的AMW实验干预将：通过纳入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；根据个人进展增加对背景敏感指导的参与；为记忆任务提供评估更大类别和样本样本的机会；并增加用户指导的练习。这产生了一个具有以下主要特征的总体设计：1)基线评估和随机化，分为10个疗程的实验干预组、10个疗程的实验干预+4个疗程的强化组或等待名单对照条件，以及2)立即的后测和6个月的随访测试。在线形式的使用将使必要的广泛传播成为可能，从而开始改变老年人的生活，他们有兴趣在面临与年龄有关的记忆障碍时监测和保持他们的记忆表现、认知活力和生活质量，并开始减少制度化的成本。几个社区组织已经准备好并能够参与。

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.