From Evidence-Base to Practice: Implementing RDAD in AAA Community-Based Services

描述（由申请人提供）：老年痴呆症患者因功能性活动障碍而发生跌倒相关损伤和丧失独立性的风险很高。本提案是对1RO1 AG041716《从证据基础到实践：在AAA社区服务中实施RDAD》的修订，RDAD（减少阿尔茨海默病的残疾；L. Teri， PI）的转化研究。家长RO1调查了减少阿尔茨海默病残疾（RDAD）的翻译、实施和有效性，由八个地区老龄化机构（AAA）管理，帮助老年人保持健康并尽可能长时间地住在自己的家里。为了遵循RFA的翻译特性，原始提案中提出的评估主要依赖于自我报告和举报人报告。这一修订将使我们能够增加一个创新的现成的翻译，用户友好的计算机化系统，以量化老年痴呆症患者家中功能活动的措施。利用父母补助金，将采用交错时间序列设计对78对参加RDAD的夫妇（痴呆症患者及其家庭照顾者）进行三次家庭评估。本研究的主要目标是增加这些更敏感的功能活动能力测量来研究RDAD的有效性，并通过检查创新的家庭功能活动能力测量与父母研究结果之间的关系来确定解释独立性丧失的潜在机制和预测因素。这些家庭措施的增加将解决有利于家长研究的两个独特目标：1)评估RDAD的有效性，2)确定解释独立性丧失的潜在机制和预测因素。这项研究对未来旨在帮助老年人在社区中保持健康和独立的研究有一些启示。首先，它将引入创新技术，量化痴呆症患者家中的功能活动能力。其次，除了调查RDAD的有效性之外，我们将能够研究潜在的机制以及父母研究结果的预测因素。最后，根据我们的研究结果，它将通过制定明智的策略来帮助老年痴呆症患者保持健康和独立，从而进一步翻译RDAD。

DESCRIPTION (provided by applicant): Older adults with dementia are at high risk for fall-related injuries and loss of independence due to functional mobility impairments. This proposal is a revision to 1RO1 AG041716, From Evidence-Base to Practice: Implementing RDAD in AAA Community Services, a translational investigation of RDAD (Reducing Disability in Alzheimer's disease; L. Teri, PI). The parent RO1 investigates the translation, implementation, and effectiveness of Reducing Disability in Alzheimer's Disease (RDAD), as administered by eight Area Agencies on Aging (AAA), in helping older adults remain healthy and living in their own homes as long as possible. To adhere to the translational properties of the RFA, assessments proposed in the original proposal rely predominantly on self and informant report. This revision will enable us to add an innovative ready-for- translation, user-friendly computerized system to quantify measures of functional mobility in the homes of older adults with dementia. Capitalizing on the parent grant, a staggered time series design will be used to conduct three in-home assessments on 78 dyads (persons with dementia and their family caregivers) enrolled in RDAD. The primary objective of the current proposal is to add these more sensitive measures of functional mobility to investigate the effectiveness of RDAD and to identify potential mechanisms and predictors that explain loss of independence by examining the relationship between innovative in-home measures of functional mobility and parent study outcomes. The addition of these in-home measures will address two unique aims that benefit the parent study: 1) To evaluate the effectiveness of RDAD, and 2) to identify potential mechanisms and predictors that explain loss of independence. This research has several implications for future studies aimed at helping older adults to maintain their health and independence in the community. First, it will introduce innovative technology to quantify functional mobility within th homes of individuals with dementia. Second, in addition to investigating the effectiveness of RDAD, we will be able to study potential mechanisms as well as predictors of parent study outcomes. Finally, based on our findings, it will lead to further translation of RDAD through the development of informed strategies to assist older adults with dementia to maintain health and independence.