The Hearthside Book Club: Pioneering Dementia-Level-Appropriate Reading Materials

描述(申请人提供)：据估计，目前有540万美国人患有阿尔茨海默病(AD)，AD病例预计将以惊人的速度上升，因此可以帮助治疗和/或规避与该疾病相关的挑战性行为的产品、方法和/或培训存在市场潜力。一种已被证明有效的办法涉及使用蒙特梭利活动方案拟订(MAP)。这项研究将进一步开发和完善一项创新的地图活动，称为炉边图书俱乐部(HBC)，这将是有史以来第一个痴呆症级别的适当阅读材料。对于32个主题中的每一个，将创建一个故事/文章的四个不同版本。为早期痴呆症患者编写的《A级阅读材料》将长达30页，并将在9年级水平上写；为痴呆症中期患者开发的《AA-级水平阅读材料》将长达25页，将在6年级水平上写；为痴呆症晚期患者编写的《AAA-级别故事》将长达20页，将在4年级水平上写；最后，《AAAA级阅读材料》将在4年级水平上写 “年级水平的故事”是为痴呆症晚期的人创作的，将长达15页，并在3年级水平上写。因此，总共将为这项研究创作128个故事。一半的故事将包含图片。共有120名患有痴呆症的老年人将参与这项研究。他们将被分配到四组中的一组：早期组(简易精神状态检查(MMSE)得分18+)，中期组(MMSE，11-17)，晚期组(MMSE，5-10)，或极晚期组(MMSE&lt；5)。参加HBC会议的人员的参与度将与他们参与标准的基线活动进行比较。HBC会议期间的参与度也将与阅读圆桌会议(R)(RR)会议的参与度进行比较。RR故事是为痴呆症患者设计的，但没有针对不同程度的痴呆症进行调整。关键的近端结果测量包括参与和沟通模式；关键的远端结果测量包括生活质量、抑郁和激动。远端测量将在基线时进行，在RR疗程后一个月，在没有图片的HBC疗程后一个月，在有图片的HBC疗程之后一个月。这项研究的具体目标是：(1)根据第一阶段的经验教训开发改进的HBC故事；(2)为两个月的活动规划开发足够数量的HBC故事；(3)为严重进展型痴呆症患者开发HBC故事(MMSE&lt；5)；(4)在三种类型的设施(养老院、辅助生活设施和成人日间中心)实施阅读小组；(5)检查阅读小组的近端和远端影响；(6)检查阅读小组对痴呆症患者交流模式的影响；(7)检查干预的效果是否在三种护理水平之间有所不同；以及(8)利用第二阶段研究的结果来创建该产品的最终、市场就绪的版本。

DESCRIPTION (provided by applicant): An estimated 5.4 million Americans are currently suffering from Alzheimer's disease (AD), and AD cases are expected to rise at an alarming rate, so market potential exists for products, approaches, and/or training that can help treat and/or circumvent the challenging behaviors associated with the condition. One approach that has been shown to be effective involves the use of Montessori Activity Programming (MAP). This study will involve the further development and refinement an innovative MAP activity called the Hearthside Book ClubTM (HBC), which will be the first-ever dementia-level appropriate reading materials. For each of 32 topics, four different versions of a story/essay will be created. Developed for persons in the early stages of dementia, "A- Grade Level Reading Materials" will be 30 pages in length and be written at an 9th grade level; "AA-Grade Level Reading Materials", developed for persons in the Middle Stages of dementia, will be 25 pages in length and will be written at the 6th grade level; "AAA-Grade Level Stories", created for persons in the Late Stages of Dementia, will be 20 pages in length, and will be written at the 4th grade level; finally, "AAAA Grade Level Stories", created for persons in the Very Late Stages of Dementia, will be 15 pages in length, and be written at the 3rd grade level. So, a total of 128 stories will be created for ths study. Half of the stories will contain pictures. A total of 120 older adults with dementia will participate in the study. They will be assigned to one of four groups: the Early Stage Group (Mini-Mental Status Exam (MMSE) score of 18+), the Middle Stage Group (MMSE, 11-17), the Late Stage Group (MMSE, 5-10), or the Very Late Stage Group (MMSE<5). The engagement of persons taking part in HBC sessions will be compared against their engagement in standard, baseline activities. Engagement during HBC sessions will also be compared against engagement in Reading Roundtable(R) (RR) sessions. RR stories are designed for persons with dementia, but are not adjusted for varying levels of dementia. Key proximal outcome measures include engagement and communication patterns; key distal outcome measures include quality of life, depression, and agitation. Distal measures will be taken at baseline, afte one month of RR sessions, after one month of HBC sessions without pictures, and after one month of HBC sessions with pictures. The Specific Aims of the study are: (1) to develop improved HBC stories based upon lessons learned in Phase 1; (2) to develop a enough number of HBC stories for two months of activity programming; (3) to develop HBC stories for persons with severely advanced dementia (MMSE<5); (4) to implement reading groups at three types of facilities (nursing homes, assisted living facilities, and adult day centers); (5) to examine the proximal and distal effects of the reading groups; (6) to examine the effects of the reading groups on communication patterns of persons with dementia; (7) to examine whether the effects of the intervention varies among the three levels of care; and (8) to use results of the Phase 2 study to create a final, market-ready version of the product.