A novel computer-based functional skills assessment and training program

摘要 有认知障碍的人，如痴呆症或轻度认知障碍(MCI)的人，通常 在日常活动中遇到困难，特别是那些涉及技术的活动 通常涉及到新的学习。此外，认知方面与年龄相关的标准化变化通常会导致表现 缺乏以前学到的技能，也阻碍了新的学习，如学习使用新技术 在当今技术驱动的世界里无处不在的系统。这一点非常令人担忧，因为 人口，越来越多的老年人有认知障碍，以及持续部署 新技术在日常生活中的应用。目前，人们对开发工具来检测 认知和功能衰退的最早表现和发展有效的药物和 对认知和功能障碍患者的非药物干预 有问题。拟议的第一阶段研究将完善和评估一种新的基于计算机的集成功能 技能评估和培训(FST)计划，提供对独立至关重要的日常任务的培训 生活(例如，财务和药物管理)。程序中的任务是真实的 日常活动和现实世界的系统和培训是为个人的独特需求量身定做通过 评估部分。样本将包括75名未受损的老年人和75名患有MCI的成年人，他们 将被随机分配到FST条件、认知康复训练(CRT)条件或 FST/CRT组合条件。这一设计将允许我们检查效果的特殊性，并检查 与CRT相比，直接功能技能训练对功能技能(FS)和认知结果的好处 确定CRT是否提供了可进一步增强FST优势的启动效果。结果衡量标准将 包括认知和功能能力客观测量、自我报告和日常任务的告密者报告 绩效，以及自我效能感和程序的可接受性和可用性的测量。我们还将 收集有关随着时间的推移维护培训成果的数据。拟议的第一阶段的总体目标 研究是开发基于商业可用技术的综合功能技能评估和 培训计划，可部署在平板电脑或PC等各种技术平台上，并用于 具有不同成年人口的各种环境(例如，临床环境、家庭环境)。最终我们的 长期目标是开发一种产品，帮助预防和治疗功能性衰退，并保持 老年人的认知健康和功能独立。

Abstract People with cognitive impairments such as those with dementia or Mild Cognitive Impairment (MCI), often experience difficulty performing everyday routine activities, particularly those involving technology as it generally involves new learning. Further, normative age-related changes in cognition often lead to performance deficits on previously learned skills and also impede new learning, such as learning to use new technology systems, which are ubiquitous in today's technology driven world. This is of great concern given the aging of the population, the increasing number of older adults with cognitive impairments, and the continual deployment of new technologies in everyday contexts. Currently, there is a vast interest in developing tools to detect the earliest manifestations of cognitive and functional decline and in developing efficacious pharmacological and non-pharmacological interventions for those who are experiencing or at risk for cognitive and functional problems. The proposed Phase 1 study will refine and evaluate a novel integrated computer-based functional skills assessment and training (FST) program that provides training on everyday tasks critical to independent living (e.g., financial and medication management). The tasks in the program are veridical representations of everyday activities and real world systems and the training is tailored to the unique needs of an individual via the assessment component. The sample will include 75 non-impaired older adults and 75 adults with MCI, who will be randomly assigned to the FST condition, a cognitive rehabilitation training (CRT) condition or a combined FST/CRT condition. This design will allow us to examine the specificity of effects and examine the benefits of direct functional skill training relative to CRT on functional skills (FS) and cognitive outcomes and to determine if CRT provides a priming effect that further enhances the benefits of FST. Outcome measures will include objective measures of cognitive and functional abilities, self and informant reports of everyday task performance, and measures of self-efficacy and the acceptability and usability of the program. We will also gather data on the maintenance of training gains over time. The overall objective of the proposed Phase 1 study is to develop an integrated commercially available technology-based functional skills assessment and training program that can be deployed on a variety of technology platforms such as tablets or PCs and used in a variety of settings (e.g., clinical settings, home environments) with diverse adult populations. Ultimately our long term goal is to develop a product that can help prevent and treat functional declines and maintain the cognitive health and functional independence of older adults.