Assessing Cognitive and Psychosocial Mechanisms of Useful Field of View Cognitive Training using Ecological Momentary Assessment

丧失独立性、认知功能下降和日常功能障碍是非常令人担忧的领域 老年人和他们的家人。从公共卫生的角度来看，成功的努力使老年人能够 与养老院相比，在家中养老每年将节省约800亿美元。 有用视野训练(UFOVt)是一种低成本、非侵入性的认知训练干预，具有 反复证明了可靠的迁移效应对维持认知、日常功能、健康和 最近，痴呆症的发病率减少了29%。重要的是，这些日常功能影响中的许多是 在五到十年内进行维护，包括：保持驾驶机动性，故障车辆减少50% 崩溃，并维持工具性的日常生活活动(IADL)。尽管显然是一个重要的 这一计划背后的有效干预、调解人或机制尚不清楚。我们的整体 目的是评估日常生活中的认知和心理社会因素对迁移的影响。 UFOVT应用于日常工作。这项探索性的双盲试验将把老年人随机分为20小时 UFOVt或20小时活动对照组。我们将在之前评估认知和心理社会因素， 在日常生活中、训练期间和训练后。然后我们将比较这些因素，并评估它们如何影响 将UFOVt转换为日常功能。我们的中心假设是日常处理的改进 速度和注意力是高级认知功能的关键组成部分，它们之间的关系最强 随着日常功能的变化。这项探索性研究是此类研究的第一次，将用于提供 与未来更大规模的随机对照试验相关的重要数据，该试验检查认知训练的中介因素 在具有代表性的成年人样本中。这些信息将有助于今后更有效的开发 以家庭和社区为基础的干预措施，维持日常功能。

Loss of independence, cognitive decline, and difficulties in everyday function are areas of great concern for older adults and their families. From a public health perspective, successful efforts that enable older adults to age within their homes, as compared to nursing homes, will save an estimated $80 billion dollars per year. Useful Field of View training (UFOVt) is one low cost, noninvasive cognitive training intervention that has repeatedly demonstrated reliable transfer effects to maintained cognition, everyday function, health, and most recently, a 29% reduction in incident dementia. Importantly, many of these everyday function effects are maintained across five to ten years including: maintained driving mobility, 50% reduction in at-fault vehicle crashes, and maintained Instrumental Activities of Daily Living (IADL). Although clearly an important and effective intervention, the mediators, or mechanisms, underlying this program are unknown. Our overall objective is to assess the cognitive and psychosocial factors within daily life that account for the transfer of UFOVt to everyday function. This exploratory double-blind trial will randomize older adults to 20 hours of UFOVt or 20 hours of an active control group. We will assess cognitive and psychosocial factors before, during, and after training within daily life. We will then compare such factors and assess how they impact the transfer of UFOVt to everyday functioning. Our central hypothesis is that improvements in daily processing speed and attention, key components of higher order cognitive functions, will have the strongest relationship with everyday function changes. This exploratory study is the first of its kind and will be used to provide important data relevant to a future larger randomized controlled trial examining mediators of cognitive training in a representative sample of adults. This information will assist in the future development of more effective home- and community-based interventions that maintain everyday function.