Improving Care of Persons with Cognitive Impairment and their Caregivers

描述(由申请人提供)：候选人是一名博士护理研究科学家，专注于行为干预，以改善对患有轻度认知障碍的老年人的护理。候选人寻求获得神经心理评估、混合方法生物统计学、多成分临床干预和协作临床研究方面的额外培训，以成为一名独立的护理科学家。她组建了一个多学科的指导团队，帮助她进行培训和研究活动。轻度认知障碍(MCI)影响多达20%的老年人，几乎是痴呆症患者的三倍。先前的研究表明，患有MCI的人患阿尔茨海默病(AD)的风险很高。即使在痴呆症发展之前，MCI也与生产力的丧失和从事有意义的活动困难有关。这些损失都与早产儿残疾和抑郁症有关。有必要针对MCI阶段进行干预，因为在认知能力下降的早期阶段，患者及其照顾者可能有一个关键的窗口来发展重要的自我管理技能，以防止过早残疾和脱离接触。在这项拟议的研究中，候选人将领导开展一项关于“每日增强有意义的活动”(DEMA)干预措施的试点研究。据推测，识别日常有意义的活动并参与这些活动可以改善身体和情感功能以及生活质量。还假设DEMA干预将减轻护理负担。这项先导性研究的具体目标是：(1)在MCI患者照顾者中设计和现场测试DEMA干预措施，以评估可取性、可行性和可接受性；(2)获得DEMA干预措施的参与率、效果大小和结果测量的初步数据，以计划未来的随机对照临床试验。

DESCRIPTION (provided by applicant): The candidate is a PhD nursing research scientist focusing on behavioral interventions to improve the care of older adults with mild cognitive impairment. The candidate seeks to obtain additional training in neuropsychological assessment, mixed methods biostatistics, multi-component clinical interventions, and collaborative clinical research in order to become an independent nursing scientist. She has assembled a multi-disciplinary mentorship team to assist her in her training and research activities. Mild cognitive impairment (MCI) affects as many as 20% of older adults, nearly three times the number affected by dementia. Previous studies have shown that persons with MCI are at high risk for developing Alzheimer disease (AD). MCI is associated with loss of productivity and difficulty in engaging in meaningful activities even before the development of dementia. These losses are associated with both premature disability and depression. There is a need for interventions targeted at the stage of MCI because at this early stage of cognitive decline, patients and their caregivers may have a critical window to develop important self-management skills that will prevent premature disability and disengagement. In the proposed study, the candidate will lead the development of a pilot study of the "daily enhancement of meaningful activities" (DEMA) intervention. It is hypothesized that identification of daily meaningful activities and engaging in these activities can improve physical and emotional function as well as quality of life. It is also hypothesized that the DEMA intervention will reduce care giving burden. Specific aims of this pilot study are: (1) to design and field-test the DEMA intervention among MCI patient caregiver dyads to assess desirability, feasibility, and acceptability; and (2) to obtain preliminary data on participation rates, effect size, and outcome measures for the DEMA intervention to plan for a future randomized controlled clinical trial.