Smith Marianne, Jones Michael P, Dotson Megan M, Wolinsky Fredric D
College of Nursing, the University of Iowa, Iowa City, Iowa, USA.
Department of Biostatistics, College of Public Health, the University of Iowa, Iowa City, Iowa, USA.
Open Access J Clin Trials. 2018;10:29-41. doi: 10.2147/OAJCT.S154782. Epub 2018 Apr 26.
This two-arm, randomized controlled trial was designed to evaluate a computerized cognitive speed of processing (SOP) training known as in the generally older group of adults residing in assisted living (AL) and related senior housing. Study aims focused on depression-related outcomes that were observed in earlier SOP studies using with younger, home-dwelling seniors. Study design and baseline outcomes are discussed.
A community-based design engaged AL and related senior living settings as partners in research. Selected staff served as on-site research assistants who were trained to recruit, consent, and train a target of 300 participants from AL and independent living (IL) programs to use the intervention and attention-control computerized training. Ten hours of initial computerized training was followed by two booster sessions at 5 and 11 months. Outcome measures included Useful Field of View (UFOV), 9-item Patient Health Questionnaire (PHQ-9), 12-item Centers for Epidemiological Studies Depression scale (CESD-12), 7-item Generalized Anxiety Disorders GAD-7), Brief Pain Inventory (BPI) and SF-36 Health Survey. Assessments occurred before randomization (pre-training), post-training, 26 and 52 weeks.
A total of 351 participants were randomized to the intervention (n=173) and attention-control (n=178) groups. There were no significant differences between groups in demographic characteristics with the exception of education and reported osteoporosis. There were no significant differences in study outcomes between groups at baseline. Participants in AL had significantly lower SOP and self-rated health, and significantly higher depression, anxiety and pain when compared to those in IL programs on the same campus.
Compared to earlier SOP training studies using , this sample of senior living participants were older, reported more health conditions and poorer overall health, had lower UFOV scores and greater depressive symptoms at baseline. Moreover, participants in AL had greater health challenges than those in IL.
这项双臂随机对照试验旨在评估一种名为的计算机化认知处理速度(SOP)训练,该训练针对居住在辅助生活(AL)及相关老年住房中的老年成年人。研究目标聚焦于抑郁相关结局,这些结局曾在早期针对居家年轻老年人使用的SOP研究中观察到。本文将讨论研究设计和基线结局。
采用基于社区的设计,让AL及相关老年生活机构作为研究合作伙伴。选定的工作人员担任现场研究助理,他们接受培训,从AL和独立生活(IL)项目中招募、获取同意并培训300名参与者使用干预性和注意力控制计算机化训练。初始计算机化训练时长为10小时,之后在第5个月和第11个月进行两次强化训练。结局指标包括有用视野(UFOV)、9项患者健康问卷(PHQ - 9)、12项流行病学研究中心抑郁量表(CESD - 12)、7项广泛性焦虑障碍量表(GAD - 7)、简短疼痛问卷(BPI)和SF - 36健康调查。评估在随机分组前(训练前)、训练后、26周和52周进行。
共有351名参与者被随机分为干预组(n = 173)和注意力控制组(n = 178)。除教育程度和报告的骨质疏松症外,两组在人口统计学特征上无显著差异。基线时两组研究结局无显著差异。与同一校园IL项目中的参与者相比,AL中的参与者SOP和自评健康状况显著更低,抑郁、焦虑和疼痛程度显著更高。
与早期使用的SOP训练研究相比,该老年生活参与者样本年龄更大,报告的健康问题更多且总体健康状况更差;基线时UFOV得分更低且抑郁症状更严重。此外与IL中的参与者相比AL中的参与者面临更大的健康挑战。