Rodakowski Juleen, Golias Katlyn W, Reynolds Charles F, Butters Meryl A, Lopez Oscar L, Dew Mary Amanda, Skidmore Elizabeth R
Department of Occupational Therapy, University of Pittsburgh, USA.
Clinical and Translational Science Institute, University of Pittsburgh, USA.
Contemp Clin Trials Commun. 2019 May 1;15:100368. doi: 10.1016/j.conctc.2019.100368. eCollection 2019 Sep.
Non-pharmacological interventions designed to change cognitive function in older adults with Mild Cognitive Impairment have shown mixed results. Few studied interventions directly address preclinical disability. Slowing changes in disability are critical preserve independence and health related quality of life in older adults with Mild Cognitive Impairment. In this study, we discuss the design of the trial, challenges encountered, and solutions generated to guide future trials designed to prevent the onset of disability among at-risk older adults. We compared Strategy Training to enhanced-usual care in 30 older adults with Mild Cognitive Impairment. We recruited 79.7% (n = 188) of the potential participants through direct-to-consumer recruitment. We refined a three-step screening process, including a phone screen, initial in-person screening, and full in-person screening. This screening processes resulted in a high percentage of older adults completing the neuropsychological battery and adjudication of Mild Cognitive Impairment. Conducting a disability prevention among individuals without overt disability is a novel approach. Nevertheless, one of the greatest limitations to our project is the fact that follow-up is restricted to 1 year. Findings from this study can inform the design and conduct of future clinical trials that seek to slow progression of disability in older adults with Mild Cognitive Impairment.
旨在改变轻度认知障碍老年人认知功能的非药物干预措施，其结果喜忧参半。很少有研究干预措施直接针对临床前残疾问题。减缓残疾变化对于维持轻度认知障碍老年人的独立性和与健康相关的生活质量至关重要。在本研究中，我们讨论了试验的设计、遇到的挑战以及提出的解决方案，以指导未来旨在预防高危老年人残疾发生的试验。我们将策略训练与强化常规护理对30名轻度认知障碍老年人进行了比较。我们通过直接面向消费者招募的方式，招募了79.7%（n = 188）的潜在参与者。我们完善了一个三步筛查过程，包括电话筛查、初次面对面筛查和全面面对面筛查。这种筛查过程使得很大比例的老年人完成了神经心理测试组套和轻度认知障碍的判定。在没有明显残疾的个体中进行残疾预防是一种新方法。然而，我们项目最大的局限之一是随访仅限于1年这一事实。本研究的结果可为未来旨在减缓轻度认知障碍老年人残疾进展的临床试验的设计和实施提供参考。
