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.
Public Health Relevance Statement: Project Narrative This proposed project is addressing a critical public concern with a wide potential implications. The population is aging and cognitive impairments, which impact on abilities important to everyday functioning and threaten independence, are common among older adults. This study will develop and evaluate a novel technology- based integrated functional-skills assessment and training intervention that can be deployed on a variety of technology platforms such as tablets or PCs and used in a variety of settings 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 functional independence of older adults. .
Project Terms: Activities of Daily Living; Address; Adult; age related; aged; Aged, 80 and over; Aging; Area; base; Clinical; Cognition; Cognition Disorders; Cognitive; cognitive ability; cognitive change; cognitive performance; cognitive rehabilitation; Cognitive remediation; cognitive training; Communication; Computers; cost; Data; Dementia; design; Diagnostic; dosage; Educational Intervention; Elderly; ethnic diversity; experience; functional decline; functional gain; Goals; Health; Healthcare; Home environment; Impaired cognition; Impairment; improved; improved functioning; Independent Living; indexing; Individual; informant; interest; Intervention; Lead; Learning; low socioeconomic status; Maintenance; Measures; Medication Management; mild cognitive impairment; Minority; Neurobehavioral Manifestations; Neuropsychological Tests; new technology; novel; Occupational activity of managing finances; Outcome; Outcome Measure; Performance; Persons; Pharmacology; Phase; phase 1 study; Pilot Projects; Population; Population Dynamics; Population Heterogeneity; prevent; programs; Protocols documentation; Randomized; Reporting; Risk; Role playing therapy; Sampling; Schizophrenia; Self Efficacy; Services; skills; skills training; social; Specificity; standard measure; System; Tablets; Task Performances; Technology; Testing; Time; tool; Training; Training Programs; Transferable Skills; trend; usability; Work
