R01AG066748

Compensation Training and Lifestyle Modifications to Promote Healthy Aging in Persons at Risk for Alzheimer's Disease: A Digital Application Supported Intervention

The prevalence of Alzheimer's Disease and other disorders (ADRD) is now a public health crisis. In the absence of effective medical treatment, there is a critical need for behavioral interventions to prevent or delay symptom onset. Multidomain interventions simultaneously targeting multiple modifiable risks for ADRD have shown promise, but additional innovative approaches that could be highly accessible by capitalizing on user-friendly digital applications to support and strengthen behavior modification are needed.

Training in the use of compensatory aids (e.g., calendars and note-taking systems) can improve daily independence. These same compensatory tools can be employed to facilitate the adoption of lifestyle changes that support brain health (e.g., exercise, cognitive engagement, stress management) through management of goal-setting, behavioral monitoring, tracking, and feedback.

The current project will test a 6-month intervention that provides training in both compensatory aids and lifestyle modification. A comprehensive suite of digital tools encapsulated in the Digital Memory Notebook (DMN), an easy-to-use, interactive application, will be used to facilitate behavioral change and enhance participant motivation. Furthermore, the DMN allows collection of real-time data to track intervention adherence. The DMN has been successfully applied to improving compensation among individuals with mild cognitive impairment.

The proposed work capitalizes on a critical window for building resilience by targeting individuals at risk for ADRD due to a subjective cognitive concern (SCC) but who remain cognitively normal. We will conduct a randomized controlled trial (RCT) among ethnoracially diverse older adults with SCC to compare our digital app supported compensation training and lifestyle modification intervention to an education-only control group that will not use the DMN or be provided with guidance on how to implement the educational material into their daily lives.

Specific aims of the project include:

1) Evaluate intervention efficacy on primary outcomes (global cognition and everyday function); secondary outcomes focus on well-being, cognitive domains (memory and executive function), activities of daily living (IADLs), physical function, compensation, and health behaviors.

2) Evaluate characteristics of treatment responders.

3) Evaluate adherence and identify the effective components of the target intervention using a mixed-method approach.

4) Design machine learning algorithms that use patterns of change in real-time DMN data metrics to identify incipient declines in treatment adherence and changes in health status.

The intervention under study is novel because it applies training in compensation to support lifestyle modifications and everyday functioning using a digital app that also monitors adherence to each component of the intervention in real-time. The project is expected to expand understanding of factors that may impact adherence to and outcomes of a preventative intervention, leading to optimization of a scalable intervention to reduce dementia risk applicable to diverse populations.

Davis University Of California

TO ENCOURAGE BIOMEDICAL, SOCIAL, AND BEHAVIORAL RESEARCH AND RESEARCH TRAINING DIRECTED TOWARD GREATER UNDERSTANDING OF THE AGING PROCESS AND THE DISEASES, SPECIAL PROBLEMS, AND NEEDS OF PEOPLE AS THEY AGE. THE NATIONAL INSTITUTE ON AGING HAS ESTABLISHED PROGRAMS TO PURSUE THESE GOALS. THE DIVISION OF AGING BIOLOGY EMPHASIZES UNDERSTANDING THE BASIC BIOLOGICAL PROCESSES OF AGING. THE DIVISION OF GERIATRICS AND CLINICAL GERONTOLOGY SUPPORTS RESEARCH TO IMPROVE THE ABILITIES OF HEALTH CARE PRACTITIONERS TO RESPOND TO THE DISEASES AND OTHER CLINICAL PROBLEMS OF OLDER PEOPLE. THE DIVISION OF BEHAVIORAL AND SOCIAL RESEARCH SUPPORTS RESEARCH THAT WILL LEAD TO GREATER UNDERSTANDING OF THE SOCIAL, CULTURAL, ECONOMIC AND PSYCHOLOGICAL FACTORS THAT AFFECT BOTH THE PROCESS OF GROWING OLD AND THE PLACE OF OLDER PEOPLE IN SOCIETY. THE DIVISION OF NEUROSCIENCE FOSTERS RESEARCH CONCERNED WITH THE AGE-RELATED CHANGES IN THE NERVOUS SYSTEM AS WELL AS THE RELATED SENSORY, PERCEPTUAL, AND COGNITIVE PROCESSES ASSOCIATED WITH AGING AND HAS A SPECIAL EMPHASIS ON ALZHEIMER'S DISEASE. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.866 - Aging Research

National Institute on Aging (NIA) [HHS - NIH]

California United States

State-Wide

Early Stage Clinical Trials for the Spectrum of Alzheimers Disease and Age-related Cognitive Decline (R01 Clinical Trial Optional) (PAR-18-877)

Amendment Since initial award the total obligations have increased 502% from $692,048 to $4,167,823.