This is a competing revision (supplement) application for 1 R01 AG031126, Cognitive Behavioral Therapy for Arthritis Pain and Insomnia in Older Adults, M. V. Vitiello Contact Principal Investigator.
The aim of the funded randomized controlled trial parent study is to assess whether a behavioral intervention that targets both pain and sleep disturbance vs. one that targets pain alone vs. an attention-control, will substantially improve pain- and sleep-related symptoms, functional outcome, and health care utilization in a large sample of older adults with co-morbid osteoarthritis and insomnia. Parent study assessments are made pretreatment, post-treatment and at 9 and 18 month follow-ups. Numerous reports in the literature link pain and sleep disturbance to compromised cognitive function;an effect that is particularly exacerbated for older adults when these conditions co-occur. Therefore, an intervention which is likely to reduce pain and improve sleep will likely have a desirable cognition-enhancing effect as well, particularly for cognitive abilities most susceptible to the influences of these conditions. Funds are requested to support the addition of a cognitive assessment to the 9 and 18 month follow-up assessments of the parent study and the analysis of the cognitive data. This will allow us to examine the potential acute and long term cognitive benefits associated with two behavioral interventions vs. a control in older adults with co-morbid osteoarthritis and insomnia.
Osteoarthritis (OA) pain debilitates half of all older adults, most of whom also experience significant sleep disturbance. The parent project seeks to determine whether a cognitive-behavioral treatment targeting both pain and co-morbid sleep disturbance in older adults with painful OA results in substantially greater reductions in pain and improvements in sleep and functional outcomes compared a cognitive-behavioral treatment targeting pain alone, or an attention-control condition. This competing revision(supplement) seeks to add a cognitive assessment to the outcome measures of the parent study since an intervention which is likely to reduce pain and improve sleep will likely have a desirable cognition-enhancing effect as well. Given the recent limitations on pharmacologic options for effective management of OA pain, this project has major implications for improving management of both pain and co-morbid sleep disturbance in the rapidly growing population of older Americans suffering from OA.
|Balderson, Benjamin H; McCurry, Susan M; Vitiello, Michael V et al. (2016) Information without Implementation: A Practical Example for Developing a Best Practice Education Control Group. Behav Sleep Med 14:514-27|
|McCurry, Susan M; Shortreed, Susan M; Von Korff, Michael et al. (2014) Who benefits from CBT for insomnia in primary care? Important patient selection and trial design lessons from longitudinal results of the Lifestyles trial. Sleep 37:299-308|
|Vitiello, Michael V; McCurry, Susan M; Shortreed, Susan M et al. (2014) Short-term improvement in insomnia symptoms predicts long-term improvements in sleep, pain, and fatigue in older adults with comorbid osteoarthritis and insomnia. Pain 155:1547-54|
|Gooneratne, Nalaka S; Vitiello, Michael V (2014) Sleep in older adults: normative changes, sleep disorders, and treatment options. Clin Geriatr Med 30:591-627|
|Vitiello, Michael V; McCurry, Susan M; Shortreed, Susan M et al. (2013) Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: the lifestyles randomized controlled trial. J Am Geriatr Soc 61:947-56|
|Parthasarathy, Sairam; Vitiello, Michael V (2012) 2011 NIH Sleep Disorders Research Plan: a rising tide that lifts all boats. J Clin Sleep Med 8:7-8|
|Von Korff, Michael; Vitiello, Michael V; McCurry, Susan M et al. (2012) Group interventions for co-morbid insomnia and osteoarthritis pain in primary care: the lifestyles cluster randomized trial design. Contemp Clin Trials 33:759-68|
|McCurry, Susan M; Von Korff, Michael; Vitiello, Michael V et al. (2011) Frequency of comorbid insomnia, pain, and depression in older adults with osteoarthritis: predictors of enrollment in a randomized treatment trial. J Psychosom Res 71:296-9|
|Ficca, Gianluca; Axelsson, John; Mollicone, Daniel J et al. (2010) Naps, cognition and performance. Sleep Med Rev 14:249-58|
|Vitiello, Michael V; Rybarczyk, Bruce; Von Korff, Michael et al. (2009) Cognitive behavioral therapy for insomnia improves sleep and decreases pain in older adults with co-morbid insomnia and osteoarthritis. J Clin Sleep Med 5:355-62|