EXCEED THE SPACE PROVIDED. We plan to evaluate the short-term and longer-term efficacy and effectiveness of apharmacologic augmentation strategyfor our nonpharmacologic treatment to improve memory performance in nondemented older adults. Specifically, we plan a randomizedcontrolled trial with a parallel groups design that compares two treatments (DONEPEZIL + COGNITIVE TRAINING versus PLACEBO + COGNITIVE TRAINING). This five-year study will ultimately include 200 older adults. Three hypotheses will be tested: Primary Hypothesis Hypothesis 1: Overall Outcome. We hypothesize that pharmacologic treatment will augmentthe effects of nonpharmacologic treatment such that the DONEPEZIL + COGNITIVE TRAINING group will perform better than the PLACEBO + COGNITIVE TRAINING group. Primary outcome measures are performance on measures of delayed recall. Secondary analyses will be conductedon quality of life and functional capacity measures. Secondary Hypotheses: Hypothesis 2: IndividualDifferences in Response (Moderators). We hypothesize that the efficacy of treatment will vary across individualsand will depend on selected demographic, cognitive, and biological measures assessed at baseline. Hypothesis 3: Mechanisms of Action (Mediators). We hypothesize that changes in selected biological and cognitive measures under donepezil therapy may account for some of the ability of subjects to benefit from cognitive training. Maintenance of memory and cognitive function helps preserve independence and quality of life in an increasingly technological society that puts greater cognitive demands on aging individuals. The eliminationof mandatory retirement for most occupations has made it possible for the elderly to stay in the workplace. Extended longevity rates and increasing numbers of older adults in our society suggest that older persons may be required to continueworking to prevent financial overload on the retirement and pension systems. Maintenance of memory and cognitive function is obviously important for older adults who want to or are obliged to continue working. The proposed treatment may help older adults better meet this challenge. PERFORMANCE SITE ========================================Section End===========================================

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH035182-21
Application #
6912625
Study Section
Special Emphasis Panel (ZMH1-ITV-D (01))
Program Officer
Evans, Jovier D
Project Start
1984-02-01
Project End
2008-06-30
Budget Start
2005-07-01
Budget End
2008-06-30
Support Year
21
Fiscal Year
2005
Total Cost
$325,000
Indirect Cost
Name
Stanford University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
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Rosen, Allyson C; Sugiura, Lisa; Kramer, Joel H et al. (2011) Cognitive training changes hippocampal function in mild cognitive impairment: a pilot study. J Alzheimers Dis 26 Suppl 3:349-57
Yesavage, Jerome A; Friedman, Leah; Ashford, J Wesson et al. (2008) Acetylcholinesterase inhibitor in combination with cognitive training in older adults. J Gerontol B Psychol Sci Soc Sci 63:P288-94
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de Medeiros, Kate; Kennedy, Quinn; Cole, Thomas et al. (2007) The impact of autobiographic writing on memory performance in older adults: a preliminary investigation. Am J Geriatr Psychiatry 15:257-61
Yesavage, Jerome; Hoblyn, Jennifer; Friedman, Leah et al. (2007) Should one use medications in combination with cognitive training? If so, which ones? J Gerontol B Psychol Sci Soc Sci 62 Spec No 1:11-8
Steffens, David C; Otey, Emeline; Alexopoulos, George S et al. (2006) Perspectives on depression, mild cognitive impairment, and cognitive decline. Arch Gen Psychiatry 63:130-8
Ota, Ken S; Friedman, Leah; Ashford, J Wesson et al. (2006) The Cost-Time Index: a new method for measuring the efficiencies of recruitment-resources in clinical trials. Contemp Clin Trials 27:494-7
O'Hara, Ruth; Schroder, Carmen M; Bloss, Cinnamon et al. (2005) Hormone replacement therapy and longitudinal cognitive performance in postmenopausal women. Am J Geriatr Psychiatry 13:1107-10

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