Five years of support are requested by the HRCA to develop cognitive approaches to help older persons provide their own self help for longer periods of time. Problems with memory and executive functioning are two of the most common cognitive difficulties associated with aging. This is true even among healthy elders that show no evidence of dementing illness. Studies have shown that such deficits correlate with impairment in self-performance in instrumental and personal activities of daily living (ADL), and, ultimately, the need for care. This study will select a sample of elders who have none or only one problem area at baseline, and who modeling suggests are at a significantly higher risk of becoming more impaired in these functional areas over a 12-month period. The overall goal of the project is to evaluate the effect of a focused memory training program on slowing the rates of decline in these """"""""at risk"""""""" elders who live in elderly and congregate housing sites. To alter the rates of functional deterioration observed in some models, the investigators will conduct a randomized, controlled trial to study functionality in everyday tasks and cognition consequent to exposure to a program of focused memory training. Impact will be studied at six and 12 months, comparing outcomes for experimental and control samples. Each comparison group will consist of 420 eligible residents identified in approximately 30 elderly housing sites in three states.
The specific aims of the study are designed to determine the program's impact on selected indicators of immediate functional performance, self performance in IADLs, personal ADLs, neuropsychological status, adherence to use of a prosthetic memory device, and service utilization (i.e., emergency room visits, hospitalization, institutionalization). Ultimately, the goal is to slow the rate of deterioration in functional performance of everyday tasks, and to provide a low cost model that can be easily replicated in vulnerable populations on a larger scale.
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