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.
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