A Multi-Modal Combination Intervention to Promote Cognitive Function in Older Intensive Care Unit Survivors
University of Washington
Summary
Up to 25% of intensive care unit (ICU) survivors experience cognitive impairment comparable in severity to mild Alzheimer's disease and related dementias after hospital discharge. Older ICU survivors (ages 60 and older) are at highest risk for delirium and subsequent cognitive impairment, which contribute to higher risk for cognitive decline related to Alzheimer's disease and related dementias. Sleep and activity are essential for recovery from critical illness, yet ICU survivors experience both sleep deficiency and profound inactivity. About 75-80% of ICU patients experience circadian dysrhythmia, which contributes to cognitive decline and increases likelihood of developing Alzheimer's disease and related dementias. The scientific premises of the proposed study are: 1) a combined sleep promotion and cognitive training intervention will have synergistic effects to mitigate the risk of cognitive impairment and development of Alzheimer's disease and related dementias in older ICU survivors; and 2) chronotherapeutic timing of interventions (i.e., adjusting timing of interventions according to circadian rhythm) may improve intervention efficacy.
Description
Using a 2 x 2 factorial design, 100 English- or Spanish-speaking older ICU survivors will be enrolled after discharge out of ICU and randomized to one of 4 combinations of two interventions: SLEEP and COG. We propose that the combination of a nighttime sleep promotion intervention \[SLEEP: nighttime use of earplugs and eye masks\] and a daytime computerized cognitive training intervention \[COG: daily 30-minute cognitive training sessions\] may produce synergistic effects on cognitive function to mitigate delirium and reduce risk of incident Alzheimer's disease and related dementias. Because c…
Eligibility
- Age range
- 60+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Age greater than or equal to 60 years old * Current hospitalization at University of Washington Medical Center or Harborview Medical Center * Intensive care unit (ICU) length of stay greater than 24 hours * Recovery from critical care status to acute care status, and/or discharge out of ICU * Fluent in English or Spanish * Functional independence on activities of daily living prior to hospitalization (Katz Index = 6) Exclusion Criteria: * Documented history or suspicion of Alzheimer's disease or dementia, or current prescription of anti-dementia medication * Documented…
Interventions
- BehavioralSLEEP + COG
Combination of SLEEP and COG interventions
- BehavioralCOG
Daily 30-minute session of computerized cognitive training
- BehavioralSLEEP
Nighttime use of both ear plugs and eye masks
- BehavioralAC
Educational modules on cognitive and sleep health
Location
- University of WashingtonSeattle, Washington