Optimal Timing of Computerized Cognitive Training for Older Intensive Care Unit Survivors

Description

More than 60% of intensive care unit (ICU) patients are adults ages 60 and older, who are at high risk for ICU-acquired cognitive impairment. After ICU discharge, ICU survivors often experience sleep disturbances and inactivity, and almost 80% of ICU patients experience disturbances in circadian rhythm, which may affect cognitive function. Understanding the optimal, chronotherapeutic timing of cognitive interventions is crucial to promote circadian realignment and cognitive function, and may improve intervention feasibility, acceptability, and efficacy. Specific Aim 1 will determine feasibility, acceptability, and preliminary effect sizes for: 1) a morning session of a computerized cognitive training intervention \[COG\]; and 2) a late afternoon/early evening session of the COG intervention; compared to 3) standard inpatient care/usual care \[UC\]. Specific Aim 2 will examine circadian rhythm parameters to determine the optimal timing of the daily COG intervention. Exploratory Aim 3 will explore if the effects of the COG intervention on cognitive function are mediated by daytime activity, and explore if selected biological and clinical factors moderate intervention effects on cognitive function.

Conditions

Critical Illness, Cognitive Impairment, Circadian Dysrhythmia, Intensive Care Unit Delirium, Aging

Study Overview

Study Details

Study overview

More than 60% of intensive care unit (ICU) patients are adults ages 60 and older, who are at high risk for ICU-acquired cognitive impairment. After ICU discharge, ICU survivors often experience sleep disturbances and inactivity, and almost 80% of ICU patients experience disturbances in circadian rhythm, which may affect cognitive function. Understanding the optimal, chronotherapeutic timing of cognitive interventions is crucial to promote circadian realignment and cognitive function, and may improve intervention feasibility, acceptability, and efficacy. Specific Aim 1 will determine feasibility, acceptability, and preliminary effect sizes for: 1) a morning session of a computerized cognitive training intervention \[COG\]; and 2) a late afternoon/early evening session of the COG intervention; compared to 3) standard inpatient care/usual care \[UC\]. Specific Aim 2 will examine circadian rhythm parameters to determine the optimal timing of the daily COG intervention. Exploratory Aim 3 will explore if the effects of the COG intervention on cognitive function are mediated by daytime activity, and explore if selected biological and clinical factors moderate intervention effects on cognitive function.

Optimal Timing of Computerized Cognitive Training for Older Intensive Care Unit Survivors

Optimal Timing of Computerized Cognitive Training for Older Intensive Care Unit Survivors

Condition
Critical Illness
Intervention / Treatment

-

Contacts and Locations

Seattle

University of Washington Medical Center, Seattle, Washington, United States, 98195

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Age ≥ 60 years
  • * ICU length of stay ≥ 24 hours
  • * Active transfer order or expected discharge from ICU to a post-ICU unit
  • * Fluent in English
  • * Functional independence prior to hospital admission (Katz Index = 6)
  • * No suspicion of Alzheimer's disease/dementia
  • * Current hospitalization at University of Washington Medical Center
  • * Documented history or suspicion of Alzheimer's disease/dementia, or current prescription of anti-dementia medication
  • * Documented history of bipolar disorder or schizophrenia
  • * Documented acute stroke or acute traumatic brain injury
  • * Severe visual impairment
  • * Severe hearing impairment
  • * Severe dominant arm paresis/paralysis
  • * Transfer from inpatient rehabilitation or skilled nursing care facility

Ages Eligible for Study

60 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

University of Washington,

Maya N Elias, PhD, MA, RN, PRINCIPAL_INVESTIGATOR, University of Washington

Study Record Dates

2024-12-31