Feasibility of the Memory and Attention Adaptation Training-Geriatrics Intervention in Older Cancer Survivors with Mild Cognitive Impairment
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PROJECT SUMMARY Alzheimer’s Disease (AD) and Alzheimer’s Disease Related Dementias (ADRD) affect more than 6 million older adults in the United States and although the relationship between risks of cancer and AD/ADRD are not fully elucidated, a proportion of older cancer survivors will subsequently develop AD/ADRD months to years after cancer treatment. Older cancer survivors are a rapidly growing population; in the United States there are >10 million cancer survivors aged 65. Older cancer survivors experience long-term side effects from prior therapy, such as Cancer-Related Cognitive Dysfunction (CRCD). CRCD is a prevalent side effect and creates difficulties in memory, attention and executive function. Up to 35% of cancer survivors experience CRCD symptoms months to years after completion of their cancer therapy. Older patients with cancer, particularly those with lower cognitive reserve, are most vulnerable to CRCD. One hypothesis is that CRCD may contribute to cognitive effects in older cancer survivors with Mild Cognitive Impairment (MCI) and AD/ADRD. Prior studies evaluating non-pharmacologic interventions (e.g. Cognitive Training) for older adults with MCI and AD have demonstrated improvement in cognitive and neuropsychiatric symptoms. Older cancer survivors with MCI are at risk of progressing to AD, however if CRCD is contributing to cognitive difficulties, this may be a reversible component. Memory and Attention Adaptation Training-Geriatrics (MAAT-G) is a cognitive behavioral therapy-based intervention for CRCD. Providing MAAT-G to older cancer survivors with MCI who are at greatest risk for developing AD/ADRD may afford improvements in perceived and objective cognitive function by addressing the reversible components of CRCD. MAAT-G is delivered by a clinical psychologist via videoconferencing during a series of ten workshop sessions. As a component of the parent K76 award, MAAT-G was adapted by the PI using the Contextual, Cohort-based, Maturity, Specific Challenge (CCMSC) model; feedback from older cancer survivors guided further adaptation of the intervention. The primary goal of the K76 is to assess the preliminary efficacy of MAAT-G on older adults with cancer actively on treatment. Though in the parent study as currently designed, many of these patients may not meet criteria for MCI. Therefore, the overarching goal of this administrative supplement is to evaluate the feasibility of delivering MAAT-G in 35 older cancer survivors with MCI who have completed cancer therapy by determining consent rate, intervention adherence rate, and study completion rate in this population. We will also examine the change in perceived and objective cognitive function and functional independence following the intervention. Additionally, we will gather perspectives on the feasibility and perceived cognitive benefits of MAAT-G in older cancer survivors with MCI through semi-structured interviews with patients and caregivers of the enrolled patients. If MAAT-G is feasible to deliver in older cancer survivors with MCI, future work would evaluate the benefit of MAAT-G on perceived and objective cognition and functional independence in a randomized clinical trial in this population.
