Long Term Depressive Symptom Course & Adverse Health Outcomes among Older Women

长期抑郁症状课程

• 批准号: 8037713
• 负责人: Kristine Yaffe
• 金额: $ 33.45万
• 依托单位: NORTHERN CALIFORNIA INSTITUTE/RES/EDU
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-04 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8037713
• 关键词: Accounting; Address; Affect; Age; Aged, 80 and over; Aging; Amyloid; Biological; Biology; Blood; Cardiovascular Diseases; Chronic Disease; Clinic Visits; Clinical; Cognitive; Data; Development; Disease; Elderly; Elderly woman; Enrollment; Funding; Health; Impaired cognition; Impairment; Inflammation; Knowledge; Light; Link; Mediating; Mental Depression; Mental Health; Monitor; Morbidity - disease rate; National Institute of Mental Health; Nature; Outcome; Participant; Pathway interactions; Peripheral; Plasma; Population; Prevalence; Prevention; Prevention strategy; Prospective Studies; Recruitment Activity; Research Priority; Risk Factors; Serum Markers; Severities; Site; Sleep; Strategic Planning; Subgroup; Symptoms; Time; United States National Institutes of Health; Visit; Woman; adverse outcome; age related; aged; base; cardiovascular risk factor; cognitive function; cohort; cost effective; depressive symptoms; disability; follow-up; functional decline; functional status; geriatric depression; high risk; insight; novel; older women; osteoporosis with pathological fracture; prevent; public health relevance

DESCRIPTION (provided by applicant): Depressive symptoms are very common in the elderly, especially among women, and have been linked with cognitive and physical disability, although the nature and direction of this association, including the causal interpretation, remains controversial. We propose to investigate how depressive symptoms among elderly women are associated with cognitive and functional decline over the long term. Assessing depressive symptoms at only one timepoint (as has been done in almost all previous studies) is inadequate because depressive symptoms are commonly variable over time, and because the cumulative impact of depressive symptoms may take time to manifest itself. To best investigate the full impact of a chronic disease such as depression, we need to study its long-term course, in accord with the 2008 NIMH Strategic Plan to chart trajectories of mental health symptoms and with research priorities expressed in PA-07-163. We also propose to investigate several targeted biological mechanisms that may underlie the association between depressive symptoms and cognitive and functional decline. Few studies, if any, have comprehensively investigated these mechanisms and yet, their discovery could yield important opportunities for prevention and treatment, not to mention an essential understanding of the biology of depression. Finally we propose to study the effects of depressive symptoms in the oldest old. Little information exists on the prevalence and severity of depressive symptoms and their associated health outcomes in this population, typically defined as elders aged =85 years, and the fastest growing segment of the U.S. population. Based on our preliminary data, substantial depressive symptoms are common in this population, affecting 15-25% of the oldest old. Our aims will be addressed from ongoing prospective study of over 10,000 elderly women (including 3800 oldest old) who enrolled at age = 65 years and who have been rigorously followed for almost 20 years. In an extremely cost-effective approach, we will determine the long-term course of depressive symptoms and how these symptoms are associated with the development of cognitive and functional decline. In addition, we will determine if the association between depressive symptoms and these outcomes is partially explained by key biological pathways such as inflammation, sleep quality, cardiovascular disease and blood ¿-amyloid level. Knowledge gained from this proposal will be both novel and critical for understanding the impact of depressive symptoms over the long term on health outcomes in older women including the oldest old. It will shed important insights on both the clinical need for monitoring/treating the elderly with depressive symptoms and on the biological mechanisms that may link depression to cognitive impairment and disability. PUBLIC HEALTH RELEVANCE: Knowledge gained from this proposal will be both novel and critical for understanding the impact of geriatric depressive symptoms on age-related health outcomes in older women including the oldest old. It will shed important insights on both the clinical need for monitoring/treating the elderly with depressive symptoms and on the biological mechanisms that may link depression to cognitive and functional decline.

描述（由适用提供）：抑郁症状在老年人中，尤其是在女性中很常见，并且与认知和身体残疾有联系，尽管这种关联的性质和方向（包括因果解释）仍然有争议。我们建议研究老年女性的抑郁症状如何与认知症状有关 长期的功能下降。仅在一个时间点评估抑郁症状 （就像几乎所有先前的研究中所做的那样）是不充分的，因为抑郁症状随着时间的流逝通常是变化的，并且由于抑郁症状的累积影响可能需要时间才能表现出来。为了最好地研究慢性疾病（例如抑郁症）的全部影响，我们需要根据2008年NIMH战略计划来研究其长期课程，以绘制精神健康症状的轨迹以及在PA-07-163中表达的研究优先级。我们还建议研究几种可能是抑郁症状与认知和功能下降之间关联的靶向生物学机制。很少有研究（如果有的话）对这些机制进行了全面研究，但是它们的发现可以带来预防和治疗的重要机会，更不用说对抑郁症的生物学的基本理解。 最后，我们建议研究最古老的老年抑郁症状的影响。关于抑郁症状的患病率和严重程度及其在该人群中相关的健康结果的信息很少，通常定义为老年人= 85岁，是美国人口增长最快的部分。根据我们的初步数据，在该人群中很常见，影响了最古老的老年人的15-25％。我们的目标将通过对10,000多名最古老的妇女（包括3800名最古老）的前瞻性研究来解决，她们在年龄= 65岁且经过近20年的严格遵循。在一种极其成本效益的方法中，我们 将确定抑郁症状的长期过程，以及这些症状与认知和功能下降的发展如何相关。此外，我们将确定抑郁症状和这些结果之间的关联是否部分通过关键的生物学途径（例如感染，睡眠质量，心血管疾病和血液» - 淀粉样蛋白水平）来解释。从该提案中获得的知识将是新颖的，对于理解抑郁症状在长期中对包括老年最古老的老年妇女健康结果的影响至关重要。它将对以抑郁症状进行监测/治疗的临床需求以及可能将抑郁症与认知障碍和残疾联系在一起的生物学机制的重要见解。 公共卫生相关性：从这项提案中获得的知识将是新颖和至关重要的，对于了解老年抑郁症状对年龄相关的老年妇女的健康状况的影响至关重要。它将对以抑郁症状进行监测/治疗的临床需求以及可能将抑郁症与认知和功能下降联系起来的生物学机制的重要见解。