Sleep, Inflamation, and Depression Occurrence in Breast Cancer Survivors

乳腺癌幸存者的睡眠、炎症和抑郁发生率

基本信息

批准号：
9128555
负责人：
Michael R Irwin
金额：
$ 79.38万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-18 至 2019-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9128555
关键词：
Address Adult Age Behavioral Biological Biological Factors Breast Cancer Patient Breast Cancer survivor California Cancer Survivor Clinical Clinical Management Cohort Studies Communities Cross-Sectional Studies Data Development Diagnosis Early Diagnosis Elderly Epidemiology Fatigue General Population Health Planning Individual Inflammation Inflammatory Intervention Lead Link Major Depressive Disorder Malignant Neoplasms Mental Depression Methods Modeling Participant Patients Prevalence Publishing Recording of previous events Reporting Risk Risk Factors Role Signal Transduction Sleep Sleep Disorders Sleep disturbances Sleeplessness Staging Time Woman base cancer diagnosis cancer therapy depression prevention genomic biomarker high risk improved inflammatory marker malignant breast neoplasm member middle age modifiable risk older women prospective tumor registry

项目摘要

DESCRIPTION (provided by applicant): In 2006, there were over 11.4 million cancer survivors in the US. However for many individuals with cancer, improved survival is complicated by long-term behavioral effects including depression. Indeed, the prevalence of depression in breast cancer survivors is nearly three to five times greater than the general population. Yet, the unique clinical, behavioral, and biological factors that prospectively contribute to increased depression risk in breast cancer survivors is not known. In older adults, we have found that sleep disturbance independently contributes to depression occurrence, and this prospective risk is specific to those with a history of depression. Breast cancer status may add to that risk, as we have found that breast cancer survivors with insomnia have a prevalence of depression history that is nearly twice that in older women with insomnia; yet, other factors in the prior risk model do not generalize to breast cancer survivors. There are no published prospective data that have examined the independent contribution of sleep disturbance on depression occurrence in breast cancer survivors. Increasing evidence also implicates sleep disturbance in the activation of inflammatory signaling, which serves as a biological mechanism that contributes to depression. Hence, in this SEER-affiliated tumor registry-based study, we will evaluate 300 early stage-, older adult (>55 years) breast cancer survivors and 300 age-matched comparison women, stratified by a history of major depression. All participants will be community members of Kaiser Permanente Southern California (KPSC), a large nonprofit health plan that serves over 3 million members. In a prospective cohort study, older adult breast cancer survivors vs. comparisons, stratified by depression history will be evaluated at baseline (i.e., 1 year post- primary treatmen for breast cancer survivors) and at 6, 12, 18, and 24 months with the following aims: 1) to determine the prospective association between sleep disturbance and depression occurrence; 2) to evaluate the prospective association between sleep disturbance and cellular and genomic markers of inflammation; and 3) to examine the prospective relationships between sleep disturbance, cellular and genomic markers of inflammation, and depression occurrence. Understanding the cancer-specific clinical, behavioral, and biological factors that prospectively contribute to depression risk in breast cancer survivors vs. comparison older women will substantially alter clinical management by leading to the development of a targeted intervention for depression prevention, specific for breast cancer survivors.

描述（由申请人提供）：2006年，美国有超过1,140万癌症幸存者。然而，对于许多癌症患者而言，长期行为影响（包括抑郁症）的长期行为影响变得更加复杂。实际上，乳腺癌幸存者抑郁症的患病率是普通人群的三到五倍。然而，尚不清楚乳腺癌幸存者抑郁症风险增加的独特临床，行为和生物学因素。在老年人中，我们发现睡眠障碍独立促进抑郁症的发生，这种预期风险是特定于患有抑郁史的风险。乳腺癌状况可能会增加这种风险，因为我们已经发现失眠症患有抑郁史的乳腺癌幸存者几乎是失眠的老年女性的两倍。但是，先前风险模型中的其他因素并未推广到乳腺癌幸存者。尚无公开的前瞻性数据检查睡眠障碍对乳腺癌幸存者抑郁症发生的独立贡献。越来越多的证据也暗示睡眠障碍在炎症信号传导的激活中，这是有助于抑郁症的生物学机制。因此，在这项基于肿瘤注册表的研究中，我们将评估300个早期，老年人（> 55年）乳腺癌幸存者和300名年龄匹配的比较女性，并由严重抑郁史进行分层。所有参与者将是Kaiser Permanente南加州（KPSC）的社区成员，这是一项大型非营利性健康计划，为超过300万成员提供服务。在一项前瞻性队列研究中，将在基线时（即，在乳腺癌幸存者的初级治疗后1年）和6、12、18和24个月以下目的评估老年人乳腺癌幸存者与比较，以抑郁史进行分层：1年，目的：1），以确定睡眠干扰和抑郁症之间的前瞻性关联； 2）评估炎症的睡眠障碍与细胞和基因组标记之间的前瞻性关联； 3）检查睡眠障碍，炎症的细胞和基因组标记与抑郁症发生之间的前瞻性关系。了解癌症特异性的临床，行为和生物学因素，这些因素前瞻性地导致乳腺癌幸存者与比较老年妇女的抑郁症风险，从而通过导致针对预防抑郁症的靶向干预措施，对乳腺癌幸存者的抑郁症预防进行有针对性的干预。