Gender Disparities in Pain and Treatment and their Association with Alzheimer's Disease and Related Dementias (ADRD)

疼痛和治疗方面的性别差异及其与阿尔茨海默病和相关痴呆症 (ADRD) 的关系

• 批准号: 10685413
• 负责人: Sadaf Arefi Milani
• 金额: $ 12.38万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10685413
• 关键词: Acceleration; Address; Age; Aging; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Applications Grants; Area; Characteristics; Clinical; Clinical Data; Competence; Complex; Data; Data Reporting; Dementia; Diagnosis; Disparity; Disparity in diagnosis; Elderly; Epidemiology; Ethnic Origin; Extramural Activities; Funding; Gender; Geriatrics; Goals; Health; Health Personnel; Health and Retirement Study; Health behavior; Health system; High Prevalence; Individual; Inequality; Internal Medicine; Intervention; Knowledge; Leadership; Learning; Life Cycle Stages; Life Expectancy; Link; Longitudinal Studies; Manuscripts; Medical; Medicare; Medicare claim; Mentors; National Institute on Aging; Outcome; Pain; Pain Measurement; Pain management; Palliative Medicine; Pathogenesis; Pathology; Pathway interactions; Patient Self-Report; Process; Provider; Public Health; Race; Research; Research Personnel; Research Priority; Research Project Grants; Resources; Risk Factors; Role; Sex Differences; Social status; Socioeconomic Factors; Source; Statistical Methods; Surveys; System; Techniques; Texas; Training; Training Activity; Universities; Woman; care outcomes; career; chronic pain; chronic pain management; experience; gender difference; gender disparity; health data; health disparity; improved; men; modifiable risk; novel; older women; population based; professor; programs; psychologic; self diagnosis; sex; skills; social; treatment and outcome; treatment disparity

PROJECT SUMMARY/ABSTRACT I am an Assistant Professor in the Department of Internal Medicine, Division of Geriatrics and Palliative Medicine, at the University of Texas Medical Branch. My long term-career goal is to become an independent researcher who identifies drivers and consequences of gender disparities in health among older adults with Alzheimer’s disease and related dementias (ADRD), blending life course social and health constructs with clinical details from medical claims. To accomplish this goal, I will complete the following four training objectives that build upon my prior training in the epidemiology of aging: (1) Understand the complex processes that impact pain and ADRD among older adults; (2) Learn context of sex/gender and techniques to analyze results by sex and gender, with a focus on sex and gender differences in pain and ADRD; (3) Develop statistical skills for analyzing Medicare claims data linked to survey data; and (4) Increase competencies required to function effectively as an independent extramurally-funded investigator, by developing mentoring and leadership skills and enhancing manuscript and, grant applications, and leadership skills. Training in these areas will include coursework, shadowing interdisciplinary teams in clinical settings, and experiences accessing, managing, and analyzing Medicare files. My training activities have been integrated with a research project in which I will use data from the Health and Retirement Study, a nationally representative longitudinal study of older adults in the US, linked to Medicare claims (2006-2018) to complete the following specific aims: (A) Evaluate gender differences in the underdiagnosis of pain by comparing self-reports of pain from survey data to the diagnosis of chronic pain from claims data in older adults, by ADRD status; (B) Examine gender disparities in the treatment of chronic pain among older adults with pain, by ADRD status; and (C) Assess gender disparities in the association of chronic pain and pain treatment with incident ADRD. The expected findings of this research will provide evidence for pain and pain treatment as a modifiable risk factor for ADRD and inform potential pain treatment interventions aimed at reducing the treatment gap between men and women and ultimately reducing the gender disparity in ADRD burden. Completion of the K01 mentored training and research plans will provide me with the knowledge, skills, and expertise required to understand disparities among older adults with ADRD, in order to develop a program of research that blends life course social and health constructs with clinical data, with the goal of reducing gender disparities among older adults with pain and ADRD.

项目概要/摘要 我是内科老年病学和姑息医学科的助理教授， 我的长期职业目标是成为一名独立研究员。 谁确定了患有阿尔茨海默病的老年人健康中性别差异的驱动因素和后果 疾病及相关痴呆症 (ADRD)，将生命历程的社会和健康结构与临床细节相结合 为了实现这一目标，我将完成以下四个培训目标： 我之前接受过的衰老流行病学培训：(1) 了解影响疼痛和 ADRD 的复杂过程 在老年人中；(2) 了解性/性别的背景以及按性别分析结果的技术， 关注疼痛和 ADRD 方面的性别差异； (3) 培养分析医疗保险的统计技能； 与调查数据相关联的索赔数据；以及 (4) 提高有效运作所需的能力 独立的外部资助调查员，通过发展指导和领导技能并增强 这些领域的手稿和资助申请以及领导技能培训将包括课程作业、 在临床环境中跟踪跨学科团队，并获得访问、管理和分析的经验 我的培训活动已与一个研究项目相结合，在该项目中我将使用来自的数据。 健康与退休研究是一项针对美国老年人的全国代表性研究，该研究将 医疗保险索赔（2006-2018）以完成以下具体目标： (A) 评估医疗保险索赔中的性别差异 通过将调查数据中的疼痛自我报告与慢性疼痛的诊断进行比较来诊断疼痛 (B) 检查慢性疼痛治疗中的性别差异 在患有疼痛的老年人中，按 ADRD 状况分类；以及 (C) 评估与慢性疼痛相关的性别差异 本研究的预期结果将为 ADRD 事件的疼痛和疼痛治疗提供证据。 疼痛和疼痛治疗作为 ADRD 的可改变危险因素，并为潜在的疼痛治疗干预措施提供信息 旨在缩小男女之间的待遇差距，并最终缩小性别差异 ADRD 负担。完成 K01 指导的培训和研究计划将为我提供知识， 了解患有 ADRD 的老年人之间的差异所需的技能和专业知识，以便制定 将生命历程的社会和健康结构与临床数据相结合的研究计划，其目标是 减少患有疼痛和 ADRD 的老年人的性别差异。