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; 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.

项目摘要/摘要 我是老年医学和姑息医学部内科学系的助理教授， 在德克萨斯大学医学分公司。我的长期职业目标是成为一名独立研究员 谁确定了老年人与阿尔茨海默氏症的驱动因素和性别分布的后果 疾病和相关痴呆症（ADRD），将生活课程与临床细节结合在一起 从医疗主张。为了实现这一目标，我将完成以下四个培训对象 我先前在衰老流行病学方面的培训：（1）了解影响疼痛和ADRD的复杂过程 在老年人中； （2）学习性别/性别和技术的背景，以通过性别和性别分析结果 专注于性别和性别差异在疼痛和adrd中的差异； （3）开发分析Medicare的统计技能 链接到调查数据的索赔数据； （4）增加有效发挥作用的能力 通过发展心理和领导能力并增强独立的外部资助研究者 手稿，授予申请和领导技能。在这些领域的培训将包括课程工作， 在临床环境中遮蔽跨学科团队，并经验访问，管理和分析 Medicare文件。我的培训活动已与一个研究项目集成在一起，我将使用来自 健康与退休研究是美国老年人的全国代表性纵向研究 致Medicare主张（2006- 2018年）以完成以下具体目的：（a）评估性别差异 通过比较调查数据的疼痛自我报告与诊断慢性疼痛的诊断，疼痛的诊断不足 通过ADRD身份向老年人索赔数据； （b）检查治疗慢性疼痛的性别分布 在有疼痛的老年人中，处于Adrd身份； （c）评估慢性关联中的性别分布 疼痛和疼痛治疗因事件而进行。这项研究的预期发现将为 疼痛和疼痛治疗是ADRD的可修改风险因素，并告知潜在的疼痛治疗干预措施 旨在减少男女之间的治疗差距，并最终减少性别差异 阿德德负担。完成K01修改培训和研究计划的完成将为我提供知识， 了解ADRD老年人之间需要差异所需的技能和专业知识，以发展 将生活课程社会和健康构建与临床数据融合在一起的研究计划，目的是 减少患有疼痛和ADRD的老年人的性别分布。