Posttraumatic Stress Disorder, Accelerated Biological Aging, and Veteran Health

创伤后应激障碍、加速生物衰老和退伍军人健康

• 批准号: 10705915
• 负责人: Kyle J. Bourassa
• 金额: --
• 依托单位: DURHAM VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10705915
• 关键词: Acceleration; Affect; Afghanistan; Age; Aging; Award; Behavior Therapy; Behavioral Mechanisms; Biological Aging; Biological Markers; Cessation of life; Characteristics; Chronic Disease; Chronology; Clinical; DNA Markers; DNA Methylation; Data; Data Collection; Development; Disease; Electronic Health Record; Face; Goals; Health; Health Care Costs; Health Personnel; Health behavior; Human; IgE; Individual; Intervention; Iraq; Link; Longevity; Measures; Mental Health; Mental disorders; Mentors; Mentorship; Methodology; Methods; Methylation; Molecular; Outcome; Persons; Physiological; Population; Post-Traumatic Stress Disorders; Premature Mortality; Research; Research Personnel; Risk; Sampling; Scientist; Site; Social support; Speed; Testing; Time; Training; Translating; Veterans; Work; career; cohort; comorbidity; cost; disability; experience; health care service utilization; health data; improved; middle age; military veteran; novel; premature; prevent; psychosocial; theories; uptake; Acceleration; Affect; Afghanistan; Age; Aging; Award; Behavior Therapy; Behavioral Mechanisms; Biological Aging; Biological Markers; Cessation of life; Characteristics; Chronic Disease; Chronology; Clinical; DNA Markers; DNA Methylation; Data; Data Collection; Development; Disease; Electronic Health Record; Face; Goals; Health; Health Care Costs; Health Personnel; Health behavior; Human; IgE; Individual; Intervention; Iraq; Link; Longevity; Measures; Mental Health; Mental disorders; Mentors; Mentorship; Methodology; Methods; Methylation; Molecular; Outcome; Persons; Physiological; Population; Post-Traumatic Stress Disorders; Premature Mortality; Research; Research Personnel; Risk; Sampling; Scientist; Site; Social support; Speed; Testing; Time; Training; Translating; Veterans; Work; career; cohort; comorbidity; cost; disability; experience; health care service utilization; health data; improved; middle age; military veteran; novel; premature; prevent; psychosocial; theories; uptake

Posttraumatic stress disorder (PTSD) is a prevalent and costly mental health disorder associated with poorer health and higher healthcare utilization. These outcomes are a particular concern among Veterans, who have higher rates of PTSD compared to civilian populations. Veterans with PTSD, for example, are twice as likely to experience premature death compared to Veterans without PTSD. How might PTSD affect health? Recent studies have shown that PTSD can accelerate biological aging—i.e., the rate at which people evidence gradual physiological decline consistent with chronological aging. Accelerated aging is theorized to result in more disability, disease, and premature death and could explain why Veterans with PTSD are at greater risk of poor health. There is great promise in slowing aging to prevent ill health, but methods of assessing biological aging have been constrained by long and costly data collection, limiting effective application to clinical settings. Recent methods have shown the potential to use markers of DNA methylation to calculate the speed at which people are aging using biomarkers collected at a single point in time. This novel methodology could provide the opportunity to identify and treat Veterans who are at risk of rapid aging—such as those with PTSD—years before poor health develops. These findings could help promote the importance and uptake of PTSD treatment among both Veterans and healthcare providers, reducing healthcare costs and human suffering. Doing so, however, would require applying these methods in Veteran samples and empirically validating this approach. This Research Plan proposes to examine the links between PTSD, accelerated aging, and later health. The main hypotheses guiding this work are that Veterans with PTSD will evidence accelerated aging, and this accelerated aging will be associated with poorer health 5 years later. A further goal will be to test whether candidate psychosocial characteristics— higher social support, fewer comorbid mental health disorders, positive health behaviors, and treatment for PTSD—might protect against accelerated aging for Veterans with PTSD. Specific Aims—Aim 1: Examine whether Veterans with PTSD have accelerated biological aging. Aim 2: Test whether accelerated biological aging predicts Veterans’ midlife health over the subsequent 5 years. Aim 3: Determine whether candidate psychosocial characteristics are associated with slower aging and better midlife health for Veterans with PTSD. These aims will be achieved using existing data from the Post-Deployment Mental Health (PDMH) study, a multi-site cohort of Afghanistan and Iraq era Veterans. PDMH data, including methylation data used to derived biological aging scores, will be linked to health outcomes in the VA electronic health record (EHR). This study will help determine whether Veterans with PTSD have accelerated biological aging compared to Veterans without PTSD, as well as if accelerated aging predicts poorer Veteran health. This study will provide the first evidence that biological aging explains how PTSD results in poor Veteran health, as well as what psychosocial characteristics could be targeted by intervention to slow aging. The results of these aims will be used to support a Merit Review award submission proposing to examine change in biological aging following behavioral intervention for Veterans with PTSD. The Training and Mentoring plans outline the professional development, training, and mentorship activities that will support the applicant’s development as an early-career investigator in the VA. Specifically, the Training and Mentoring plans will extend the applicant’s methodological expertise to include DNA methylation measures of biological aging in Veteran populations with PTSD, expanding the applicant’s expertise in using VA EHR health data, and support the applicant’s long-term career goal of using interventions to improve the health of Veterans with PTSD. The ongoing mentorship and support the applicant will receive during the CDA-2 award period and beyond will help his development as a Research Health Scientist at the Durham VAMC.

创伤后应激障碍（PTSD）是一种普遍且昂贵的精神健康障碍，与较差有关 健康和更高的医疗保健利用。这些结果在退伍军人中特别关注 与平民相比，PTSD的比率更高。例如，具有PTSD的退伍军人的可能性是 与没有PTSD的退伍军人相比，经历过早死亡。 PTSD会如何影响健康？最近的 研究表明，PTSD可以加速生物学衰老，即人们证据等级的速度 生理下降与年代老化一致。理论上将加速衰老得出更多 残疾，疾病和过早死亡，可以解释为什么具有PTSD的退伍军人的风险更大 健康。 放缓衰老以防止健康状况不佳，但是评估生物衰老的方法已经有很大的希望 受到长期且昂贵的数据收集的限制，将有效的应用程序限制在临床环境中。最近的 方法表明有可能使用DNA甲基化标记来计算人们的速度 正在使用单个时间点收集的生物标志物衰老。这种新颖的方法可以提供 识别和治疗有快速衰老风险的退伍军人（例如有PTSD） 在健康发展不良之前。这些发现可以帮助促进PTSD治疗的重要性和吸收 在退伍军人和医疗保健提供者中，减少医疗保健成本和人类痛苦。这样做， 但是，将需要在退伍军人样本中应用这些方法，并通过经验验证这种方法。 该研究计划的建议旨在检查PTSD，加速衰老和后来的健康状况之间的联系。这 指导这项工作的主要假设是，具有PTSD的退伍军人将证明衰老，这是 5年后，加速衰老将与健康状况较差有关。另一个目标是测试是否 候选社会心理特征 - 更高的社会支持，合并症的较少，精神健康障碍， 健康行为和PTSD的治疗 PTSD。特定目的 - AIM 1：检查具有PTSD的退伍军人是否加速了生物衰老。 AIM 2：测试是否加速了在随后的生物老化预测退伍军人的中年健康状况 5年。目标3：确定候选的社会心理特征是否与较慢有关 PTSD的退伍军人衰老和中年健康状况更好。这些目标将使用现有数据实现 摘自剥夺后的心理健康（PDMH）研究，这是一个多站点的阿富汗和伊拉克时代 退伍军人。 PDMH数据，包括用于得出生物衰老评分的甲基化数据，将与 VA电子健康记录（EHR）中的健康结果。这项研究将有助于确定退伍军人是否 与没有PTSD的退伍军人相比 老化的预测退伍军人健康。这项研究将提供第一个证据，表明生物老化解释了 PTSD如何导致退伍军人健康不良，以及哪些社会心理特征可以由 干预减慢衰老。这些目标的结果将用于支持优异审查奖提交 提议检查具有PTSD的退伍军人行为干预后生物学老化的变化。 培训和指导计划概述了专业发展，培训和指导活动 将支持申请人作为弗​​吉尼亚州早期研究员的发展。具体而言，培训和 指导计划将扩展申请人的方法论专业知识，以包括DNA甲基化度量 PTSD的退伍军人人口中的生物老化，扩大了申请人使用VA EHR健康方面的专业知识 数据，并支持申请人使用干预措施改善退伍军人健康的长期职业目标 与PTSD。申请人将在CDA-2奖励期内获得的持续的精通和支持 超越将有助于他在达勒姆VAMC担任研究健康科学家的发展。