Adaptability and Resilience in Aging Adults (ARIAA)

老年人的适应性和复原力 (ARIAA)

• 批准号: 9335241
• 负责人: Emily J. Bartley
• 金额: $ 11.53万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9335241
• 关键词: Achievement; Address; Adult; Affective; Age; Aging; Aging-Related Process; Anxiety; Attenuated; Biological; Biological Markers; Chronic low back pain; Clinical; Development; Development Plans; Distress; Economics; Educational Intervention; Effectiveness; Elderly; Exposure to; Fibrinogen; Fostering; Goals; Health; Immune; Immunologic Markers; Immunologics; Impairment; Inflammatory; Intervention; Intervention Studies; Knowledge; Maintenance; Measures; Mental Depression; Mentors; Methods; Neurosecretory Systems; Outcome; Pain; Pain intensity; Pain management; Participant; Pathway interactions; Pattern; Persistent pain; Phase; Physical Function; Physiological; Play; Population; Process; Psychosocial Assessment and Care; Randomized Clinical Trials; Recovery; Regulation; Reporting; Research; Resources; Risk; Risk Factors; Role; Stress; System; Testing; Therapeutic; Training; Work; age related; aging population; base; biomarker selection; biopsychosocial; career development; chronic pain; clinical predictors; cohort; design; disability; effective intervention; efficacy testing; functional disability; health care service utilization; health related quality of life; improved; inflammatory marker; innovation; intervention effect; knowledge base; novel strategies; pain adaptation; pain inhibition; psychologic; psychosocial; public health relevance; resilience; response

 DESCRIPTION (provided by applicant): Growing evidence supports the presence of dysregulated pain modulation in older adults, an effect which may heighten age-associated risk for chronic pain. While persistent pain is common in older adults, chronic low back pain is the leading cause of disability in this population and results in significant impairments in psychosocial and physical functioning. Given reports of suboptimal treatment of pain in older adults, improvements in pain management in this cohort are of critical importance. Resilience is characterized as a dynamic process resulting in positive adjustment and adaptation after exposure to adversity. The benefits of resilience in health-related functioning are manifold, and recent evidence suggests that resilience plays an important role in fostering adaptive physiological and affective responses to pain. Given this, capitalizing on positive resources is a promising target for enhancing pain adaptation, and is especially salient to older adults given the burden of high-impact pain in this group. Therefore, the overall goal for this mentored career development application (K99/R00) is to fill this knowledge gap and characterize resilience mechanisms associated with adaptive pain modulatory capacity in older adults with chronic low back pain. Primary training goals for the current application are to: 1) develop a comprehensive knowledge base in biopsychosocial processes of aging and enhance training in the assessment and treatment of older adults; 2) increase knowledge in the understanding and assessment of psychosocial and biological (i.e., inflammatory, neuroendocrine) markers associated with pain and resilience; and 3) augment training in the design, implementation, and analysis of randomized clinical trials. The proposed study is delineated into two phases. Study 1 (K99 Phase) will examine associations among measures of resilience, biological markers of inflammation and neuroendocrine activity, and pain modulatory capacity in older adults with chronic low back pain. Increased knowledge and understanding of the resilience pathways that promote adaptability to pain will allow for the development of a targeted resilience intervention during Study 2 (R00 Phase). This phase will provide the opportunity for examining intervention effects on pain modulatory function and patterns of pain- evoked recovery in physiological and affective systems, and will establish whether a resilience-oriented intervention confers benefits in psychosocial and physical functioning in older adults with chronic low back pain. The proposed career development plan extends from the PI's prior work on affective regulation and mechanisms of vulnerability in chronic pain, and will forge a path towards understanding and investigating psychological therapies of resilience that improve pain and disability in older adults.

 描述（由申请人提供）：越来越多的证据支持老年人存在疼痛调节失调，这种效应可能会增加与年龄相关的慢性疼痛风险。虽然持续性疼痛在老年人中很常见，但慢性腰痛是主要原因。鉴于老年人疼痛治疗效果不佳的报告，改善该群体的疼痛管理至关重要，因为这是一个导致积极调整的动态过程。以及之后的适应适应力对健康相关功能的好处是多方面的，最近的证据表明，适应力在促进对疼痛的适应性生理和情感反应方面发挥着重要作用，因此，利用积极的资源是增强疼痛的一个有希望的目标。适应能力，对于老年人来说尤其重要，因为该群体承受着高影响力的疼痛。因此，这个指导性职业发展应用程序 (K99/R00) 的总体目标是填补这一知识空白并描述复原力。 与患有慢性腰痛的老年人的适应性疼痛调节能力相关的机制当前应用的主要培训目标是：1）开发衰老生物心理社会过程的综合知识库并加强老年人评估和治疗的培训； 2) 增加对与疼痛和复原力相关的社会心理和生物（即炎症、神经内分泌）标志物的理解和评估；3) 加强随机临床试验的设计、实施和分析方面的培训。进入研究 1（K99 阶段）将检查患有慢性腰痛的老年人的恢复力测量、炎症和神经内分泌活动的生物标志物以及疼痛调节能力之间的关联，增加对促进适应能力的恢复力途径的认识和理解。疼痛将允许在研究 2（R00 阶段）期间制定有针对性的复原力干预措施，该阶段将提供检查干预措施对疼痛调节功能以及生理和情感系统中疼痛诱发恢复模式的影响的机会，并将确定是否有效果。一个以复原力为导向的干预措施有利于患有慢性腰痛的老年人的心理社会会议和身体机能。拟议的职业发展计划延伸自PI之前关于慢性疼痛的情感调节和脆弱性机制的工作，并将开辟一条理解和调查的道路。恢复力心理疗法可改善老年人的疼痛和残疾。