Characterizing neurocognitive symptoms in older adults with primary hyperparathyroidism

原发性甲状旁腺功能亢进症老年人的神经认知症状特征

• 批准号: 10725231
• 负责人: Hadiza S Kazaure
• 金额: $ 32.2万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2025-08-14
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10725231
• 关键词: Affect; Age; Aging; Algorithms; Alzheimer' s Disease; Ambulatory Care Facilities; American; Artificial Intelligence; Award; Biochemical; Biochemical Markers; Biological; Calcium; Cardiovascular system; Caring; Characteristics; Chronic; Clinic; Clinic Visits; Clinical; Clinical assessments; Cognition; Cognitive deficits; Creatinine; Data; Diagnosis; Disease of parathyroid glands; Documentation; Early Diagnosis; Early treatment; Elderly; Electronic Health Record; Endocrine; Endocrine Surgical Procedures; Endocrine System Diseases; Endocrinology; Exclusion; Fracture; Goals; Growth; Health; Health system; Hypercalcemia; Hyperparathyroidism; Impaired cognition; Impairment; Kidney; Kidney Calculi; Knowledge; Learning; Machine Learning; Measures; Memory; Memory impairment; Morbidity - disease rate; Natural Language Processing; Neurocognition; Neurocognitive; Neurocognitive Deficit; Neuropsychological Tests; Operative Surgical Procedures; Osteoporosis; Outpatients; PTH gene; Parathyroid gland; Parathyroidectomy; Patients; Pattern; Polypharmacy; Population; Prevalence; Prize; Procedures; Process; Quality of life; Renal function; Research; Research Methodology; Research Personnel; Specialist; Surveys; Symptoms; Techniques; Testing; Time; Twin Multiple Birth; United States; United States National Institutes of Health; Universities; Verbal Learning; Visit; Visuospatial; Vulnerable Populations; Work; aging population; blind; bone loss; brain fog; career development; cognitive function; cognitive testing; comorbidity; demographics; follow-up; functional decline; high risk; human old age (65+); improved; machine learning method; neurocognitive test; non-verbal; novel strategies; older patient; preservation; prospective; public health relevance; response; symptomatic improvement; treatment guidelines; treatment response

PROJECT SUMMARY Primary hyperparathyroidism (PHPT) is a common endocrine disorder affecting ~1 million older (age ≥ 65 years) Americans. Untreated PHPT is associated with osteoporosis, fractures, kidney stones, renal function decline, and cardiovascular-related morbidity. However, more than 80% of patients with PHPT lack classic symptoms such as kidney stones; they are often “asymptomatic” even as bone loss and renal decline silently occur. Neurocognitive (NC) symptoms, including memory impairment and cognitive dysfunction (“brain fog”), are common subjective complaints and may be the only symptoms with which patients present. Studies utilizing objective neurocognitive testing have found that PHPT patients have significantly diminished concentration levels, impairments in nonverbal learning processes, and compromised constructional and visuospatial memory. These impairments result in significant functional decline and decreased quality of life (QoL) in older adults – the very subpopulation that prizes the preservation of cognition as a critical health metric. Parathyroidectomy, commonly done as an outpatient procedure, is the first-line treatment for PHPT and is often curative. Several studies have demonstrated improvements (and even normalization) in cognitive function and quality of life following surgery. Nonetheless, PHPT is too often overlooked as a diagnosis, and up to 70% of older adults are undertreated for PHPT even when they meet the criteria for surgical treatment. Further, no studies on NC symptoms in older adults with PHPT have been conducted to date. Thus, there is a paucity of data on PHPT-associated NC symptoms among older adults, including specific cognitive deficits that may be prevalent among them and their response to treatment. In this proposal, we aim to (a) prospectively characterize NC symptoms and treatment-response patterns for older adults with PHPT using a validated subjective survey instrument and a battery of 3 objective NC measures and (b) develop an artificial intelligence-based strategy incorporating machine learning and natural language processing techniques, to expedite PHPT diagnosis. All studies will be conducted within the Duke University Health System. The aims of the proposal are: 1: Characterize NC symptoms of older adults with PHPT 2: Delineate factors associated with treatment-response patterns among older patients with PHPT-associated NC symptoms 3: Develop an artificial intelligence-based algorithm to expedite the diagnosis of PHPT among older adults with or without NC symptoms

项目摘要 原发性甲状旁腺功能亢进（PHPT）是一种常见的内分泌疾病，影响了约100万（年龄≥65岁） 美国人。未经处理的PHPT与骨质疏松症，骨折，肾结石，肾功能下降有关， 和与心血管相关的发病率。但是，超过80％的PHPT患者缺乏经典症状 例如肾结石；即使骨骼流失和肾脏下降默默地发生，它们通常也“无症状”。 神经认知（NC）症状，包括记忆障碍和认知功能障碍（“脑雾”），是 常见的主观投诉，可能是患者出现的唯一符号。使用的研究 客观神经认知测试发现，PHPT患者的浓度显着降低 级别，非语言学习过程中的障碍以及造成的结构和视觉记忆。 这些障碍导致老年人的功能下降和改善的生活质量（QOL） - 隐私将认知保留为关键健康指标的非常子群。 甲状旁腺切除术通常是门诊手术，是PHPT的一线治疗方法，通常是 治愈性。几项研究表明，认知功能和 手术后的生活质量。尽管如此，PHPT经常被视为诊断，多达70％ 即使符合手术治疗标准，老年人即使pHPT也被低估了。此外，不 迄今为止，已经对患有PHPT的老年人的NC症状进行了研究。那很少 老年人中与PHPT相关的NC符号的数据，包括可能是特定的认知缺陷 它们中的流行及其对治疗的反应。 在此提案中，我们旨在（a）前瞻性地表征NC符号和治疗响应模式 使用经过验证的主题调查仪器和3个目标NC测量的pHPT的老年人使用PHPT （b）制定基于人工智能的策略编码机器学习和自然语言 处理技术，以加快PHPT诊断。所有研究将在杜克大学内进行 卫生系统。 该提案的目的是： 1：表征pHPT的老年人的NC符号 2：与pHPT相关的老年患者中与治疗反应模式相关的划定因素 NC符号 3：开发一种基于人工智能的算法，以加快老年人的PHPT诊断 或没有NC符号