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

基本信息

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
项目类别：
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&apos 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

项目摘要

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

项目概要原发性甲状旁腺功能亢进症 (PHPT) 是一种常见的内分泌疾病，影响约 100 万老年人（年龄 ≥ 65 岁）美国人。未经治疗的 PHPT 与骨质疏松、骨折、肾结石、肾功能衰退有关，然而，超过 80% 的 PHPT 患者缺乏典型症状。例如肾结石；即使骨质流失和肾功能衰退悄然发生，它们也常常“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”）常见的主观主诉可能是患者出现的唯一症状。客观的神经认知测试发现 PHPT 患者的注意力明显下降水平、非语言学习过程障碍以及结构和视觉空间记忆受损。这些损伤会导致老年人的功能显着下降和生活质量 (QoL) 下降正是这一群体将认知能力的保存视为一项重要的健康指标。甲状旁腺切除术通常作为门诊手术进行，是 PHPT 的一线治疗方法，通常是多项研究表明认知功能和认知功能得到改善（甚至正常化）。然而，PHPT 作为一种诊断经常被忽视，高达 70% 的患者都忽视了 PHPT。即使老年人符合手术治疗标准，PHPT 的治疗也不足。迄今为止，针对患有 PHPT 的老年人的 NC 症状进行的研究还很少。老年人中与 PHPT 相关的 NC 症状的数据，包括可能与他们之间的普遍情况以及他们对治疗的反应。在本提案中，我们的目标是 (a) 前瞻性地描述 NC 症状和治疗反应模式患有 PHPT 的老年人使用经过验证的主观调查工具和 3 项客观 NC 测量 (b) 制定结合机器学习和自然语言的基于人工智能的战略处理技术，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：描述患有 PHPT 的老年人的 NC 症状特征图 2：描述与 PHPT 相关老年患者治疗反应模式相关的因素 NC 症状 3：开发一种基于人工智能的算法，以加快患有 PHPT 的老年人的诊断或没有 NC 症状