Neuropsychological Predictors of Functional Decline in Elders with Cancer

患有癌症的老年人功能下降的神经心理学预测因素

基本信息

批准号：
7924104
负责人：
JASON Ellsworth SCHILLERSTROM
金额：
$ 15.83万
依托单位：
UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-15 至 2014-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7924104
关键词：
Activities of Daily Living Adjuvant Chemotherapy Affect Age Albumins Anemia due to Chronic Disorder Attention Behavior Biological Markers Brain region Cancer Survivor Cerebrum Chronic Disease Cognition Colon Carcinoma Comorbidity Control Groups Decision Making Elderly Functional disorder Future Hemoglobin Impaired cognition Impairment Interleukin-1 Interleukin-6 Interleukins Intervention Intervention Studies K-Series Research Career Programs Lead Longitudinal Studies Malignant Neoplasms Maps Measures Mediating Memory Metabolic Metabolism Methods Modeling Moods Morbidity - disease rate Operative Surgical Procedures Parietal Patients Performance Physiological Physiology Population Principal Investigator Relative (related person)Rest Risk Role Serum Severities Testing Time aged chemotherapy executive function fluorodeoxyglucose positron emission tomography frailty functional decline functional disability functional status glucose metabolism improved mortality neuroimaging neuropsychological nutrition processing speed translational study treatment adherence treatment response

项目摘要

DESCRIPTION (provided by applicant): Patients with cancer who are treated with surgery and adjunctive chemotherapy often have improved survival, yet they remain at risk for disabling functional decline. Cancer, like other chronic diseases affecting the aged, is associated with neuropsychological and physiological changes that likely contribute to this decline. However, this hypothesis has not been tested with longitudinal observation. Moreover, executive function, which is strongly associated with functional impairment in multivariable models, is rarely assessed in populations with cancer. No longitudinal studies have utilized neuroimaging to extend our understanding of the critical brain regions associated with functional decline. Longitudinal studies incorporating multidimensional neuropsychological assessment, neuroimaging, and serum biomarkers are needed to understand how cognition, cerebral metabolism, and physiological changes interact to precipitate functional decline in cancer survivors. The purpose of this application is to describe the one-year postsurgical change in lADL functional status and neuropsychological performance observed in non-demented elders with colon cancer referred for adjuvant chemotherapy compared to a cancer-free elder control group. We will identify the neuropsychological domains associated with functional decline in elders with colon cancer during the one-year postsurgical period. We will determine the association between post chemotherapy cerebral glucose metabolism as measured with resting fluorodeoxyglucose positron emission tomography (FDG-PET) and functional status in nondepressed colon cancer survivors. Finally, we will explore the relationship between serum biomarkers for physiological changes associated with cancer (interleukin 1, interleukin 6, hemoglobin, and albumin) and functional and cognitive decline. RELEVANCE: This study will be the first to describe longitudinal change in functional status, neuropsychological performance, and serum biomarkers for frailty across multiple methods of assessment in elder cancer survivors. It will also be the first to establish FDG-PET neuroimaging as a biomarker for functional status in elder cancer survivors. This project will inform future intervention studies that target the neuropsychological impairments and physiological changes mediating functional decline in colon cancer survivors.

描述（由申请人提供）：接受手术和辅助化学疗法治疗的癌症患者的生存率通常提高，但仍处于禁用功能下降的风险。癌症与其他影响老年人的慢性疾病一样，与可能导致这种下降的神经心理学和生理变化有关。但是，该假设尚未通过纵向观察进行检验。此外，在多变量模型中与功能障碍密切相关的执行功能很少在癌症种群中评估。没有纵向研究利用神经影像来扩展我们对与功能下降相关的关键大脑区域的理解。纵向研究纳入了多维神经心理学评估，神经影像学和血清生物标志物，以了解认知，脑代谢和生理变化如何相互作用，以使癌症幸存者的功能下降相互作用。该应用的目的是描述与无癌症的老年对照组相比，在非痴呆的结肠癌中观察到的LADL功能状况和神经心理学表现的一年术后变化。我们将在一年的术后期间确定与长老患有结肠癌的功能下降相关的神经心理学领域。我们将确定化学疗法后脑葡萄糖代谢之间的关联，如静息氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）和非抑郁的结肠癌幸存者中的功能状态。最后，我们将探索与癌症（白介素1，白介素6，血红蛋白和白蛋白）与功能和认知能力下降有关的生理变化的血清生物标志物之间的关系。相关性：这项研究将是第一个描述功能状况的纵向变化，神经心理学表现和血清生物标志物的纵向变化，以跨多种评估方法中的多种评估方法。这也将是第一个建立FDG-PET神经影像学作为在老年癌症幸存者中功能状态的生物标志物。该项目将为未来的干预研究提供信息，该研究针对神经心理学障碍和生理变化，介导结肠癌幸存者的功能下降。