Non-cancer pain and cognitive impairment: A disabling relationship

非癌症疼痛和认知障碍：一种失能的关系

• 批准号: 7923801
• 负责人: JOSEPH W SHEGA
• 金额: $ 15.21万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7923801
• 关键词: Acetaminophen; Activities of Daily Living; Age; Aging; Amines; Analgesics; Area; Arthritis; Award; Chronic; Clinical Research; Clinical Trials; Cognition; Cognitive; Communities; Data; Databases; Degenerative polyarthritis; Dependence; Descriptor; Development; Doctor of Philosophy; Education; Educational Activities; Educational Intervention; Elderly; Emotional; Epidemiologic Studies; Frequencies; Geriatrics; Gills; Goals; Health; Impaired cognition; Impairment; Institutionalization; Instruction; Intervention; Intervention Studies; Knee; Lead; Malignant Neoplasms; Measures; Medicine; Mentors; Modeling; Morbidity - disease rate; Ontario; Opioid; Outcome; Outcome Assessment; Pain; Pain Measurement; Pain Research; Pain management; Palliative Care; Participant; Patient Self-Report; Persons; Policies; Population; Prevalence; Principal Investigator; Program Development; Psychological Impact; Qualitative Methods; Quality of life; Reading; Rehabilitation therapy; Reporting; Research; Research Personnel; Research Proposals; Series; Severities; Surveys; Symptoms; Thermometers; Time; Universities; Walking; Work; career; career development; chronic pain; comparative efficacy; design; experience; falls; frailty; functional decline; functional disability; functional loss; functional outcomes; functional status; improved functioning; indexing; instrumental activity of daily living; longitudinal analysis; medical schools; meetings; mental state; mortality; non-cancer pain; population based; professor; programs; prospective; self-reported functional status; skills; social

DESCRIPTION (provided by applicant): The goal of the proposed development program is to prepare the applicant, Joseph W. Shega MD, for a career as an independent investigator and leader in the field of chronic pain in persons with cognitive impairment. The award will provide 5 years of supervised research with the following career objectives: (1) To obtain advanced instruction in pain. (2) To obtain research skills in qualitative methods, survey research, database research, clinical trials, and outcome assessment. (3) To utilize the relationships, skills, and research completed during the award to submit an R-series application. The candidate will achieve these goals through mentored research, coursework, directed readings, and educational activities. Dr. Linda Emanuel the Buehler Professor of Medicine and Judith Paice PhD RN FANN Research Professor of Medicine both at Northwestern University Feinberg School of Medicine serve as co-mentors and will meet with Dr. Shega regularly throughout the award period. His advisory panel includes: (1) D. Weiner-non- cancer pain measurement and functional outcomes, (2) M. Ersek-educational interventions in non-cancer pain, (3) K. Rockwood-large database analysis, (4) T. Schnitzer-analgesic clinical trials, (5) N. Harden- rehabilitation approaches to pain. The proposed research compliments his career development and has two components, an analysis of the Canadian Study of Health and Aging, a large (N=5,703 participants) nationwide population based study (Aims 1, 2, and 3) and a pharmacologic pain management intervention (Aims 4 and 5). The specific aims of this project are to: (1) determine whether cognitive status (no versus mild to moderate cognitive impairment) is associated with the prevalence of non-cancer pain self-report; (2) and (3) describe the association of an older adults 1996 non-cancer pain self-report with 1996 and 2001 functional status (self-report IADL and ADL and TUG) and to determine if 1996 cognitive status modifies this relationship; (4) compare the efficacy of long-acting opioid to extended-release acetaminophen in older persons with no and mild to moderate cognitive impairment and persistent moderate non-cancer knee arthritis pain; and (5) describe the association of change in non-cancer pain self-report with an older adults functional status (TUG and 6-minute walk) and to determine if cognitive status modifies this relationship. RELEVANCE (See instructions): The proposed award provides Dr. Shega with the skills and experience to become an independent investigator in chronic non-cancer pain research. He seeks to apply this paradigm to palliative care and geriatrics populations particularly those with cognitive impairment. Research in this area and population is imperative as then number of persons with cognitive impairment is projected to rise, pain has a substantial physical and psychological impact on older adults, and it remains under treated.

描述（由申请人提供）：拟议的开发计划的目标是为申请人约瑟夫·夏格（Joseph W. Shega）做好准备，成为认知障碍者的慢性疼痛领域的独立调查员和领导者的职业。该奖项将提供以下职业目标的5年监督研究：（1）获得痛苦的高级指导。 （2）获得定性方法，调查研究，数据库研究，临床试验和结果评估的研究技能。 （3）利用奖励期间完成的关系，技能和研究以提交R系列申请。候选人将通过指导的研究，课程，定向阅读和教育活动来实现这些目标。 Buehler医学教授Linda Emanuel博士和朱迪思·佩斯（Judith Paice）博士学位RN FANN研究教授，西北大学费恩伯格医学院（Feinberg School of Feinberg Medicine）担任联合会，并将在整个奖项期间定期与Shega博士会面。他的咨询小组包括：（1）D。Weiner-non-癌症疼痛测量和功能结果，（2）M。Ersek- ers-Dedecational Destracation Destractional in非癌症疼痛，（3）K。Rockwood-large数据库分析，（4）T。Schnitzer-schnitzer-Analgesic临床试验，（5）N。Harden-harden-harden-harden-hard-hard-hard-Reher-Rebhistical sain for Pains to Pains for Pains for Pains for Pains for Pain。拟议的研究称赞他的职业发展，并有两个组成部分，分析了加拿大的健康和衰老研究，一项大型（n = 5,703名参与者）全国人口的研究（目标1、2和3）以及一项药理疼痛管理干预措施（目标4和5）。该项目的具体目的是：（1）确定认知状况（没有与中度至中度认知障碍）是否与非癌症疼痛自我报告的患病率有关； （2）和（3）描述了1996年非癌症疼痛自我报告与1996年和2001年功能状态（自我报告IADL和ADL和TUG）的关联，并确定1996年的认知状况是否会改变这种关系； （4）比较长效阿片类药物对没有轻度至中度认知障碍和持续性中度非癌症膝关节炎疼痛的老年人的抗乙酰氨基酚的疗效； （5）描述非癌症疼痛自我报告的变化与老年人功能状态（拖船和6分钟步行）的变化的关联，并确定认知状况是否会改变这种关系。相关性（请参阅说明）：拟议的奖项为Shega博士提供了成为慢性非癌症疼痛研究的独立研究者的技能和经验。他试图将此范式应用于姑息治疗和老年治疗，尤其是认知障碍的人群。当时，该领域和人口的研究是必须的，因为预计认知障碍的人数会增加，疼痛对老年人产生了重大的身体和心理影响，并且仍然受到治疗。