Posttraumatic Stress Disorder and Cognitive Decline in Women

女性创伤后应激障碍和认知能力下降

• 批准号: 8920166
• 负责人: FRANCINE GRODSTEIN
• 金额: $ 21.87万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-02 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8920166
• 关键词: 12 year old; Address; Age; Age of Onset; Aging; Alcohol consumption; Animal Model; Area; Attention; Automobile Driving; Body mass index; Brain; Brain Injuries; Cardiovascular Diseases; Catecholamines; Circadian Rhythms; Cognition; Cognitive; Collection; Communities; Computers; Conflict (Psychology); Cross-Sectional Studies; Data; Data Collection; Dementia; Diabetes Mellitus; Diagnosis; Disease remission; Elements; Feedback; Functional disorder; Genetic; Glucocorticoid Receptor; Glucocorticoids; Goals; Health; Health Status; Health behavior; Holocaust; Holocaust survivor; Human; Hydrocortisone; Hypertension; Impaired cognition; Impairment; Intervention; Investigation; Learning; Life Style; Link; Longitudinal Studies; Mediating; Mediator of activation protein; Memory; Mental Depression; Mental Health; Mental disorders; Military Personnel; Neurobiology; Neurosecretory Systems; Nurses; Nurses' Health Study; Participant; Policy Research; Population; Post-Traumatic Stress Disorders; Prospective Studies; Public Health; Reaction Time; Recording of previous events; Reporting; Research; Risk; Risk Factors; Sampling; Sentinel; Sleep; Smoking; Stress; Structure; Symptoms; Time; Trauma; Vascular Diseases; Veterans; Woman; Work; age group; aging brain; base; biological adaptation to stress; cognitive change; cognitive function; cognitive process; cohort; computerized; cost; cost effective; design; executive function; follow-up; hypothalamic-pituitary-adrenal axis; interest; male; meetings; men; middle age; novel; population based; processing speed; response

DESCRIPTION (provided by applicant): Posttraumatic stress disorder (PTSD) is a pervasive and debilitating mental disorder in the U.S. population and particularly common among women: 1 in 9 women will meet criteria for the diagnosis during their lives. PTSD is the sentinel stress-related mental disorder and is characterized by hypothalamic-pituitary-adrenal axis and neuroendocrine dysregulation; animal models and human correlational studies have linked such dysregulation in the HPA axis and neuroendocrine function to alterations in multiple cognitive processes, brain structure, and function. However, questions remain as to whether PTSD and its associated dysregulated stress response produce cognitive decrements as extant studies report conflicting results. Understanding the relation of PTSD and cognitive health -- including elements influencing an association, such as duration and intensity of symptoms and mechanisms underlying an association, such as sleep quality, health status, cardiovascular disease -- could inform interventions aimed at mitigating any risks PTSD may pose for cognitive health. We propose to examine PTSD and subsequent cognitive function within 54,282 women age 48-65 years from the Nurses' Health Study II, who are part of a sub-cohort followed since 1989 with detailed data on PTSD. Women are currently age 48-65 years. Our primary aim is to evaluate if PTSD, independent of depression, is associated with worse cognition in middle-aged women and to collect preliminary data on cognitive change. In accomplishing this aim, we will utilize a brief, validated, computerized cognitive battery (CogState), allowing highly efficient daa collection in these computer-savvy nurses. As a secondary aim we will evaluate specific elements of any relation of PTSD to cognition, including factors acting as mediators and effect modifiers, which could be targeted for interventions. Prior work on PTSD and cognition has focused on small samples from specific populations, such as Holocaust survivors or larger samples of primarily male military personnel or veterans. This application represents a unique opportunity to begin to leverage a large, existing cohort of women to understand the larger scope of effects of PTSD in the broader-based population - at very modest cost. Women's risk of PTSD is twice that of men' risk and, therefore, understanding the impact of PTSD on cognition in women of great public health importance. Finally, in addition to directly addressing our Aims, we will generate important data for planning future research on PTSD, and other areas of interest as well; for example, preliminary data on rates of cognitive change in this age group will allow us to appropriately design prospective studies of the mechanisms driving the relation between PTSD and cognition, including other health, mental health and lifestyle variables.

描述（由申请人提供）：创伤后应激障碍（PTSD）是美国人群中普遍存在且使人衰弱的精神障碍，在女性中尤其是普遍：其中1个女性将符合其一生中诊断的标准。 PTSD是哨兵应力相关的精神障碍，其特征是下丘脑 - 垂体 - 肾上腺轴和神经内分泌失调。动物模型和人类相关研究已将HPA轴的这种失调与神经内分泌功能与多种认知过程，大脑结构和功能的改变联系起来。然而，关于PTSD及其相关的失调压力反应是否会导致认知降低，因为现有研究报告了相互矛盾的结果，但仍存在问题。了解PTSD和认知健康的关系 - 包括影响关联的元素，例如症状的持续时间和强度和关联性的机制的强度，例如睡眠质量，健康状况，心血管疾病 - 旨在减轻PTSD可能对认知健康构成风险的干预措施。我们建议在54,282名妇女48-65岁的护士健康研究II中检查PTSD和随后的认知功能，这些研究是自1989年以来的一部分，随后是PTSD的详细数据。妇女目前年龄48-65岁。我们的主要目的是评估与抑郁症无关的PTSD是否与中年妇女的认知差有关，并收集有关认知变化的初步数据。在实现这一目标时，我们将利用一个简短的，经过验证的计算机认知电池（Cogstate），在这些精通计算机的护士中允许高效的DAA收集。作为次要目的，我们将评估PTSD与认知关系的任何关系的特定要素，包括充当介体的因素和效果修饰符，这些因素可以针对干预措施。先前关于PTSD和认知的工作集中在特定人群的小样本上，例如大屠杀幸存者或主要是男性军事人员或退伍军人的较大样本。该应用程序是一个独特的机会，可以开始利用大量现有的妇女队列来理解PTSD在基于更广泛的人群中的较大影响范围 - 价格适中。女性患PTSD的风险是男性风险的两倍，因此，了解PTSD对公共健康重要性较高的妇女认知的影响。最后，除了直接解决我们的目标外，我们还将生成重要的数据，以计划对PTSD的未来研究以及其他感兴趣的领域；例如，有关该年龄段认知变化率的初步数据将使我们能够适当地设计推动PTSD与认知之间关系的机制的前瞻性研究，包括其他健康，心理健康和生活方式变量。