Epidemiologic Study of Decision Making in Preclinical Alzheimer's Disease

阿尔茨海默病临床前决策的流行病学研究

• 批准号: 9117352
• 负责人: PATRICIA A BOYLE
• 金额: $ 57.2万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-15 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9117352
• 关键词: Affect; Affective; Age; Aged, 80 and over; Aging; Alzheimer' s Disease; Alzheimer' s disease risk; Area; Autopsy; Behavior Therapy; Behavioral; Cerebrovascular Disorders; Clinical; Clinical Data; Cognition; Cognitive; Complex; Data; Decision Making; Dementia; Disease; Dopamine; Elderly; Epidemiologic Studies; Exhibits; Fraud; Funding; Goals; Health; Healthcare; Hospitalization; Influentials; Internet; Lewy Bodies; Life; Link; Medicare claim; Memory; Neurons; Norepinephrine; Outcome; Pathologic; Pathology; Personal Satisfaction; Persons; Public Health; Reporting; Research; Resources; Role; System; Testing; Time; Ventral Tegmental Area; Victimization; adverse outcome; age difference; age related; base; clinical decision-making; cognitive function; cohort; contextual factors; density; disability; dopaminergic neuron; health economics; indexing; literacy; locus ceruleus structure; mild cognitive impairment; mortality; neuropathology; novel therapeutic intervention; pre-clinical; psychological outcomes; rate of change; Affect; Affective; Age; Aged, 80 and over; Aging; Alzheimer' s Disease; Alzheimer' s disease risk; Area; Autopsy; Behavior Therapy; Behavioral; Cerebrovascular Disorders; Clinical; Clinical Data; Cognition; Cognitive; Complex; Data; Decision Making; Dementia; Disease; Dopamine; Elderly; Epidemiologic Studies; Exhibits; Fraud; Funding; Goals; Health; Healthcare; Hospitalization; Influentials; Internet; Lewy Bodies; Life; Link; Medicare claim; Memory; Neurons; Norepinephrine; Outcome; Pathologic; Pathology; Personal Satisfaction; Persons; Public Health; Reporting; Research; Resources; Role; System; Testing; Time; Ventral Tegmental Area; Victimization; adverse outcome; age difference; age related; base; clinical decision-making; cognitive function; cohort; contextual factors; density; disability; dopaminergic neuron; health economics; indexing; literacy; locus ceruleus structure; mild cognitive impairment; mortality; neuropathology; novel therapeutic intervention; pre-clinical; psychological outcomes; rate of change

 DESCRIPTION (provided by applicant): Many of life's most complex and influential decisions are made in old age, paradoxically just as neuropathology accumulates and cognitive function declines. Despite increased recognition that poor decision making in old age poses a critical public health and economic challenge, decision making has received surprisingly little scientific focus in aging research. In the first funding period, we assessed decision making in >800 older persons without dementia from the Memory and Aging Project, an ongoing longitudinal clinical-pathologic study of aging. We reported that decision making requires diverse resources (i.e., cognitive, affective, and contextual), and that many older persons without dementia exhibit poor decision making in domains critical for independence and well being (e.g., financial, healthcare). Poor decision making also is associated with a substantially increased risk of Alzheimer's disease (AD) and mild cognitive impairment, suggesting that it may be an early manifestation of preclinical dementia. The overall goal of the proposed continuation (R01AG33678) is to examine the causes and consequences of age-related changes in decision making over time. We will quantify changes in decision making over many years in a large cohort of older persons without dementia and document the association of change in decision making with critical health and psychological outcomes. Next, based on compelling preliminary data showing that the neuropathologies of AD and cerebrovascular disease (CVD) are associated with decision making, we will test the hypothesis that common neuropathologies contribute to age-related changes in decision making. Further, based on research demonstrating the important role of aminergic systems as modulators of decision making, we will test the hypothesis that aminergic systems help preserve decision making in the face of neuropathology. Finally, we will examine how contextual and other behavioral factors interact with neurobiologic indices to influence decision making. The proposed study offers a unique opportunity to integrate up to 12 years of annual decision making and clinical data with neurobiologic indices of the most common neuropathologies known to impair function in old age (i.e., AD, CVD, Lewy body pathology) and aminergic systems (i.e., dopamine, norepinephrine) in order to identify the neurobiologic basis and consequences of age-related changes in decision making. We are not aware of other studies in which similar analyses could be performed. This study is uniquely poised to inform on the consequences and causes of age-related changes in decision making and will facilitate new therapeutic approaches to promote independence, health and well-being in old age.

 描述（由适用提供）：许多生命中最复杂，最有影响力的决定都是在老年中做出的，就像神经病理学的积累一样，认知功能下降。尽管人们越来越认识到老年职位的决策不良是一个批判的公共卫生和经济挑战，但决策在衰老研究中几乎没有科学的关注点。在第一个资金期间，我们评估了> 800名没有记忆和衰老项目的老年人的决策，这是一项持续的衰老纵向临床研究。我们报告说，决策需要潜水资源（即认知，情感和上下文），并且许多没有痴呆症的老年人在对独立和幸福至关重要的领域中表现出较差的决策（例如，财务，医疗保健）。决策不良与第二增加了阿尔茨海默氏病（AD）和轻度认知障碍的风险有关，这表明这可能是临床前痴呆症的早期表现。拟议延续的总体目标（R01AG33678）是检查随着时间的推移，决策与年龄相关的变化的原因和后果。我们将在许多没有痴呆症的老年人中量化多年来决策的变化，并记录决策变化与关键的健康和心理成果的关联。接下来，基于引人注目的初步数据，表明AD和脑血管疾病（CVD）的神经病理学与决策有关，我们将检验以下假设：常见神经病理学有助于与年龄相关的决策变化。此外，基于研究表明AMINEGIC系统作为决策制定的调节剂的重要作用，我们将检验以下假设：AMINEGIC系统有助于面对神经病理学的决策。最后，我们将研究上下文和其他行为因素如何与神经生物学指数相互作用以影响决策。 The proposed study offers a unique opportunity to integrate up to 12 years of annual decision making and clinical data with neurobiologic indices of the most common neuropathology known to impair function in old age (i.e., AD, CVD, Lewy body pathology) and aminergic systems (i.e., dopamine, norepinephrine) in order to identify the Neurobiologic basis and consequences of age-related changes in decision making.我们不知道可以进行类似分析的其他研究。这项研究是独特的中毒，可以告知与年龄相关的决策变化的后果和原因，并将促进新的治疗方法，以促进老年人的独立性，健康和福祉。