Sedative-Hypnotic Use Patterns and Risk for Cognitive Decline and Alzheimer's Disease

摘要 这项建议的K01申请将支持克里斯托弗·N·考夫曼博士，MHS，在追求他的 职业目标是成为一名独立资助的阿尔茨海默病健康服务研究员。这 应用程序由两个相辅相成的部分组成：a)考察认知轨迹的研究项目 与使用镇静催眠药有关的衰老、阿尔茨海默病和痴呆症结果， 和b)为期5年的全面培训计划，包括指导、教学和专业发展 机会和体验式培训活动，旨在弥补他过去培训中的三个差距：a)认知 老龄化和阿尔茨海默病研究，b)利用和分析行政数据(包括医疗保险 索赔)，以及c)对老化轨迹进行统计建模的纵向数据分析，所有这些都在提交时达到高潮 在3-5年中使用R01应用程序。在拟议的研究项目中，考夫曼博士将研究如何使用 镇静-催眠药物与认知表现的轨迹有关，跨越 认知状态类别(例如，正常认知、认知受损但非痴呆症和痴呆症状态)， 自2006年起的12年间，阿尔茨海默病和其他相关痴呆症诊断的发病率 到2018年。为了回答这些问题，该项目将利用NIA资助的健康和退休 使用联邦医疗保险索赔中的关联数据进行研究。该项目得到了强大的跨学科导师的支持 拥有老年病学、认知老化和阿尔茨海默氏症、卫生服务研究、纵向 数据分析、睡眠和制药科学。艾莉森·摩尔，医学博士，公共卫生硕士，老年病科主任， 在老年医学和老龄领域有广泛联系的老年人药物滥用方面的专家马克·W。 Bondi，博士，精神病学系教授，在认知评估和 阿尔茨海默病和詹姆斯·D·墨菲，医学博士，医学硕士，放射科副教授 医学和应用科学以及使用联邦医疗保险索赔数据的专家将担任这一计划的导师 申请。他们的导师将得到辛图博士的补充，他是一名高级生物统计学家，拥有广泛的 纵向数据分析经验，亚当·P·斯皮拉博士，睡眠障碍和阿尔茨海默氏症专家 疾病结果，以及Grace M.Kuo，药学D，公共卫生硕士，博士，药物安全专家。研究项目 和补充性培训计划将为考夫曼博士提供利用行政管理的实践经验 具有纵向数据的数据，以回答对认知老化和最终阿尔茨海默病重要的问题 和预防痴呆症的努力。此外，拟议的工作将为考夫曼博士提供所需的培训 以推动他的职业生涯成为一名由R01独立资助的阿尔茨海默病研究人员。

ABSTRACT This proposed K01 application will support the training of Christopher N. Kaufmann, PhD, MHS, in pursuit of his career goal of becoming an independently funded Alzheimer’s disease health services researcher. This application consists of two complementary components: a) a research project examining trajectories of cognitive aging and Alzheimer’s disease and dementia outcomes associated with use of sedative-hypnotic medications, and b) a 5-year comprehensive training plan comprised of mentorship, didactic and professional development opportunities, and experiential training activities designed to address three gaps in his past training: a) cognitive aging and Alzheimer’s disease research, b) utilizing and analyzing administrative data (including Medicare claims), and c) longitudinal data analysis to statistically model aging trajectories, all culminating in the submission of an R01 application in years 3-5. In the proposed research project, Dr. Kaufmann will examine how use of sedative-hypnotic medications are associated with trajectories of cognitive performance, transition across cognitive status categories (e.g., normal cognition, cognitively impaired but not dementia, and dementia status), and incidence of Alzheimer’s disease among other related dementia diagnoses over a 12-year period from 2006 to 2018. To answer these questions, the project will take advantage of the NIA-funded Health and Retirement Study with linked data from Medicare claims. The project is supported by a strong interdisciplinary mentorship team with expertise in geriatrics, cognitive aging and Alzheimer’s disease, health services research, longitudinal data analysis, sleep, and pharmaceutical sciences. Alison Moore, MD, MPH, Chief of the Division of Geriatrics, and expert in substance abuse in seniors with extensive contacts within the geriatrics and aging field, Mark W. Bondi, PhD, Professor in the Department of Psychiatry, with extensive research in cognitive assessment and Alzheimer’s disease, and James D. Murphy, MD, MS, Associate Professor in the Department of Radiation Medicine and Applied Sciences and expert in use of Medicare claims data, will serve as the mentors of this application. Their mentorship will be complemented by that of Xin Tu, PhD, a senior biostatistician with extensive experience in longitudinal data analysis, Adam P. Spira, PhD, an expert in sleep disturbances and Alzheimer’s disease outcomes, and Grace M. Kuo, PharmD, MPH, PhD, a medication safety expert. The research project and complementary training plan will provide Dr. Kaufmann with hands-on experience in utilizing administrative data with longitudinal data to answer questions important to cognitive aging and ultimately Alzheimer’s disease and dementia prevention efforts. Further, the proposed work will provide Dr. Kaufmann with the training needed to propel his career towards becoming an independently R01-funded Alzheimer’s disease researcher.