Perioperative Cognitive Anesthesia Network Extension for Socially Vulnerable Older Adults

摘要 美国医疗保健系统照顾越来越多的老年人，包括那些患有阿尔茨海默氏症的人 疾病和相关的痴呆症，谁需要手术麻醉。区域社会不平等现象， 区域贫困指数和社会脆弱性指数等空间指数， 围手术期和神经退行性结局的差异。数据也支持一个重要的关联 邻里水平的区域剥夺指数与阿尔茨海默病神经病理学之间的关系。尽管 新出现的证据将健康的社会决定因素与老年人术后结果的差异联系起来 成年人，这些领域的调查越来越需要不同主题的专业知识，包括 临床围手术期实践，老年医学，神经心理学，健康的社会决定因素，地理空间分析， 甚至是人工智能。K 07申请人是美国国立卫生研究院（NIH）资助的独立 研究员和研究员培训麻醉师，具有区域麻醉和整形外科方面的专业知识， 以及在机器学习，地理空间差异，围手术期疼痛和认知方面的研究经验。 这项建议的目的是促进机构和社区认识到社会脆弱性如何 影响老年人的围手术期结局，包括阿尔茨海默病和相关痴呆症患者， 特别是那些与术后疼痛和认知有关的结果。本提案的总体战略 是沿着跨学科培训计划开发跨学科研究基础设施， 交叉传播研究团队该结构将通过围手术期认知麻醉进行组织 网络社会脆弱性（PeCANSV）的建设有三个目标：目标1：召开PeCANSV多学科 咨询小组将在以下领域建立三个补充核心：1）地理空间基础设施; 2） 健康; 3）人工智能。目标2：通过跨学科研究途径加速研究发现 通过正式确定PeCANSV补充核心与UF资源和现存地理空间之间的新生联系， 环境，认知和临床围手术期数据库在UF健康和整个佛罗里达。目标3： 培养一支由临床和基础科学研究人员组成的跨学科队伍，以领导跨学科团队 解决老年外科病人的社会脆弱性。军事行动包括定期分析 优势、机会、愿望和结果、跨学科提案提交以及受训者的证明 在老年人（包括阿尔茨海默病患者）社会差异的围手术期研究中取得成功 以及相关的痴呆症

ABSTRACT The U.S. healthcare system cares for increasing numbers of older adults, including those with Alzheimer’s disease and related dementias, who require surgery with anesthesia. Regional social inequities, as measured by spatial indices such as area deprivation and social vulnerability indices, independently contribute to differences in perioperative and neurodegenerative outcomes. Data also support a significant association between neighborhood-level area deprivation indices with Alzheimer’s disease neuropathology. Despite emerging evidence linking social determinants of health with disparities in postoperative outcomes in older adults, investigations in these areas increasingly require expertise with disparate subject matters, including clinical perioperative practice, geriatrics, neuropsychology, social determinants of health, geospatial analyses, and even artificial intelligence. The K07 applicant is a National Institutes of Health (NIH)-funded independent investigator and fellowship-trained anesthesiologist with expertise in regional anesthesia and orthopedic surgery, as well as research experience in machine learning, geospatial disparities, and perioperative pain and cognition. The purpose of this proposal is to promote institutional and community awareness of how social vulnerabilities impact perioperative outcomes in older adults, including those with Alzheimer’s disease and related dementias, and particularly those outcomes related to postoperative pain and cognition. The overall strategy of this proposal is to develop interdisciplinary research infrastructure along with transdisciplinary training programs to crosspollinate research teams. This structure will be organized via the Perioperative Cognitive Anesthesia Network-Social Vulnerability (PeCANSV) construct in three aims: Aim 1: Convene a PeCANSV multidisciplinary advisory team to establish three supplemental cores in 1) geospatial infrastructure; 2) social determinants of health; 3) artificial intelligence. Aim 2: Accelerate research discovery through interdisciplinary research pathways by formalizing nascent linkages between supplemental PeCANSV cores and UF resources and extant geospatial, environmental, cognitive, and clinical perioperative databases at UF Health and throughout Florida. Aim 3: Develop a transdisciplinary workforce of clinical and basic science researchers to lead interdisciplinary teams addressing the social vulnerability of older adult surgical patients. Milestones include regular analysis of strengths, opportunities, aspirations, and results, interdisciplinary proposal submissions, and evidence of trainee success in perioperative research in social disparities of older adults, including those with Alzheimer’s disease and related dementias.