Sleep-Wake Disturbance as a Predictor of Delirium and Subsequent Alzheimer's Disease and Related Dementias after Surgical Aortic Valve Replacement

睡眠-觉醒障碍是主动脉瓣置换术后谵妄和随后的阿尔茨海默病及相关痴呆的预测因素

• 批准号: 10370731
• 负责人: Mark Alan Oldham
• 金额: $ 18.1万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10370731
• 关键词: Address; Adult; Affect; Age; Alzheimer disease prevention; Alzheimer' s Disease; Alzheimer' s disease pathology; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; Apnea; Biological Markers; Blood Vessels; Cardiac Surgery procedures; Caring; Cerebrovascular Disorders; Clinical; Cognition; Cognitive; Complement; Consultations; Delirium; Development; Elderly; Enrollment; Environmental Exposure; FDA approved; Foundations; Functional disorder; Goals; High Prevalence; Home; Hospitals; Hour; Human; Impaired cognition; Incidence; Individual; Institutionalization; Interdisciplinary Study; Intervention; Investigation; Light; Link; Longitudinal Studies; Measurable; Measures; Medicine; Mental Health; Methods; Mission; Morbidity - disease rate; Neuropsychological Tests; Neuropsychology; Operative Surgical Procedures; Outcome; Pathogenesis; Pathology; Patients; Perioperative; Physicians; Physiological; Pilot Projects; Play; Postoperative Period; Prevention trial; Prospective cohort study; Provider; Psychiatrist; Public Health; Reading; Research; Resources; Rest; Risk; Risk Factors; Role; Science; Scientist; Severities; Signal Transduction; Sleep; Sleep Apnea Syndromes; Sleep Architecture; Solid; Statistical Methods; Study Subject; System; Testing; Time; Training; Vascular Dementia; Vascular Diseases; actigraphy; aortic valve; aortic valve replacement; base; career; career development; circadian; cohort; cost estimate; demographics; design; experience; functional outcomes; glymphatic clearance; glymphatic dysfunction; high risk; improved; indexing; insight; interest; mortality risk; neurocognitive disorder; novel; postoperative delirium; prevent; programs; risk stratification; sleep physiology; statistics; translational potential; treatment trial; trend

Project Summary/Abstract Applicant: I am a consultation-liaison psychiatrist keenly interested in delirium and the role that sleep-wake disturbance (SWD) plays in delirium vulnerability, its pathogenesis, and its relationship with subsequent Alzheimer’s disease and related dementias (ADRD). My mission is to improve the care and clinical outcomes of those with and at risk for delirium and to be a champion for excellence in care for older adults. This application is designed for me to obtain expertise in longitudinal study conduct and design, assessment of SWD, neuropsychological training relevant to delirium and the two neurocognitive disorders associated with it (Alzheimer’s disease and vascular neurocognitive disorder), and a solid background in statistical methods to become an independent physician-scientist. Project: I am proposing a prospective cohort study of subjects undergoing surgical aortic valve replacement with the goal of investigating objective SWD before surgery—both actigraphy and unattended type II home sleep tests (HST)—for its association with postoperative delirium and subsequent ADRD. This study represents a novel application of type II HST, which provides comprehensive assessment of sleep architecture, to characterize preoperative SWD as a marker of delirium risk and evidence in support of a mechanistic link between delirium and subsequent Alzheimer’s disease or vascular neurocognitive disorder. Professional development: I will obtain practical experience in empirical methods by conducting a longitudinal study with expertise in assessing SWD using unattended methods, neuropsychological testing, and relevant statistics. My training plan incorporates hands-on experiences in sleep medicine, neuropsychology, and statistics, complemented by coursework and directed readings that will provide the necessary theoretical foundation. Goals: My career goals are to establish an interdisciplinary research program at URMC with cardiac surgery and sleep medicine, to explore how SWD is mechanistically involved in delirium risk, onset, and its dire outcomes, and to advance the science of delirium pathophysiology and subsequent risk of ADRD.

项目总结/文摘