Binge Eating Spectrum Treatment in Older Women (BESTOW): An Investigation and Intervention-Tailoring Project

项目摘要 Beeson Emerging Leaders in Aging职业发展奖(K76)旨在为Lisa Kilpela博士配备 成为饮食失调方面领先的老年学专家所需的专业知识和专业技能 和营养病理学，并推动这一新兴而重要的领域。随着女性年龄的增长，生理上的， 心理和生活方式的改变可能会导致营养失调和相关的健康问题。 在老年女性中，一个日益被认识到的因素可能会加剧这些担忧，那就是饮食失调 病理学，它构成了一组复杂的精神障碍，其特征是调节失调和 不正常的饮食行为。如果不加以治疗，饮食失调可能会导致严重的发病率和死亡率。 一项快速发展的研究表明，在历史上被概念化为青春期障碍的人 令人惊讶的是，障碍症状在老年女性中普遍存在。基尔佩拉博士作为胡椒的初步研究 RL5中心学者发现，老年女性最常见的饮食失调形式是暴饮暴食 (BE；定义为在感觉失控的情况下吃下异常大量的食物)，26.5%的女性 60岁以上，每周至少报告一次BE发作。BE与肥胖和抑郁症密切相关，甚至 与这些合并症无关，与代谢功能障碍、睡眠问题、残疾和 生活质量更差。因此，BE似乎是老年妇女的一个重大健康问题 其流行率比人们想象的要高。尽管针对BE的循证治疗对于年轻女性来说已经存在， 这些治疗需要为老年妇女量身定做，以解决与衰老相关的因素，这些因素在 对治疗有影响的年轻女性(例如，认知能力下降、更年期症状)。因此， 这项拟议的研究旨在：(1)确定与老年女性有关的独特影响因素，(2) 利用目标1中收集的信息来指导理论驱动的、量身定制的行为干预的发展 对患有BE的老年妇女和试点实施，以确定其可行性，以及(3)完成整合工作 在职业发展计划内的目标1和目标2，以促进基尔佩拉博士在 (A)临床老年学；(B)老龄妇女的健康；(C)将其纳入BE，以支持 R01申请全面试用。作为对拟议研究的补充，基尔佩拉博士将完成一项 职业发展计划，以获得科学和专业发展技能，以过渡到 独立调查员。这项提议得到了一个由老龄化领域的著名科学家组成的导师团队的支持 研究(Musi和Espinoza博士)、妇女健康(LaCroix博士)和饮食失调(Keel博士)，以及 老年医学教育顾问(Sanchez-Reilly博士)和生物统计学顾问(Gelfond博士)。这支队伍，沿着 通过圣安东尼奥胡椒中心和Barshop长寿和老龄化研究所提供的资源 研究，包括为基尔佩拉博士成功实现促进健康老龄化的目标提供理想的环境 通过解决饮食紊乱和营养病理问题，改善老年妇女的营养状况。

PROJECT ABSTRACT This Beeson Emerging Leaders in Aging Career Development Award (K76) seeks to equip Dr. Lisa Kilpela with the expertise and professional skill set needed to become a leading gerontological expert in disordered eating and nutrition pathology, and to advance this emerging and important field. As women age, biological, psychological, and lifestyle changes can contribute to nutritional disorders and associated health problems. Among older women, an increasingly recognized factor that can exacerbate these concerns is eating disorder pathology, which constitutes a group of complex psychiatric disorders characterized by dysregulated and abnormal eating behaviors. When left untreated, eating disorders can cause significant morbidity and mortality. Historically conceptualized as disorders of youth, a rapidly evolving body of research suggests that eating disorder symptoms are surprisingly prevalent in older women. Dr. Kilpela’s preliminary research as a Pepper Center RL5 Scholar found that the most common form of disordered eating in older women is binge eating (BE; defined as eating an unusually large amount of food while feeling a loss of control), with 26.5% of women aged 60+ reporting at least weekly BE episodes. BE is closely linked to obesity and depression and, even independent of these comorbidities, is associated with metabolic dysfunction, sleep problems, disability, and poorer quality of life. Therefore, BE appears to represent a significant health problem for older women with greater prevalence than once thought. Although evidence-based treatments for BE exist for younger women, these treatments need to be tailored for older women in order to address aging-related factors not present in younger women that have implications for treatment (e.g., cognitive decline, menopausal symptoms). As such, the proposed research aims to: (1) identify factors that uniquely impact older women in relation to BE, (2) utilize information gathered in Aim 1 to guide development of a theory-driven, behavioral intervention tailored for older women with BE and pilot implementation to determine its feasibility, and (3) integrate work completed in Aims 1 and 2 within a career development program to advance the Dr. Kilpela’s knowledge and expertise in (a) clinical gerontology, (b) women’s health in aging, and (c) their integration in the context of BE, to support an R01 application for a full-scale trial. Complementary to the proposed research, Dr. Kilpela will complete a program of career development to gain the scientific and professional development skills to transition to an independent investigator. This proposal is supported by a mentorship team of renowned scientists in aging research (Drs. Musi and Espinoza), women’s health (Dr. LaCroix), and eating disorders (Dr. Keel), and advisors in geriatric medicine education (Dr. Sanchez-Reilly) and biostatistics (Dr. Gelfond). This team, along with resources available through the San Antonio Pepper Center and Barshop Institute for Longevity and Aging Studies, comprise an ideal environment for Dr. Kilpela to successfully reach her goal to promote healthy aging in older women by addressing disordered eating and nutrition pathology.