Cognitive Sequelae of early and mid-life depression

描述(由申请人提供)：这份K23申请将为候选人在晚年精神障碍的临床流行病学方面的独立研究生涯做准备。该研究项目的重点是确定早年和中年抑郁谱系障碍在多大程度上增加了在晚年发展认知缺陷的风险。晚年抑郁与晚年认知缺陷的发展有关，但之前没有研究探讨过早年和中年抑郁与晚年认知缺陷之间的联系。这项拟议的研究提供了一个不同寻常的、时间敏感的机会，通过利用最近资助的巴尔的摩流行病学集水区(ECA)研究的第四波来检验这一假设。使用回溯性队列设计，研究人员建议在巴尔的摩ECA研究的前几波评估中对50岁之前患有抑郁症的人进行抽样，并在10到23年后检查他们的神经心理结果。建议的具体目的是：1)确定早中期抑郁谱系障碍(50岁之前)是否会增加晚年(60岁以后)发展为轻度认知障碍或痴呆症的风险；2)调查早中期抑郁谱系障碍与特定神经心理领域(即执行功能和记忆)的晚期认知障碍之间的纵向联系；以及3)估计早中期抑郁谱系障碍的持续时间、发作次数和严重程度对晚年认知障碍的预测。这项研究将作为候选人在老龄化人口流行病学研究的设计和实地工作中获得宝贵经验的工具。为了补充他的实际研究培训，候选人将同时注册正规的流行病学和老龄生物统计学课程，并满足硕士学位的要求。他将参加神经心理学博士后项目的研讨会，以发展神经心理学仪器的使用和解释方面的高级知识。一个由导师和顾问组成的小组(康斯坦丁·莱克索斯博士、威廉·伊顿博士、杰森·勃兰特博士、乔治·雷博克博士、梁功义博士、乔治·亚历克索普洛斯博士和阿南德·库马尔博士)将指导他的研究和培训。这一奖项将为他成为老年精神障碍临床流行病学专家的长期目标奠定基础。

DESCRIPTION (provided by applicant): This K23 application will prepare the candidate for an independent research career in the clinical epidemiology of late-life mental disorders. The focus of the research project is to determine the degree to which early and mid-life depressive spectrum disorder increases risk of developing cognitive deficits in later life. Late-life depression has been associated with subsequent development of cognitive deficits in late life,but no previous study has examined the association between early and mid-life depression and later life cognitive deficits. The proposed study provides an unusual, time-sensitive opportunity to test this hypothesis by taking advantage of the recently funded fourth wave of the Baltimore Epidemiologic Catchment Area (ECA) study. Using a retrospective cohort design, the investigator proposes to sample people with depression before age 50 as assessed in previous waves of the Baltimore ECA studies, and examine their neuropsychological outcomes 10 to 23 years later. The specific aims of the proposal are: 1) to determine whether early and mid-life depressive spectrum disorder (before age 50) increases risk of developing Mild Cognitive Impairment or dementia in later life (after age 60), 2) to investigate the longitudinal association between early and mid-life depressive spectrum disorder and late life cognitive deficits in specific neuropsychological domains (i.e. executive function and memory), and 3) to estimate what extent duration, number of episodes, and severity of early and mid-life depressive spectrum disorder predict cognitive impairment in late life. This study will serve as a vehicle for the candidate to obtain invaluable experience in the design and fieldwork of an epidemiologic study of the aging population. To complement his practical research training, the candidate will concurrently enroll in formal courses in Epidemiology and Biostatistics of Aging and fulfill the requirements for a Master's degree. He will participate in seminars in the post-doctoral program in neuropsychology to develop advanced knowledge in use and interpretation of neuropsychological instruments. A panel of mentors and consultants (Drs. Constantine Lyketsos, William Eaton, Jason Brandt, George Rebok, Kung-Yee Liang, George Alexopoulos, and Anand Kumar) will guide his research and training. This award will provide groundwork for his long term goal of becoming an expert in clinical epidemiology of late life mental disorders.