Latent Mobility Abnormalities and Disability

描述（由申请人提供）：这个保罗·比森职业发展奖的申请是为了进一步发展候选人作为一个独立的研究者在病人为导向的老年研究。职业发展计划直接建立在候选人之前在医学、神经病学、神经生理学和流行病学方面的培训基础上。三年职业发展计划强调四个领域：1)纵向定量方法和分析，2)转化生物学研究，3)步态/移动，4)生物伦理学。强调五种不同的学习模式：a)正式课程，b)阅读教程，c)研究座谈会和研讨会，d)与导师的现场和非现场实践，e)有监督的研究计划。超过三分之一的65岁以上成年人报告至少有一种严重残疾。失能过程描述了一个连续体，从疾病到损伤，到功能限制，最终残疾。缺乏这一过程早期阶段的临床和生物学标志物，特别是在高功能老年人中。身体和认知压力测试可能揭示低生理储备的高功能老年人潜在的活动异常。本应用的研究重点是识别非残疾老年人潜在的活动异常及其生物学基础。具体来说，我们将1)研究潜在的活动异常在身体和认知压力源反应中的作用，作为残疾的预测因素。2)确定潜伏性运动异常与炎症生物标志物之间的关系。为了实现这些目标，将在五年内每隔六个月对300名非残疾老年人进行全面的定性和定量流动性评估。识别潜在的活动能力异常将有助于在残疾过程的早期引入具体的干预措施。本申请中的职业发展活动将使候选人成为一名独立的老龄化研究人员，认知和身体残疾的临床专家，以及下一代研究人员的导师。

DESCRIPTION (provided by applicant): This Paul B. Beeson Career Development Award in Aging application is designed to further the candidate's development as an independent investigator in patient-oriented geriatric research. The career development plan builds directly on the candidate's previous training in Medicine, Neurology, Neurophysiology, and Epidemiology. The three-year career development plan emphasizes four areas: 1) longitudinal quantitative methods and analysis, 2) translational biological research, 3) gait/mobility, and 4) bioethics. Five different learning modalities are emphasized: a) formal coursework, b) reading tutorials, c) research colloquia and seminars, d) on and off-site practical with mentors, and e) supervised research proposal. Over one-third of adults over age 65 report at least one severe disability. The disablement process describes a continuum leading from disease to impairments, to functional limitations, and ultimately disability. Clinical and biological markers of the earliest stages of this process are lacking, especially in high functioning older adults. Physical and cognitive stress tests may reveal latent mobility abnormalities in high functioning older adults with low physiological reserves. The research focus of this application is to identify latent mobility abnormalities and their biological basis in non-disabled older adults. Specifically, we will 1) Examine the role of latent mobility abnormalities in response to physical and cognitive stressors as predictors of disability. 2) Determine the relationship between latent mobility abnormalities and inflammatory biomarkers. To achieve these aims, 300 non-disabled older adults will be assessed with comprehensive qualitative and quantitative mobility assessments at 6-monthly intervals over five years. Identifying latent mobility abnormalities will allow introduction of specific interventions early in the disablement process. The career development activities in this application will enable the candidate to be an independent investigator in aging, a clinical expert in cognitive and physical disability, and a mentor for the next generation of investigators.