Physiologic Distress and Neuropsychiatric Behaviors in Alzheimer's Disease

描述（由申请人提供）：本次申请的目的是支持我的职业目标，成为一名独立的护士调查员，专门研究阿尔茨海默病（AD）的神经内分泌机制和神经精神特征之间的关系。广泛的基础研究表明，神经内分泌因子调节核心的行为和认知过程。最近的研究结果表明，神经内分泌失调影响与进展性阿尔茨海默病相关的神经精神症状的表现。我提出了一个培训计划，包括获得肾上腺皮质评估方面的专业知识，整合生物学和行为数据的统计设计和研究分析，以及设计和测试基于感觉的干预措施，以减轻老年AD患者的神经内分泌窘迫。拟议的3年研究计划通过将从行为和社会科学中收集的科学见解和技术与生物医学学科的方法相结合，代表了对该领域的独特贡献。本研究的具体目的是：(1)以神经内分泌和行为反应为终点，确定基于感觉、触觉的治疗方案在缓解老年AD患者痛苦方面的初步疗效；(2)根据照顾者表达的满意度来确定感官协议的可接受性。总共78名阿尔茨海默病患者-家庭照顾者将被招募参加一项随机等候名单对照研究。如果这项研究发现初步有效性和可接受性的证据，将开发R01申请进行更大的随机对照试验。期望这个研究项目的发现最终会导致减缓病程和/或控制老年痴呆症晚期患者症状的治疗方法。

DESCRIPTION (provided by applicant): The aim of this NINR Mentored Patient Oriented Research Career Development Award application is to support my career objective to become an independent nurse investigator specializing in the relationship between neuroendocrine mechanisms and neuropsychiatric features of Alzheimer's disease (AD). Extensive basic research shows that neuroendocrine factors modulate core behavioral and cognitive processes. Recent findings indicate that neuroendocrine dysregulation influences the presentation of neuropsychiatric symptoms related to advancing AD. I propose a training plan that includes obtaining expertise in adrenocortical assessment, statistical design and analysis of studies integrating biological and behavioral data, and the design and testing of sensory-based interventions to alleviate neuroendocrine distress in older adults with AD. The proposed 3 year research plan represents a unique contribution to the field by merging the scientific insights and technologies gleaned from behavioral and social sciences with approaches from biomedical disciplines. The specific aims of the proposed research are: (1) to determine the preliminary efficacy of the sensory based, tactile protocol in alleviating distress in a sample of older adults with AD using neuroendocrine and behavioral responses as endpoints; and (2) to determine the acceptability of the sensory-based protocol based on satisfaction expressed by caregivers. A total of 78 AD patient-family caregiver dyads will be recruited to participate in a randomized wait-list control study. If this study finds evidence of preliminary efficacy and acceptability, an R01 application will be developed to conduct a larger randomized controlled trial. The expectation is that the findings from this program of study will ultimately result in treatments to slow the course and/or manage symptoms of those with advancing AD. PUBLIC HEALTH RELEVANCE: The research outlined in this proposal aims to examine the interplay of neuroendocrine responses and neuro-psychiatric symptoms in older adults with dementia and to test novel intervention strategies that can be implemented in real-world contexts to advance dementia care.