Physiologic Distress and Neuropsychiatric Behaviors in Alzheimer's Disease

描述（由申请人提供）：申请 NINR 指导的以患者为导向的研究职业发展奖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，神经内分泌因素调节核心行为和认知过程。最近的研究结果表明，神经内分泌失调会影响与 AD 进展相关的神经精神症状的表现。我提出了一项培训计划，其中包括获得肾上腺皮质评估方面的专业知识、整合生物和行为数据的研究的统计设计和分析，以及基于感觉的干预措施的设计和测试，以减轻患有 AD 的老年人的神经内分泌困扰。拟议的三年研究计划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。拟议研究的具体目标是：（1）以神经内分泌和行为反应为终点，确定基于感觉、触觉的方案在缓解患有 AD 的老年人样本中的痛苦方面的初步功效； (2) 根据护理人员表达的满意度来确定基于感觉的方案的可接受性。总共 78 名 AD 患者-家庭护理人员二人组将被招募参加随机等待名单对照研究。如果这项研究发现初步疗效和可接受性的证据，将开发 R01 应用程序以进行更大规模的随机对照试验。预计该研究项目的结果将最终带来治疗方法，以减缓 AD 患者的病程和/或控制其症状。 公共卫生相关性：本提案概述的研究旨在检查患有痴呆症的老年人的神经内分泌反应和神经精神症状之间的相互作用，并测试可在现实世界中实施的新颖干预策略，以推进痴呆症护理。

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.