Physiologic Distress and Neuropsychiatric Behaviors in Alzheimer's Disease

摘要 NINR以患者为导向的研究职业发展奖的目的 申请是为了支持我成为一名独立护士的职业目标 专门研究神经内分泌机制和 阿尔茨海默病(AD)的神经精神病学特征。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。近期 研究结果表明，神经内分泌失调会影响 与进展期AD相关的神经精神症状。我提出了一个培训计划， 包括获得肾上腺皮质评估、统计设计和 分析整合生物和行为数据的研究，以及设计和测试 以感觉为基础的干预措施缓解老年患者的神经内分泌痛苦 广告。拟议的三年研究计划是对该领域的独特贡献，由 将从行为和社交中收集的科学见解和技术融合在一起 科学与生物医学学科的方法。建议的具体目标 研究内容主要有：(1)初步确定以感官、触觉为主的疗效 使用神经内分泌缓解老年AD患者痛苦的方案 和行为反应作为终点；以及(2)确定可接受的 以照顾者所表达的满意度为基础的感官方案。总共是公元78年 患者-家庭照顾者双方将被招募参加随机等待名单 对照研究。如果这项研究发现了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。这个 人们的期望是，这个研究项目的结果最终将导致 治疗以减缓病程和/或控制进展期AD患者的症状。

Abstract 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.