Sedative-Hypnotic Use Patterns and Risk for Cognitive Decline and Alzheimer's Disease

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ABSTRACT This proposed K01 application will support the training of Christopher N. Kaufmann, PhD, MHS, in pursuit of his career goal of becoming an independently funded Alzheimer’s disease health services researcher. This application consists of two complementary components: a) a research project examining trajectories of cognitive aging and Alzheimer’s disease and dementia outcomes associated with use of sedative-hypnotic medications, and b) a 5-year comprehensive training plan comprised of mentorship, didactic and professional development opportunities, and experiential training activities designed to address three gaps in his past training: a) cognitive aging and Alzheimer’s disease research, b) utilizing and analyzing administrative data (including Medicare claims), and c) longitudinal data analysis to statistically model aging trajectories, all culminating in the submission of an R01 application in years 3-5. In the proposed research project, Dr. Kaufmann will examine how use of sedative-hypnotic medications are associated with trajectories of cognitive performance, transition across cognitive status categories (e.g., normal cognition, cognitively impaired but not dementia, and dementia status), and incidence of Alzheimer’s disease among other related dementia diagnoses over a 12-year period from 2006 to 2018. To answer these questions, the project will take advantage of the NIA-funded Health and Retirement Study with linked data from Medicare claims. The project is supported by a strong interdisciplinary mentorship team with expertise in geriatrics, cognitive aging and Alzheimer’s disease, health services research, longitudinal data analysis, sleep, and pharmaceutical sciences. Alison Moore, MD, MPH, Chief of the Division of Geriatrics, and expert in substance abuse in seniors with extensive contacts within the geriatrics and aging field, Mark W. Bondi, PhD, Professor in the Department of Psychiatry, with extensive research in cognitive assessment and Alzheimer’s disease, and James D. Murphy, MD, MS, Associate Professor in the Department of Radiation Medicine and Applied Sciences and expert in use of Medicare claims data, will serve as the mentors of this application. Their mentorship will be complemented by that of Xin Tu, PhD, a senior biostatistician with extensive experience in longitudinal data analysis, Adam P. Spira, PhD, an expert in sleep disturbances and Alzheimer’s disease outcomes, and Grace M. Kuo, PharmD, MPH, PhD, a medication safety expert. The research project and complementary training plan will provide Dr. Kaufmann with hands-on experience in utilizing administrative data with longitudinal data to answer questions important to cognitive aging and ultimately Alzheimer’s disease and dementia prevention efforts. Further, the proposed work will provide Dr. Kaufmann with the training needed to propel his career towards becoming an independently R01-funded Alzheimer’s disease researcher.