Posttraumatic Stress Disorder, Accelerated Biological Aging, and Veteran Health

创伤后应激障碍、加速生物衰老和退伍军人健康

• 批准号: 10705915
• 负责人: Kyle J. Bourassa
• 金额: --
• 依托单位: DURHAM VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10705915
• 关键词: Acceleration; Affect; Afghanistan; Age; Aging; Award; Behavior Therapy; Behavioral Mechanisms; Biological Aging; Biological Markers; Cessation of life; Characteristics; Chronic Disease; Chronology; Clinical; DNA Markers; DNA Methylation; Data; Data Collection; Development; Disease; Electronic Health Record; Face; Goals; Health; Health Care Costs; Health Personnel; Health behavior; Human; IgE; Individual; Intervention; Iraq; Link; Longevity; Measures; Mental Health; Mental disorders; Mentors; Mentorship; Methodology; Methods; Methylation; Molecular; Outcome; Persons; Physiological; Population; Post-Traumatic Stress Disorders; Premature Mortality; Research; Research Personnel; Risk; Sampling; Scientist; Site; Social support; Speed; Testing; Time; Training; Translating; Veterans; Work; career; cohort; comorbidity; cost; disability; experience; health care service utilization; health data; improved; middle age; military veteran; novel; premature; prevent; psychosocial; theories; uptake

Posttraumatic stress disorder (PTSD) is a prevalent and costly mental health disorder associated with poorer health and higher healthcare utilization. These outcomes are a particular concern among Veterans, who have higher rates of PTSD compared to civilian populations. Veterans with PTSD, for example, are twice as likely to experience premature death compared to Veterans without PTSD. How might PTSD affect health? Recent studies have shown that PTSD can accelerate biological aging—i.e., the rate at which people evidence gradual physiological decline consistent with chronological aging. Accelerated aging is theorized to result in more disability, disease, and premature death and could explain why Veterans with PTSD are at greater risk of poor health. There is great promise in slowing aging to prevent ill health, but methods of assessing biological aging have been constrained by long and costly data collection, limiting effective application to clinical settings. Recent methods have shown the potential to use markers of DNA methylation to calculate the speed at which people are aging using biomarkers collected at a single point in time. This novel methodology could provide the opportunity to identify and treat Veterans who are at risk of rapid aging—such as those with PTSD—years before poor health develops. These findings could help promote the importance and uptake of PTSD treatment among both Veterans and healthcare providers, reducing healthcare costs and human suffering. Doing so, however, would require applying these methods in Veteran samples and empirically validating this approach. This Research Plan proposes to examine the links between PTSD, accelerated aging, and later health. The main hypotheses guiding this work are that Veterans with PTSD will evidence accelerated aging, and this accelerated aging will be associated with poorer health 5 years later. A further goal will be to test whether candidate psychosocial characteristics— higher social support, fewer comorbid mental health disorders, positive health behaviors, and treatment for PTSD—might protect against accelerated aging for Veterans with PTSD. Specific Aims—Aim 1: Examine whether Veterans with PTSD have accelerated biological aging. Aim 2: Test whether accelerated biological aging predicts Veterans’ midlife health over the subsequent 5 years. Aim 3: Determine whether candidate psychosocial characteristics are associated with slower aging and better midlife health for Veterans with PTSD. These aims will be achieved using existing data from the Post-Deployment Mental Health (PDMH) study, a multi-site cohort of Afghanistan and Iraq era Veterans. PDMH data, including methylation data used to derived biological aging scores, will be linked to health outcomes in the VA electronic health record (EHR). This study will help determine whether Veterans with PTSD have accelerated biological aging compared to Veterans without PTSD, as well as if accelerated aging predicts poorer Veteran health. This study will provide the first evidence that biological aging explains how PTSD results in poor Veteran health, as well as what psychosocial characteristics could be targeted by intervention to slow aging. The results of these aims will be used to support a Merit Review award submission proposing to examine change in biological aging following behavioral intervention for Veterans with PTSD. The Training and Mentoring plans outline the professional development, training, and mentorship activities that will support the applicant’s development as an early-career investigator in the VA. Specifically, the Training and Mentoring plans will extend the applicant’s methodological expertise to include DNA methylation measures of biological aging in Veteran populations with PTSD, expanding the applicant’s expertise in using VA EHR health data, and support the applicant’s long-term career goal of using interventions to improve the health of Veterans with PTSD. The ongoing mentorship and support the applicant will receive during the CDA-2 award period and beyond will help his development as a Research Health Scientist at the Durham VAMC.

创伤后应激障碍(PTSD)是一种普遍且代价高昂的心理健康障碍，与贫困相关 健康和更高的医疗保健利用率。这些结果是退伍军人特别关注的问题，他们已经 与平民人口相比，创伤后应激障碍的发生率更高。例如，患有创伤后应激障碍的退伍军人患上创伤后应激障碍的可能性是 与没有创伤后应激障碍的退伍军人相比，他们经历了过早的死亡。创伤后应激障碍会如何影响健康？近期 研究表明，创伤后应激障碍可以加速生物衰老--即人们表现出逐渐衰老的速度 生理衰退与时序老化相一致。理论上，加速衰老会导致更多 残疾、疾病和过早死亡，可以解释为什么患有创伤后应激障碍的退伍军人面临更大的贫困风险 健康。 延缓衰老以防止健康不良是很有希望的，但评估生物衰老的方法却有 受限于漫长且昂贵的数据收集，限制了在临床环境中的有效应用。近期 方法已经表明，有可能使用DNA甲基化的标记来计算人类 使用在单个时间点收集的生物标记物进行老化。这一新颖的方法可以提供 有机会识别和治疗面临快速老龄化风险的退伍军人--例如那些患有创伤后应激障碍的退伍军人 在健康状况恶化之前。这些发现有助于促进创伤后应激障碍治疗的重要性和接受度。 在退伍军人和医疗保健提供者中，降低医疗成本和人类痛苦。这样做， 然而，需要在老兵样本中应用这些方法，并从经验上验证这种方法。 这项研究计划建议研究创伤后应激障碍、加速衰老和后来的健康之间的联系。这个 指导这项工作的主要假设是，患有创伤后应激障碍的退伍军人将证明衰老加速，而这一点 5年后，加速衰老将与健康状况变差有关。另一个目标将是测试 应聘者的心理社会特征--更高的社会支持，更少的共病心理健康障碍， 积极的健康行为和创伤后应激障碍的治疗-可能会防止退伍军人加速衰老 创伤后应激障碍。具体目标-目标1：检查患有创伤后应激障碍的退伍军人是否加速了生物衰老。 目标2：检验加速的生物衰老是否预测退伍军人随后的中年健康 五年了。目标3：确定应聘者的心理社会特征是否与反应迟缓有关 患有创伤后应激障碍的退伍军人的老龄化和更好的中年健康。这些目标将使用现有数据来实现 来自部署后心理健康(PDMH)研究，阿富汗和伊拉克时代的多地点队列 退伍军人。PDMH数据，包括用于得出生物老化分数的甲基化数据，将链接到 退伍军人事务部电子健康记录(EHR)中的健康结果。这项研究将有助于确定退伍军人 与没有创伤后应激障碍的退伍军人相比，患有创伤后应激障碍的退伍军人加速了生物衰老 年龄增长预示着退伍军人的健康状况会变差。这项研究将提供生物衰老解释的第一个证据 创伤后应激障碍如何导致退伍军人健康状况不佳，以及哪些心理社会特征可能成为目标 干预以延缓衰老。这些目标的结果将用于支持功绩审查奖的提交 建议研究对患有创伤后应激障碍的退伍军人进行行为干预后生物衰老的变化。 培训和指导计划概述了下列职业发展、培训和指导活动 将支持申请者作为退伍军人管理局职业生涯早期调查员的发展。具体地说，培训和 指导计划将扩展申请人的方法学专长，以包括DNA甲基化测量 患有创伤后应激障碍的退伍军人群体的生物老龄化，扩大申请者在使用VA EHR健康方面的专业知识 数据，并支持申请者使用干预措施改善退伍军人健康的长期职业目标 患有创伤后应激障碍。申请人将在CDA-2授权期内获得持续的指导和支持，以及 Beyond将帮助他成为达勒姆VAMC的研究健康科学家。