Mental Health Outcomes in Alzheimer's Disease Patients and Their Partners

阿尔茨海默病患者及其伴侣的心理健康结果

• 批准号: 10726776
• 负责人: Casey Crump
• 金额: --
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2023-09-02
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10726776
• 关键词: Address; Age; Alzheimer' s Disease; Alzheimer' s disease patient; Alzheimer' s disease related dementia; Anxiety Disorders; Birth; Cessation of life; Chronic; Communities; Data; Data Set; Dementia; Diagnosis; Distress; Early Intervention; Health; Hospital Records; Incidence; Individual; Inpatients; Institution; Intervention; Knowledge; Major Depressive Disorder; Mental Health; Mental disorders; Morbidity - disease rate; Outcome; Outpatients; Patient Self-Report; Patients; Persons; Population; Prevalence; Primary Care; Public Health; Quality of life; Registries; Relative Risks; Reporting; Research; Research Personnel; Risk; Risk Assessment; Sample Size; Socioeconomic Factors; Spouses; Stress; Subgroup; Suicide; Suicide attempt; Sweden; Symptoms; Testing; Time; United States National Institutes of Health; Vulnerable Populations; alcohol use disorder; burden of illness; caregiving; clinical care; cohort; comorbidity; cost; cost efficient; follow-up; global health; high risk; improved; indexing; innovation; medical specialties; mortality; next generation; population based; premature; prevent; psychosocial; residence; sex; sociodemographic factors

Alzheimer's disease (AD) is a leading cause of morbidity and mortality and is expected to triple in prevalence worldwide by 2050. AD has a high disease burden that may cause psychosocial distress in AD patients and their spouses/partners, and may increase risks of mental illness. Importantly, mental disorders are treatable, and early intervention could reduce suffering, improve quality of life, and prevent premature death in AD patients and their partners. Despite the high public health burden of mental disorders, they are understudied compared with somatic outcomes of AD. A comprehensive understanding of mental health sequelae is critically needed to improve clinical care and outcomes for AD patients and their partners. Prior studies have had key limitations, including limited follow-up times and sample sizes, and ascertainment of mental disorders using either self-report which is potentially subject to reporting bias, or hospital records which capture only the most severe cases. No large-scale studies have included partners. We will address these limitations by conducting the first comprehensive study of mental health outcomes in AD patients and their partners in a national cohort (N = 6 M) using highly complete data from primary care, specialty outpatient, and inpatient settings. We hypothesize that AD patients and their partners have increased risks of major mental disorders and suicide. To test this hypothesis, we will examine these outcomes in 233,792 persons diagnosed with AD and 660,807 persons with any dementia (included for comparison with AD findings) in Sweden during 1998- 2018 and their 342,298 partners, compared with 3.3 M without dementia (matched 5:1 on sex and birth year) and their 1.7 M partners, followed up through 2020. Sweden is an ideal setting because individual-level data on AD and all-cause dementia diagnoses, mental health outcomes, and covariates are available for the entire population. Moreover, the incidence and treatment of AD and common mental disorders are comparable to the US. Our specific aims are to determine risks of 4 major mental health outcomes (major depression, anxiety disorders, alcohol use disorder, and suicide) in AD and all-cause dementia patients and their spouses/partners, and identify high-risk subgroups. The proposed research is significant because AD is a major global health problem that is increasing in prevalence, and its mental health sequelae may have substantial impacts that are understudied and preventable or treatable. It is innovative because it will provide the first comprehensive assessment of 4 major mental health outcomes in a national cohort of AD and all-cause dementia patients and their partners by integrating unparalleled individual-level data for 6 M people. It is highly cost-efficient because we will leverage data from multiple national registries in Sweden that are unavailable or prohibitively costly to assemble in the US. The results will fill critical knowledge gaps by identifying, for the first time, mental health outcomes in AD and all-cause dementia patients, their partners, and high-risk subgroups in a national population, which will help guide timely interventions to improve their quality of life and health outcomes.

阿尔茨海默氏病（AD）是发病率和死亡率的主要原因，预计在患病率上将三倍 到2050年，全球范围内。广告的疾病负担很高，可能会导致广告患者的社会心理困扰 他们的配偶/伴侣，可能会增加精神疾病的风险。重要的是，精神障碍是可以治疗的， 早期干预可以减少苦难，改善生活质量并防止广告过早死亡 病人及其伴侣。尽管精神障碍的公共卫生负担很大，但他们还是被研究了 与AD的体细胞结局相比。对心理健康后遗症的全面了解是 为了改善广告患者及其伴侣的临床护理和结果，至关重要的是。先前的研究已有 有关键的局限性，包括有限的随访时间和样本量以及精神障碍的确定 使用可能受到报告偏见的自我报告，或仅捕获的医院记录 最严重的情况。没有大规模研究包括合作伙伴。我们将通过 在广告患者及其伴侣的心理健康成果中进行首次全面研究 国家队列（n = 6 m）使用初级保健，专业门诊和住院的高度完整数据 设置。我们假设AD患者及其伴侣的主要精神障碍风险增加 和自杀。为了检验这一假设，我们将在被诊断为AD的233,792人中检查这些结果 1998年瑞典的660,807名患有痴呆症的人（包括与广告发现进行比较） - 2018年及其342,298伙伴，而没有痴呆症的3.3 m（在性别和出生年度为5：1） 以及他们的1.7 M合作伙伴，随后到2020年。瑞典是一个理想的环境，因为个人级别的数据 在AD和全因痴呆症诊断上，精神健康成果和协变量可用于整个 人口。此外，AD和常见精神障碍的发病率和治疗与 我们。我们的具体目的是确定4种主要心理健康结果的风险（重度抑郁症，焦虑症 AD和全因痴呆症患者及其配偶/伴侣的疾病，酒精使用障碍和自杀）， 并确定高风险亚组。拟议的研究很重要，因为广告是全球主要健康 患病率及其心理健康后遗症的问题可能会产生实质性影响 研究，可预防或可以治疗。它具有创新性，因为它将提供第一个综合 评估全国性的AD和全因痴呆症患者的4个主要心理健康成果，以及 他们的合作伙伴通过将无与伦比的个人级别数据集成为6 m的人。这是高度成本效益的，因为 我们将利用来自瑞典多个国家注册机构的数据，这些数据不可用或昂贵的数据 在美国组装。结果将通过首次识别心理健康来填补关键知识差距 全国范围 人口将有助于指导及时的干预措施，以改善其生活质量和健康成果。