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.

阿尔茨海默病 (AD) 是发病率和死亡率的主要原因，预计患病率将增加两倍 到 2050 年，AD 的疾病负担很高，可能会导致 AD 患者的社会心理困扰， 他们的配偶/伴侣，并可能增加患精神疾病的风险。重要的是，精神障碍是可以治疗的 早期干预可以减少 AD 患者的痛苦、提高生活质量并预防过早死亡 患者及其伴侣。尽管精神障碍给公共卫生带来沉重负担，但人们对它们的研究还不够充分 与 AD 的躯体结果进行比较。对心理健康后遗症的全面了解是 迫切需要改善 AD 患者及其伴侣的临床护理和结果。先前的研究有 存在关键局限性，包括有限的随访时间和样本量以及精神障碍的确定 使用可能存在报告偏差的自我报告，或仅记录真实情况的医院记录 最严重的情况。没有大规模研究纳入合作伙伴。我们将通过以下方式解决这些限制 对 AD 患者及其伴侣的心理健康结果进行了首次全面研究 全国队列（N = 6 M）使用来自初级保健、专科门诊和住院患者的高度完整的数据 设置。我们假设 AD 患者及其伴侣患重大精神疾病的风险增加 和自杀。为了检验这一假设，我们将检查 233,792 名被诊断患有 AD 的患者的这些结果 1998 年期间，瑞典有 660,807 名患有痴呆症的人（包括在内以与 AD 调查结果进行比较） 2018 年及其 342,298 名伴侣，而没有痴呆症的伴侣为 330 万（性别和出生年份匹配为 5:1） 及其 170 万合作伙伴，随访至 2020 年。瑞典是一个理想的环境，因为个人层面的数据 关于 AD 和全因痴呆症的诊断、心理健康结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普通精神障碍相当。 我们。我们的具体目标是确定 4 种主要心理健康结果（重度抑郁、焦虑）的风险 AD 和全因痴呆患者及其配偶/伴侣的疾病、酒精使用障碍和自杀）， 并确定高风险亚组。拟议的研究意义重大，因为 AD 是一个主要的全球健康问题 问题日益普遍，其心理健康后遗症可能会产生重大影响 研究不足且可以预防或治疗。它是创新的，因为它将提供第一个全面的 对全国 AD 和全因痴呆患者队列的 4 项主要心理健康结果进行评估 通过整合 600 万人无与伦比的个人数据来帮助他们的合作伙伴。它具有很高的成本效益，因为 我们将利用来自瑞典多个国家登记处的数据，这些数据无法获得或成本高昂。 在美国集合。研究结果将通过首次确定心理健康来填补关键的知识空白 国家研究中 AD 和全因痴呆患者、其伴侣以及高风险亚组的结果 人口，这将有助于指导及时干预，以改善他们的生活质量和健康结果。