Developing a Risk Index for Functional Decline in Middle-Aged and Older Adults with HIV
制定中老年艾滋病毒感染者功能衰退的风险指数
基本信息
- 批准号:10762280
- 负责人:
- 金额:$ 4.03万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-09-30 至 2026-09-29
- 项目状态:未结题
- 来源:
- 关键词:AccelerationAcquired Immunodeficiency SyndromeAddressAdultAdverse eventAgeAgingBehavioralBiologicalBuffersCaliforniaCharacteristicsClinicalClinical ResearchCognitionCognitive agingCommunitiesCommunity PracticeComplexCross-Sectional StudiesDataData SetDedicationsDevelopmentDevelopment PlansDiabetes MellitusDimensionsDiseaseElderlyEmotionalExhibitsFosteringHIVHIV SeronegativityHIV antiretroviralHyperlipidemiaIncidenceIndividualInterceptIntervention StudiesKnowledgeLongitudinal StudiesMaintenanceMeasuresMedicalMental DepressionMentorsMentorshipMissionModelingNIH Office of AIDS ResearchNational Institute on AgingNeurocognitive DeficitOutcomePatternPersonsPopulationPrevention ResearchPrevention strategyPsychological FactorsPublic HealthResearchResearch PriorityRiskRoleSamplingScientistTimeTrainingUnemploymentUniversitiesValidationVariantWorkadverse outcomeage effectaging populationantiretroviral therapybehavior measurementbiopsychosocial factorburden of illnesscareer developmentclinical practicecomorbiditydisabilityexperiencefunctional declinefunctional independencehigh riskhuman old age (65+)improvedindexingindividualized preventionlongitudinal datasetmiddle ageneurobehavioralnovelpeerpredictive modelingpreservationprogramsprotective factorspsychologicresearch and developmentskillssocialtooltool development
项目摘要
PROJECT SUMMARY/ABSTRACT
As people with HIV (PWH) enter older adulthood, there is a growing public health need to preserve everyday
functioning in aging PWH. PWH disproportionately experience adverse factors including neurocognitive
impairment (NCI) and psychiatric (e.g., depression) and medical (e.g., diabetes) comorbidities relative to age-
comparable peers without HIV. Together, these factors put older PWH at risk for everyday functioning decline.
Despite this, there are few studies on the longer-term patterns and correlates of everyday functioning change
in PWH, and there is no well-validated multivariable risk index informed by such longitudinal data. Therefore,
the research aims of this F31 will delineate unique longitudinal trajectories of everyday functioning in PWH;
and develop and initially validate a risk index of adverse and protective factors based on longitudinal modeling
to identify PWH at risk for functional decline. This project will be conducted with support from an
interdisciplinary mentorship team at the University of California, San Diego (UCSD) HIV Neurobehavioral
Research Program (HNRP), a leading research center with experts in HIV and aging. The proposed F31 will
leverage access to two archival longitudinal studies: CNS HIV Antiretroviral Therapy Effects Research
(CHARTER; N = 704) and Multi-Dimensional Successful Aging Among HIV-Infected Adults (N = 106), that
were conducted and/or coordinated at the HNRP. Accordingly, the specific aims are to: 1) identify unique
everyday functioning trajectories in a development dataset (CHARTER); 2a) develop a prediction model using
adverse predictors for functional decline in the development dataset; 2b) validate the model in the
development (CHARTER) and validation (Successful Aging) datasets; and 3) determine if positive
psychological factors add incremental value to predicting functional decline. The training plan proposes
rigorous statistical training in developing advanced longitudinal predictive models of everyday functioning,
combined with specific mentoring in the understanding and uses of biopsychosocial variables relevant to aging
PWH as potential predictors. This F31 application is in line with the National Institute of Aging’s (NIA) mission
to support and conduct biological, clinical, behavioral, and social research on aging; in addition to their mission
to foster the development of research and clinician scientists in aging. It is also in line with an NIH Office of
AIDS Research (OAR) priority for well-validated, multivariable indices that combine a range of biological to
behavioral measures to predict which PWH are at high-risk for adverse outcomes. The opportunities afforded
via this F31 mechanism will facilitate the applicant’s professional development toward becoming an
independent academic neuropsychologist dedicated to promoting successful aging among older PWH.
项目摘要/摘要
随着艾滋病病毒感染者(PWH)进入老年,每天都有越来越多的公共卫生需要
在老化的PWH中发挥作用。PWH不成比例地经历不利因素,包括神经认知
损伤(NCI)和精神病(例如,抑郁症)和医疗(例如,糖尿病)与年龄相关的合并症-
没有艾滋病毒的同龄人。总之,这些因素使老年PWH面临日常功能下降的风险。
尽管如此,很少有关于日常功能变化的长期模式和相关性的研究
在PWH中,没有充分验证的多变量风险指数,这些纵向数据。因此,我们认为,
F31的研究目标将描绘PWH日常功能的独特纵向轨迹;
开发并初步验证了基于纵向模型的不利因素和保护因素的风险指数
以识别威尔斯亲王医院有功能衰退的风险。该项目将在一个
加州大学圣地亚哥分校(UCSD)的跨学科导师团队
研究计划(HNRP),一个领先的研究中心与艾滋病毒和老龄化的专家。F31将
利用访问两个存档纵向研究:CNS HIV抗逆转录病毒治疗效果研究
(CHARTER; N = 704)和HIV感染成人中的多维成功衰老(N = 106),
在HNRP进行和/或协调。因此,具体目标是:1)确定独特的
发展数据集(CHARTER)中的日常功能轨迹; 2a)使用
发育数据集中功能下降的不利预测因素; 2b)验证
开发(CHARTER)和验证(成功老化)数据集;以及3)确定是否为阳性
心理因素为预测功能衰退增加了增量价值。培训计划提出,
在开发日常功能的高级纵向预测模型方面进行了严格的统计培训,
结合具体指导,了解和使用与老龄化有关的生物心理社会变量
PWH作为潜在的预测因子。此F31应用程序符合美国国家老龄化研究所(NIA)的使命
支持和进行生物学,临床,行为和社会研究老化;除了他们的使命
促进老龄化研究和临床科学家的发展。它也符合美国国立卫生研究院的办公室,
艾滋病研究(OAR)优先考虑经过充分验证的多变量指标,这些指标结合了一系列生物学指标,
行为测量,以预测哪些PWH处于不良后果的高风险中。提供的机会
通过这种F31机制将促进申请人的专业发展,成为一个
独立学术神经心理学家,致力于促进老年威尔斯亲王医院的成功老龄化。
项目成果
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