An Expanded Framework to Measure Cognitive Function in Older Adults Undergoing Hematopoietic Cell Transplantation

测量接受造血细胞移植的老年人认知功能的扩展框架

• 批准号: 9812006
• 负责人: Thuy Koll
• 金额: $ 11.44万
• 依托单位: UNIVERSITY OF NEBRASKA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9812006
• 关键词: Activities of Daily Living; Address; Adult; Affect; Age; Age-Years; Aging; Allogenic; Autologous; Benefits and Risks; Cancer Center; Clinical Research; Cognitive; Cohort Studies; Decision Making; Distress; Education; Elderly; Enrollment; Family health status; Foundations; Future; Geriatric Assessment; Geriatrics; Health; Health Promotion; Hematologic Neoplasms; Hospitalization; Impaired cognition; Impairment; Individual; Information Centers; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Knowledge; Life; Long-Term Effects; Malignant Neoplasms; Measures; Medical Care Team; Memory; Methods; Mission; Morbidity - disease rate; National Institute on Aging; Neuropsychological Tests; Neuropsychology; Occupational; Outcome; Patient Education; Patients; Perception; Personal Satisfaction; Pharmaceutical Preparations; Phenotype; Pilot Projects; Population; Prevalence; Prospective cohort study; Provider; Public Health; Qualitative Methods; Quality of life; Questionnaires; Research; Risk; Risk Factors; Role; Structure; Supportive care; Thinking; Time; Toxic effect; Transplant Recipients; Treatment Protocols; United States; United States National Institutes of Health; Vascular Diseases; age related cognitive change; base; biopsychosocial; cancer therapy; cognitive change; cognitive function; cognitive reserve; cohort; curative treatments; design; experience; follow-up; frailty; functional decline; functional outcomes; hematopoietic cell transplantation; high risk; hospital readmission; improved; improved functioning; indexing; innovation; instrumental activity of daily living; mortality; neurocognitive test; neurotoxic; older patient; oncology; patient oriented; patient population; psychologic; recruit; survivorship; therapy development; transplant survivor

PROJECT SUMMARY/ABSTRACT An unprecedented number of older adults with hematological malignancies are receiving hematopoietic cell transplantation (HCT). While previously reserved for younger patients, in the past decade a growing number of older adults have undertaken this intense treatment. Cancer and treatment-related cognitive changes cause distress, hinder resumption of normal routine and roles, and worsen quality of life (QOL). The short and long- term effects of HCT on cognitive function and the extent to which these cognitive changes affect life activities and participation in social roles in older patients are not known. The prevalence and risk of cognitive decline post-HCT are likely greater for older adults because of a greater number of existing health conditions (e.g. vascular disease) and impaired physical and psychologic function pre-HCT that can be exacerbated by treatment and the overall HCT experience. To address this gap, we propose a biopsychosocial cancer and aging framework to measure cognitive function in older adults undergoing HCT. This study will expand on a current pilot cohort study and aims to: 1) examine the profile of cognitive domains affected and the trajectory of cognitive function as measured by neuropsychological testing; 2) identify geriatric assessment factors associated with pre-HCT cognitive impairment and cognitive decline at 100 days, 6 months and 12 months post-HCT; and 3) explore patients’ experiences returning to life activities, participation in social roles and QOL pre-HCT and at 6 months and 12 months post-HCT. This study will enroll 48 additional patients who are: 60 years of age and older, have a hematological malignancy and undergoing an autologous or allogeneic HCT at the Buffett Cancer Center. Patients will complete neurocognitive testing and geriatric assessments at the following time points: pre-HCT and follow-up post-HCT at 100 days, and 6 and 12 months. Patients will participate in semi-structured interviews pre-HCT and on follow up post-HCT at 6 and 12 months. We have assembled a strong interdisciplinary team with clinical and research expertise in geriatrics, geriatric oncology, neuropsychology, and qualitative methods to conduct the proposed study. This research will lay the foundation for a NIH career development award application and for a larger, multi-institutional prospective cohort study to identify factors associated with greater risk for poor cognitive outcomes and help design supportive care interventions that consider the interactions between HCT with aging, existing health conditions and multifactorial geriatric concerns to promote and improve function and QOL for older HCT recipients.

项目摘要/摘要 史无前例的血液恶性肿瘤的老年人正在接受造血细胞 移植（HCT）。虽然以前保留给年轻患者，但在过去的十年中 老年人已经接受了这种强烈的治疗。癌症和与治疗相关的认知变化导致 痛苦，阻碍正常常规和角色的恢复以及生活质量较差（QOL）。短而长的 HCT对认知功能的术语影响以及这些认知变化影响生活活动的程度 尚不清楚在老年患者中参与社会角色。认知能力下降的流行和风险 由于有更多的现有健康状况（例如 血管疾病）和身体和心理功能受损，可能会因 治疗和整体HCT经验。为了解决这一差距，我们提出了生物心理社会癌和 老年人的认知功能的老化框架正在接受HCT。这项研究将扩大 当前的飞行员队列研究，目的是：1）检查受影响的认知领域的特征和 通过神经心理学测试衡量的认知功能； 2）确定老年评估因素 与HCT前认知障碍和100天6个月和12个月的认知下降有关 后-HCT; 3）探索患者重返生活活动，参与社会角色和生活质量的经历 hct前以及6个月零12个月的HCT。这项研究将招募48名其他患者：60例 年龄及以上，患有血液学恶性肿瘤，并经历自体或同种异体HCT 巴菲特癌症中心。患者将完成神经认知测试和老年评估 以下时间点：100天后HCT前和随访，以及6和12个月。患者会 在HCT前参加半结构化访谈，并在6个月和12个月后进行HCT后续访问。我们有 组建了一个强大的跨学科团队，具有老年医学，老年肿瘤学的临床和研究专业知识， 神经心理学和进行拟议研究的定性方法。这项研究将奠定基础 进行NIH职业发展奖的申请，并进行更大的多机构的前瞻性队列研究 确定与更大的认知结果风险相关的因素，并有助于设计支持性护理 考虑HCT与衰老，现有健康状况和 多因素的老年医生关注，以促进和改善老年HCT接受者的功能和QOL。