Study of Cognitive Symptoms and Future Time Perspective in Preclinical Alzheimer's Disease

我是宾夕法尼亚大学记忆中心学者的临床心理学家和研究员，也是 宾夕法尼亚大学老年医学专业。我参加了宾夕法尼亚大学大脑精准医学项目 (P3MB)，研究在诊断和治疗阿尔茨海默氏症方面取得的有希望的进展 疾病(AD)。研究人员假设AD的一个阶段被称为临床前AD，定义为一种条件，即 个体在认知上没有受损，但有阿尔茨海默病的生物标记证据。在未来，有 临床前AD将被处方治疗和其他干预措施，以延缓或减缓疾病的进展。我 研究AD研究参与者从未受损到认知功能下降的连续过程中的经历 到中度认知障碍者，以便了解可能需要哪些类型的心理护理 支持将这一AD痴呆预防模式转化为常规做法。我建议研究两个 临床前阿尔茨海默病患者生活体验的核心特征：主观认知投诉(SCC)和 未来时间透视(FTP)。 为了做到这一点，我将检查一个人对他们的AD生物标记物结果的了解，特别是 淀粉样蛋白PET扫描结果，影响他们的SCCs和FTP，b)与SCCs的报告和AD的测量相互作用 病理，以及c)ftp的纵向变化如何影响决策。这项研究的结果将显示 SCC和ftp在临床前AD体验中的表现。了解这一点很重要，因为临床医生和 研究人员可以衡量它们，它们可以影响人们评估自己的幸福感和做出决定的方式 例如是否服药或参与其他与健康有关的干预。SCCS 目前 (舞台 个人的 vbl.已 是 用于对临床前AD的第二阶段进行分类，这是一个明显的过渡阶段， 1)和轻度受损(阶段3)。Ftp预测n 决策，如健康和财务规划行为，但这些协会没有 在临床前AD患者中进行研究。提出的研究将 Ftp是衡量一个人剩余时间的指标。一个 我将告诉您如何通过以下方式影响FTP 了解AD生物标记物的结果及其对决策的影响。了解SCCS和FTP如何 在临床前AD经验中的表现将确保临床前AD的成功翻译和 在AD的预防中，它将伴随着从研究到实践，这是我的长期目标。 为了实现我的总体目标，我建议设立一个为期5年的K奖，以支持(I)培训，使其发展为 PI并发展AD生物标志物、研究方法和临床护理的知识，以及(Ii)建立 该研究计划将开发一个基于证据的模型来指导临床前AD的心理护理。我 有一个多学科的导师团队，他们的指导记录和AD成像方面的专业知识被挑选出来 生物标记物、AD生物标记物结果的披露和决策。这个计划将给我技能和 初步数据我需要竞争R01的资金，并作为一名独立的临床科学家取得成功。

I'm a clinical psychologist and researcher, Penn Memory Center Scholar, and instructor in the Division of Geriatric Medicine at University of Pennsylvania. I joined the Penn Project on Precision Medicine for the Brain (P3MB) in late 2015 to study the promising advances being made in the diagnosis and treatment Alzheimer's disease (AD). Researchers posit a stage of AD called “preclinical AD,” defined as a condition in which individuals are cognitively unimpaired but have biomarker evidence of AD. In the future, persons with preclinical AD will be prescribed therapies and other interventions to delay or slow the disease progression. I study the experiences of AD research participants across the continuum of cognitive decline from unimpaired to moderately cognitively impaired in order to understand what types of psychological care may be needed to support the translation of this model of AD dementia prevention into routine practice. I propose to study two features central to the experience of living with preclinical AD: Subjective Cognitive Complaints (SCCs) and Future Time Perspective (FTP). To do this, I will examine how a person's knowledge of their AD biomarker result, specifically an amyloid PET scan result, affects their SCCs and FTP, b) interacts with reports of SCCs and measures of AD pathology, and c) how longitudinal changes in FTP affect decision-making. Findings from this study will show how SCCs and FTP behave in the preclinical AD experience. This is important to know, as clinicians and researchers can measure them, and they can affect how people assess their wellbeing and make decisions such as whether or not to take medication or participate in other health-related interventions. SCCs currently (stage individual's been are used to classify stage 2 of preclinical AD, which is a distinct transitional stage between asymptomatic 1) and mildly impaired (stage 3). FTP predicts n decision-making, such as health and financial planning behaviors, but these associations have not studied in individuals with preclinical AD. The studies that propose will FTP is a measure of one's sense of time remaining. a I inform how FTP is affected by learning an AD biomarker result and how this impacts decision-making. Discovering how SCCs and FTP behave in the preclinical AD experience will assure successful translation of Preclinical AD and the model of prevention in AD that it will accompany from research into practice, which is my long-term goal. To accomplish my overall objective, I propose a 5-year K award to support (i) training to develop as a PI and to develop knowledge of AD biomarkers, research methods, and clinical care, and (ii) building a research program that will develop an evidenced-based model to guide psychological care in Preclinical AD. I have a multidisciplinary team of mentors selected for their mentoring track record and expertise in AD imaging biomarkers, disclosure of AD biomarker results, and decision-making. This plan will give me the skills and preliminary data I need to compete for R01 funding and to succeed as an independent clinician-scientist.