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

我是一名临床心理学家和研究员，宾夕法尼亚记忆中心学者，以及 宾夕法尼亚大学的老年医学。我加入了宾夕法尼亚大学的大脑精准医学项目 （P3MB）在2015年底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）。研究人员将AD的一个阶段称为“临床前AD”，定义为一种情况， 个体在认知上未受损，但具有AD的生物标志物证据。今后， 临床前AD将被规定治疗和其他干预措施，以延迟或减缓疾病进展。我 研究AD研究参与者从未受损到认知能力下降的连续体的经历， 中度认知障碍，以了解可能需要哪些类型的心理护理， 支持将这种AD痴呆预防模式转化为常规实践。我建议研究两个 临床前AD患者生活体验的核心特征：主观认知主诉（SCC）， 未来时间洞察力（FTP）。 要做到这一点，我将研究如何一个人的知识，他们的AD生物标志物的结果，特别是一个 淀粉样蛋白PET扫描结果，影响他们的SCC和FTP，B）与SCC报告和AD测量相互作用 病理学，以及c）FTP的纵向变化如何影响决策。这项研究的结果将表明， SCC和FTP在临床前AD经验中的表现。作为临床医生和 研究人员可以测量它们，它们可以影响人们如何评估他们的幸福感并做出决定 例如是否服用药物或参与其他与健康有关的干预措施。SCCs 目前 （阶段 个人的 被 是 用于分类临床前AD的第2阶段，这是无症状AD和无症状AD之间的明显过渡阶段。 1)轻度受损（第3阶段）。FTP预测n 决策，如健康和财务规划行为，但这些协会没有 在患有临床前AD的个体中研究。提出的研究将 FTP是衡量一个人对剩余时间的感觉。一 我告诉FTP是如何受到影响 学习AD生物标志物结果以及这如何影响决策。发现SCC和FTP如何 在临床前AD经验中的表现将确保临床前AD和 它将伴随着从研究到实践的AD预防，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， PI和开发AD生物标志物，研究方法和临床护理的知识，以及（ii）建立一个 该研究计划将开发一个基于证据的模型，以指导临床前AD的心理护理。我 我有一个多学科的导师团队，根据他们在AD成像方面的指导记录和专业知识进行选择 生物标志物、AD生物标志物结果的披露和决策。这个计划会给我技能 我需要的初步数据，以竞争R01基金，并成功地作为一个独立的临床科学家。

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.