Exploring strategies to restore function in older Veterans with PTSD.

描述（由申请人提供） 探索策略以恢复患有PTSD的老年退伍军人的功能。 这是CDA-1的提交材料。这个奖项的候选人是凯瑟琳S。霍尔博士，达勒姆退伍军人事务医疗中心老年研究、教育和临床中心的博士后研究员。Miriam C.博士莫雷将担任主要导师和博士让C。贝克汉姆和海登B。博斯沃思将在颁奖期间担任共同导师。 该提案的总体目标是让候选人建立一个研究计划，研究多种疾病对老年人行为和功能结果的作用;特别关注除了慢性病之外，创伤后应激障碍（PTSD）的额外负担老年人常见的疾病。 霍尔博士将探讨PTSD对坚持和身体活动行为和功能结果变化的纵向轨迹的额外负担。Hall博士在一项正在进行的临床试验（增强健身研究，Morey PI）中确定了感兴趣的变量，并进行了初步分析，以探索PTSD对超重，老年退伍军人的身体活动和功能的影响，葡萄糖耐量受损。Hall博士提出的指导研究旨在通过检查基线关联和PTSD对临床结果随时间变化的影响来广泛表征该数据集中的这些关联。 该奖项下的活动包括确定该人群特有的身体活动障碍，并制定认知行为策略，以解决患有多种疾病和创伤后应激障碍的老年人的特定障碍。 这些目标的结果将为未来开展一项随机对照运动干预的试点研究提供信息，该研究旨在比较基于群体的认知行为干预与传统行为干预在这一研究不足但不断增长的老年退伍军人亚群中增加体力活动的有效性。霍尔博士的培训计划包括扩大和加强她对创伤后应激障碍的病因和表现的理解，探索创伤后应激障碍影响身体活动参与的潜在机制，加强她在认知行为技术方面的背景，并将这些原则应用于身体活动行为，以及纵向和组间分析的统计处理。 鉴于候选人在体力活动方面的强大背景以及她在行为干预和功能评估研究项目方面的经验，对PTSD作为精神科合并症的丰富知识以及她认知行为和统计知识基础的进一步发展将提高她未来的生产力和潜力。 霍尔博士将开发一个新颖独特的研究领域，该领域具有巨大的潜力，可用于制定康复策略，以维持和恢复患有多种疾病的人群的功能，这些疾病正在老化，可能会对VAMC健康服务造成高功能负担。

DESCRIPTION (provided by applicant) Exploring strategies to restore function in older Veterans with PTSD. This is a submission for a CDA-1. The candidate for this award is Katherine S. Hall, Ph.D., a postdoctoral fellow at the Geriatric Research, Education, and Clinical Center of the Durham Veterans Affairs Medical Center. Dr. Miriam C. Morey will serve as a primary mentor and Drs. Jean C. Beckham and Hayden B. Bosworth will serve as co-mentors during this award. The overarching goal of this proposal is for the candidate to build a research program in the role of multiple morbidities on behavioral and functional outcomes in older adults; specifically focusing on the added burden of posttraumatic stress disorder (PTSD) in addition to chronic conditions common to older adults. Dr. Hall will explore the added burden of PTSD on adherence and longitudinal trajectories of change in physical activity behavior and functional outcomes. Dr. Hall has identified the variables of interest in an ongoing clinical trial (the Enhancing Fitness Study, Morey PI) and has performed preliminary analysis to explore the impact of PTSD on physical activity and function in a convenience sample of overweight, older Veterans, with impaired glucose tolerance. Dr. Hall's proposed mentored research seeks to extensively characterize these associations in this dataset by examining baseline associations and the effects of PTSD on changes in clinical outcomes over time. Activities under this award include identifying the barriers to physical activity unique to this population and develop cognitive-behavioral strategies to address specific barriers for older adults with multiple morbidities and PTSD. Results from these aims will inform the future development of a pilot study of a randomized, controlled exercise intervention designed to compare the effectiveness of a group-based cognitive-behavioral intervention for increasing adherence to physical activity compared to traditional behavioral interventions in this understudied, but growing, sub-population of older Veterans. Dr. Hall's training plan includes broadening and strengthening her understanding of the etiology and manifestations of PTSD, exploring the potential mechanisms by which PTSD influences physical activity participation, strengthening her background in cognitive-behavioral techniques and applying these principles to physical activity behavior, and statistical handling of longitudinal and between-group analyses. Given the candidate's strong background in physical activity and her experience with research projects in behavioral interventions and functional assessment, a strong knowledge of PTSD as a psychiatric comorbidity and further development of her cognitive-behavioral and statistical knowledge base will enhance her future productivity and potential in this competitive field. The goal is that Dr. Hall will develop a novel and unique area of research that has tremendous potential for developing rehabilitation strategies for maintaining and restoring function in a cohort with multiple morbidities that is aging and likely to impose a high functional burden on VAMC health services.