Depression in dementia caregivers: Linking brain structure and sleep-wake risks
痴呆症护理人员的抑郁症:将大脑结构与睡眠-觉醒风险联系起来
基本信息
- 批准号:10094254
- 负责人:
- 金额:$ 10.86万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-03-08 至 2023-02-28
- 项目状态:已结题
- 来源:
- 关键词:Activity CyclesAffectAgingAnimalsAreaAtrophicBehaviorBehavioralBlood PressureBrainCaringCessation of lifeCharacteristicsChronic DiseaseCircadian desynchronyClinicalClinical ResearchDataDementiaDementia caregiversDiffuseDisease ProgressionEarly DiagnosisElderlyEpidemiologyEthicsEtiologyFunctional disorderFutureGoalsHealthHealth Care CostsHourHumanImmunologicsImpairmentInflammatoryInterdisciplinary StudyKnowledgeLeadLinkLiteratureLongitudinal StudiesMagnetic Resonance ImagingMeasuresMedicineMental DepressionMentorsMicrovascular DysfunctionModelingNeuroanatomyNeurobiologyNeurosciencesOutcomePathogenesisPathologicPathologyPatternPrevention approachPrevention strategyProspective StudiesProviderPublic HealthQuality of lifeReportingResearchResearch TrainingRestRiskRisk FactorsScienceScientistSeveritiesSleepSleep DeprivationSleep FragmentationsSleep Wake CycleSleep disturbancesStructureSubgroupSystemTechnical ExpertiseTestingThickTimeTrainingVascular DiseasesVentricularVisceralVisitaging brainbasecareer developmentcaregiver straincaregivingcerebral atrophydementia caredepression preventiondepressive symptomsdisabilityexperiencefollow-upgeriatric depressiongray matterhigh riskmultidisciplinarymultimodalityneuroimagingnovelpoor sleeppreventprogramsprospectivepsychosocialresearch studyskillsskills trainingsleep patternsleep qualitytoolwhite matterwhite matter damage
项目摘要
Abstract
There is a great need to integrate neuroscientific tools into the study of late-life depression (LLD) etiology. My
goal is to develop evidence that will help target prevention strategies to the neurobiological basis of LLD
vulnerability. Several existing studies demonstrate that LLD pathophysiology is characterized a high burden of
structural magnetic resonance imaging (sMRI) measured small vessel disease, white matter damage, and
atrophy in key networks, such as those subserving executive and central visceral controls. To build on and
extend current literature, there is a need to clarify the specific structural alterations involved in LLD
pathogenesis. There is also a fundamental need for evidence regarding the preventable risk factors for
pathological brain structural aging. The conceptual model that underlies my research program proposes that
24-hour sleep-wake activity disturbances are a key and understudied risk factor for the specific brain structural
alterations that increase LLD risk. To lead future studies that will programmatically advance the neuroscience
of depression prevention, I need to build on my past training in risk factor epidemiology and LLD neurobiology
in several areas. First, I need clinical research training in the science of depression prevention for high risk
older adults, such as dementia caregivers. Second, I must prepare myself to lead multi-modal, longitudinal
neuroimaging studies. Third, I must prepare myself to lead studies assessing and interpreting the health
relevance of 24-hour sleep-wake activity measures. Therefore, this K01 will provide me with: (1) A capstone
field training experience administering ethical, multidisciplinary clinical research studies with older adults who
are at high risk for developing depression, plus mentor-guided training in current LLD prevention approaches
and the psychosocial/behavioral basis for LLD in at-risk groups; (2) New technical skills collecting, processing,
analyzing, and interpreting multi-modal neuroimaging data, plus formal coursework in neuroanatomy/systems
neurobiology, and (3) New technical skills measuring and processing 24-hour sleep-wake activity measures,
plus grounding in clinical sleep medicine to interpret these metrics. To accomplish these training goals and
advance public health relevant knowledge regarding LLD etiology, I propose to longitudinally study changes in
depression among older informal dementia caregivers who are experiencing strain delivering care. This group
is increasingly public health relevant and at very high risk for depression. Our preliminary data indicates that
LLD in strained dementia caregivers may be due to disrupted brain structural connectivity. Longitudinal
neuroimaging studies in this group are needed to extend our preliminary findings by evaluating whether/which
specific brain structural characteristics predict future increases in the burden of depression. In addition,
dementia caregivers often have inadequate sleep and restricted daytime activity, which are both depression
risk factors that may increase the rate of brain structural aging (e.g., by activating pro-inflammatory cascades
or contributing to vascular disease). I therefore propose a prospective study (n=90) with state-of-the-art 7-
Tesla sMRI and actigraphic sleep-wake activity measures repeated at an initial visit and an 18-month follow-
up. This will enable me to test and refine a model wherein specific sleep-wake activity disturbances are
associated with brain structural changes affecting the key networks underlying LLD risk. The scientific and
career development outcomes will be: (1) identification of the specific brain structural networks and sleep-wake
activity patterns that predict increases in depression symptom severity among dementia caregivers, (2)
refinement of a model linking specific sleep-wake activity characteristics with both pathological brain structural
aging and depression symptoms, and (3) a multidisciplinary research scientist with the knowledge, skills, and
data needed to develop a confirmatory study (R01) supporting neurobiologically-informed prevention strategies
for LLD.
摘要
有一个很大的需要,以整合神经科学工具到研究晚年抑郁症(LLD)的病因。我
我们的目标是开发证据,帮助针对LLD的神经生物学基础制定预防策略
易损性.一些现有的研究表明,LLD病理生理学的特征是高负荷的
结构磁共振成像(sMRI)测量小血管疾病、白色物质损伤,
关键网络的萎缩,例如那些辅助执行和中央内脏控制的网络。依靠和
扩展目前的文献,有必要澄清涉及LLD的具体结构改变
发病机制此外,还需要有关于可预防的危险因素的证据,
病理性脑结构老化我的研究计划所依据的概念模型提出,
24-小时睡眠-觉醒活动障碍是特定大脑结构的关键和未充分研究的风险因素,
这些改变会增加LLD的风险。领导未来的研究,以编程方式推进神经科学
为了预防抑郁症,我需要在我过去在危险因素流行病学和LLD神经生物学方面的培训基础上,
在几个领域。首先,我需要接受预防高风险抑郁症科学的临床研究培训
老年人,如痴呆症护理人员。二要做好领导多模式、纵向
神经影像学研究。第三,我必须准备好领导评估和解释健康状况的研究。
24小时睡眠-觉醒活动测量的相关性。因此,K01将为我提供:(1)一个顶点
具有管理符合伦理的多学科临床研究的现场培训经验,
有患抑郁症的高风险,加上导师指导的当前LLD预防方法的培训
以及高危人群中LLD的心理社会/行为基础;(2)新的技术技能收集,处理,
分析和解释多模态神经成像数据,以及神经解剖学/系统的正式课程
神经生物学,以及(3)测量和处理24小时睡眠-觉醒活动测量的新技术技能,
加上临床睡眠医学的基础来解释这些指标。为了实现这些培训目标,
推进公共卫生相关知识关于LLD病因,我建议纵向研究的变化,
抑郁症的老年非正式痴呆症照顾者谁正在经历压力提供护理。这群
越来越多地与公共卫生相关,并且患抑郁症的风险非常高。我们的初步数据显示,
紧张的痴呆照顾者的LLD可能是由于大脑结构连接中断。纵向
需要对该组进行神经影像学研究,以通过评估是否/
特定的大脑结构特征预测未来抑郁症负担的增加。此外,本发明还提供了一种方法,
痴呆症护理人员通常睡眠不足,白天活动受限,这都是抑郁症
可能增加脑结构老化速率的风险因素(例如,通过激活促炎级联反应
或导致血管疾病)。因此,我提出了一项前瞻性研究(n = 90),采用最先进的7-
在初次就诊和18个月随访时重复特斯拉sMRI和活动记录睡眠-觉醒活动测量,
起来这将使我能够测试和完善一个模型,其中特定的睡眠-觉醒活动干扰是
与影响LLD风险的关键网络的大脑结构变化有关。科学和
职业发展的结果将是:(1)识别特定的大脑结构网络和睡眠-觉醒
活动模式预测痴呆症照顾者中抑郁症状严重程度的增加,(2)
将特定的睡眠-觉醒活动特征与病理性脑结构
衰老和抑郁症状,以及(3)多学科研究科学家的知识,技能,
开发验证性研究(R01)所需的数据,支持神经生物学知情的预防策略
对于LLD。
项目成果
期刊论文数量(21)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Timing of Daily Activities over a 24-Hour Period and Affective Status among a National Cohort of Older Dementia Caregivers.
在24小时内的日常活动的时机和全国痴呆症护理人员队列中的情感状态。
- DOI:10.1177/0898264320962363
- 发表时间:2021-01
- 期刊:
- 影响因子:2.8
- 作者:Stahl ST;Rodakowski J;Smagula SF
- 通讯作者:Smagula SF
Spectral sleep electroencephalographic correlates of sleep efficiency, and discrepancies between actigraphy and self-reported measures, in older men.
- DOI:10.1111/jsr.13033
- 发表时间:2021-04
- 期刊:
- 影响因子:4.4
- 作者:Smagula SF;Sofer T;Guo N;Prerau M;Purcell S;Mariani S;Yaffe K;Redline S;Stone KL
- 通讯作者:Stone KL
Evaluating the timing of differences in activity related to depression symptoms across adulthood in the United States.
- DOI:10.1016/j.jad.2021.01.069
- 发表时间:2021-04-01
- 期刊:
- 影响因子:6.6
- 作者:Smagula SF;Capps CS;Krafty RT
- 通讯作者:Krafty RT
Engaging Early-Career Geriatric Mental Health Investigators as Associate Editorial Board Members.
聘请早期职业生涯老年心理健康调查人员作为副编辑委员会成员。
- DOI:10.1016/j.jagp.2016.12.010
- 发表时间:2017
- 期刊:
- 影响因子:0
- 作者:Simning,Adam;Smagula,StephenF
- 通讯作者:Smagula,StephenF
New Evidence for a Biological Pathway to Mental Health Problems in Dementia Caregivers: Invited Commentary on the Article by Wells et al. (AMGP-1247).
痴呆症护理人员心理健康问题的生物途径的新证据:Wells 等人文章的特邀评论。
- DOI:10.1016/j.jagp.2019.05.003
- 发表时间:2019
- 期刊:
- 影响因子:0
- 作者:Smagula,StephenF
- 通讯作者:Smagula,StephenF
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Stephen F Smagula其他文献
Detecting Sleep/Wake Rhythm Disruption Related to Cognition in Older Adults With and Without Mild Cognitive Impairment Using the myRhythmWatch Platform: Feasibility and Correlation Study
使用 myRhythmWatch 平台检测患有和未患有轻度认知障碍的老年人中与认知相关的睡眠/觉醒节律紊乱:可行性和相关性研究
- DOI:
10.2196/67294 - 发表时间:
2025-01-01 - 期刊:
- 影响因子:4.800
- 作者:
Caleb D Jones;Rachel Wasilko;Gehui Zhang;Katie L Stone;Swathi Gujral;Juleen Rodakowski;Stephen F Smagula - 通讯作者:
Stephen F Smagula
Stephen F Smagula的其他文献
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{{ truncateString('Stephen F Smagula', 18)}}的其他基金
Combining information from multiple circadian activity rhythm metrics to optimally detect mild cognitive impairment using a consumer wearable
结合多个昼夜节律活动指标的信息,使用消费者可穿戴设备以最佳方式检测轻度认知障碍
- 批准号:
10300129 - 财政年份:2021
- 资助金额:
$ 10.86万 - 项目类别:
Developing a widely-useable wearable Circadian Profiling System to assess 24-hour behavioral rhythm disruption in people with dementia and their family caregivers
开发可广泛使用的可穿戴昼夜节律分析系统,以评估痴呆症患者及其家庭护理人员的 24 小时行为节律紊乱
- 批准号:
10321398 - 财政年份:2021
- 资助金额:
$ 10.86万 - 项目类别:
Combining information from multiple circadian activity rhythm metrics to optimally detect mild cognitive impairment using a consumer wearable
结合多个昼夜节律活动指标的信息,使用消费者可穿戴设备以最佳方式检测轻度认知障碍
- 批准号:
10478935 - 财政年份:2021
- 资助金额:
$ 10.86万 - 项目类别:
Morning Activation Deficits and Depression Symptoms: Mechanisms and Modifiability in Dementia Caregivers
早晨激活缺陷和抑郁症状:痴呆症护理人员的机制和可修改性
- 批准号:
10636933 - 财政年份:2021
- 资助金额:
$ 10.86万 - 项目类别:
Morning Activation Deficits and Depression Symptoms: Mechanisms and Modifiability in Dementia Caregivers
早晨激活缺陷和抑郁症状:痴呆症护理人员的机制和可修改性
- 批准号:
10362081 - 财政年份:2021
- 资助金额:
$ 10.86万 - 项目类别:
Developing a widely-useable wearable Circadian Profiling System to assess 24-hour behavioral rhythm disruption in people with dementia and their family caregivers
开发可广泛使用的可穿戴昼夜节律分析系统,以评估痴呆症患者及其家庭护理人员的 24 小时行为节律紊乱
- 批准号:
10612523 - 财政年份:2021
- 资助金额:
$ 10.86万 - 项目类别:
Sleep-wake, cognitive, and affective risks for a worse course of post-discharge suicidal ideation in older adults with major depression
患有重度抑郁症的老年人出院后自杀意念恶化的睡眠-觉醒、认知和情感风险
- 批准号:
9974894 - 财政年份:2020
- 资助金额:
$ 10.86万 - 项目类别:
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