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

点击翻译按钮获取中文摘要

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.