CSRD Research Career Scientist Award Application

CSRD研究职业科学家奖申请

• 批准号: 10621138
• 负责人: Amy Lynn Byers
• 金额: --
• 依托单位: VETERANS AFFAIRS MED CTR SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-10-01 至 2026-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10621138
• 关键词: Age; Aging; Alzheimer' s Disease; American; Antidepressive Agents; Antiepileptic Agents; Antipsychotic Agents; Anxiety Disorders; Area; Award; Benzodiazepines; Biometry; Biostatistical Methods; Capsicum; Cessation of life; Clinical; Collaborations; Communities; Complex; Connecticut; Creativeness; Cross-Over Studies; Data; Data Linkages; Data Set; Dementia; Detection; Diagnosis; Disease; Elderly; Epidemiology; Extramural Activities; Feeling suicidal; Female; Fostering; Funding; Future; Gerontology; Grant; Health Services Administration; Healthcare; Homelessness; Imprisonment; Investigation; Journals; Knowledge; Life Experience; Link; Manuscripts; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methodology; Military Personnel; Minority; Modality; Mood Disorders; Names; National Institute of Mental Health; National Institute on Minority Health and Health Disparities; Nature; Opioid; Outcome; Overdose; Paper; Pattern; Peer Review; Personal Satisfaction; Pharmaceutical Preparations; Polypharmacy; Positioning Attribute; Post-Traumatic Stress Disorders; Preparation; Prevention; Prevention program; Primary Care; Prisons; Probability Samples; Prognostic Factor; Program Development; Psyche structure; Psychiatry; Psychotropic Drugs; Publishing; Qualifying; Recording of previous events; Reporting; Research; Research Activity; Research Design; Research Project Grants; Risk; Risk Factors; Scientist; Seminal; Societies; Suicide; Suicide attempt; Suicide prevention; System; Trauma; United States Centers for Medicare and Medicaid Services; United States National Institutes of Health; Universities; Veterans; Veterans Health Administration; Vulnerable Populations; Work; adverse outcome; career; clinically relevant; cohort; combat; comorbidity; diagnostic signature; dual diagnosis; ethnic disparity; experience; frailty; geriatric depression; health disparity; health service use; high risk; hormone therapy; hypnotic; large-scale database; middle age; mild cognitive impairment; military veteran; mortality; neuropsychiatry; novel; older women; originality; parent grant; programs; racial disparity; sedative; social; social stigma; suicidal behavior; suicidal morbidity; suicidal risk; trauma exposure

Dr. Amy Byers’ research is predominately focused on suicide prevention in older Veterans. This work is highly relevant to and has very high impact on Veterans and VA healthcare. Veterans 50 years and older have the highest number of lives lost to suicide and make up the majority (> 70%) of the Veteran population. Older adults and, in particular, older Veterans accumulate a significant amount of life experiences, including suffering multiple comorbidities, losses, and traumas, that impact their mental and physical well-being. Even further adding to the complexity, mental health care often occurs in non-mental health settings under the influence of personal and society notions and stigmas about mental illness and about aging. Dr. Byers’ Lab is uniquely positioned to conduct research at this level of complexity. Dr. Byers has developed a deep, clinically relevant understanding of the nature of mental health in late life, its course, treatment and impact. Her research covers multiple sub-areas of late-life mental health, i.e., late-life suicide, late-life posttraumatic stress disorder, mental health services use with age, geriatric depression, and gerontological biostatistics. In particular, understanding suicide-related outcomes in older adults/Veterans requires substantially different conceptual and methodologic considerations, which Dr. Byers and her team are uniquely qualified to undertake. There are 4 over-arching research areas and Aims that Dr. Byers will actively pursue during the proposed Research Career Scientist Award period: 1) To characterize and identify patterns of health services use and diagnostic profiles at a national level among older adults/Veterans who have experienced late-life suicide or mental health disorders; 2) To identify predictors of late-life suicide; 3) To advance late-life suicide and mental health research in prominent health disparity and vulnerable groups; and 4) To advance suicide and neuropsychiatric research in Veterans incarcerated and returning to community in later life. In summary, the first 3 Aims are supported by an on-going VA CSR&D Merit Award (I01 CX001119; PI: Byers). Aim 2 and 3 are further supported by a Genius Award (PI: Byes) from the UCSF Older Americans Independence Center (NIA-funded Pepper Center). Aim 4 is supported by a NIMH Multi-PI R01 grant in collaboration with Dr. Lisa Barry from University of Connecticut (MH117604; Multi-PI: Byers/Barry). Additionally, Dr. Byers and Dr. Barry were recently awarded a NIMH/NIA Supplement to the parent grant to determine the burden of Alzheimer’s disease and related diseases in older adults/Veterans with a recent history of incarceration. There are many seminal contributions by Dr. Byers’ Lab in terms of highly cited papers in high impact journals in support of these on-going activities. To name a few, she was the first to determine the high occurrence of late-life mood and anxiety disorders at a national level, first to determine and characterize nationally that the majority (~70%) of older adults with mood or anxiety disorders did not use mental health services, first to identify comorbidity profiles in Veterans 65 years and older who were last seen in primary care prior to a suicide attempt, first to determine in a national cohort that risk of suicide attempt was increased in Veterans recently diagnosed with mild cognitive impairment or dementia (in press at JAMA Psychiatry), first to provide evidence that hormone therapy is an indicator of suicide risk among midlife to older women Veterans (even independent of psychoactive drugs), and seminal work showing a nearly 5-fold greater risk of a subsequent suicide attempt in older Veterans transitioning from prison to community. Dr. Byers is investigating other unique patterns of potential markers and predictors of late-life suicide risk (supported by I01 CX001119), including “high-risk” medication use (i.e., benzodiazepines, sedative-hypnotics, opioids, antidepressants, antiepileptics, and antipsychotics) and polypharmacy patterns, and conducting seminal research to determine specific medications causally linked to risk of suicide in older Veterans. Moreover, she is actively pursuing more research on vulnerable groups (female, minority, homeless, and PTSD), including Veterans transitioning from incarceration to community in later life.

艾米·拜尔斯博士的研究主要集中在老年退伍军人的自杀预防上。这部作品是 与退伍军人和退伍军人事务部医疗保健高度相关且具有非常高的影响。 50岁及以上的退伍军人 因自杀而丧生的人数最多，占退伍军人人口的大多数（> 70%）。年长的 成年人，特别是老年退伍军人，积累了大量的生活经历，包括痛苦 多种合并症、损失和创伤影响他们的身心健康。更进一步 更复杂的是，精神卫生保健经常在非精神卫生环境中进行，受到以下因素的影响： 个人和社会对精神疾病和衰老的观念和耻辱。拜尔斯博士的实验室独一无二 定位于在这种复杂程度进行研究。拜尔斯博士开发了一种深入的、临床相关的 了解晚年心理健康的本质、过程、治疗和影响。她的研究涵盖 晚年心理健康的多个子领域，即晚年自杀、晚年创伤后应激障碍、精神疾病 卫生服务与年龄、老年抑郁症和老年生物统计学一起使用。特别是理解 老年人/退伍军人的自杀相关结果需要截然不同的概念和方法 拜尔斯博士和她的团队非常有资格承担这些考虑。有4个总体 拜尔斯博士在拟议的研究职业科学家期间将积极追求的研究领域和目标 奖励期限： 1) 描述和确定卫生服务使用模式和诊断概况 全国范围内经历过晚年自杀或精神健康障碍的老年人/退伍军人； 2）确定晚年自杀的预测因素； 3) 推进晚年自杀和心理健康研究 突出的健康差距和弱势群体； 4) 推进自杀和神经精神病学研究 退伍军人被监禁并在晚年返回社区。总之，前 3 个目标得到了支持 持续获得 VA CSR&D 优异奖（I01 CX001119；PI：Byers）。目标 2 和 3 得到进一步支持 加州大学旧金山分校美国老年人独立中心（NIA 资助的胡椒中心）颁发的天才奖（PI：再见）。 Aim 4 得到 NIMH Multi-PI R01 赠款的支持，该赠款与来自University of University的 Lisa Barry 博士合作 康涅狄格州（MH117604；多 PI：Byers/Barry）。此外，拜尔斯博士和巴里博士最近还荣获 NIMH/NIA 对家长补助金的补充，以确定阿尔茨海默病及相关疾病的负担 最近有监禁史的老年人/退伍军人的疾病。有许多开创性的贡献 拜尔斯博士实验室在高影响力期刊上发表高被引用论文，以支持这些正在进行的活动。 仅举几例，她是第一个确定晚年情绪和焦虑症在某所医院的高发率的人。 国家层面，首先在全国范围内确定和描述大多数（约 70%）的老年人患有情绪问题 或焦虑症患者未使用心理健康服务，首先确定退伍军人的合并症概况 65 岁及以上在自杀未遂前最后一次在初级保健机构就诊的人，首先要在全国范围内确定 最近被诊断患有轻度认知障碍的退伍军人自杀企图风险增加的队列 或痴呆（JAMA Psychiatry 上发表），第一个提供证据表明激素治疗是 中年至老年女性的自杀风险 退伍军人（甚至独立于精神活性药物）和影响深远的 研究表明，从老年退伍军人过渡到老年退伍军人后，其随后自杀未遂的风险增加了近 5 倍。 监狱到社区。拜尔斯博士正在研究潜在标记物和预测因子的其他独特模式 晚年自杀风险（由 I01 CX001119 支持），包括“高风险”药物使用（即苯二氮卓类药物、 镇静催眠药、阿片类药物、抗抑郁药、抗癫痫药和抗精神病药）和多药治疗模式， 进行开创性研究以确定与老年人自杀风险有因果关系的特定药物 退伍军人。此外，她正在积极开展更多针对弱势群体（女性、少数民族、无家可归者、 和创伤后应激障碍（PTSD）），包括晚年从监禁过渡到社区的退伍军人。