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Identifying Risk Factors and Treatment Strategies for Dementia in People with Schizophrenia

确定精神分裂症患者痴呆症的危险因素和治疗策略

基本信息

批准号：
10623754
负责人：
MARK OLFSON
金额：
$ 58.45万
依托单位：
NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-04-01 至 2028-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10623754
关键词：
Address Adult Age Ambulatory Care Anti-Cholinergics Antipsychotic Agents Benzodiazepines Black, Indigenous, People of Color Cardiometabolic Disease Caring Clinical Clinical Treatment Clinical assessments Cognition Cognitive Communities Consensus Data Dementia Diabetes Mellitus Diagnosis Disease Dyslipidemias Early Diagnosis Elderly Epidemiology Evaluation Exclusion Exposure to Functional disorder Future General Population Haloperidol Health High Prevalence Hospitalization Hypertension Impaired cognition Individual Investigation Joints Label Longevity Medicaid Medicare Medicare/Medicaid Medication Management Methods Outcome Patients Persons Pharmaceutical Preparations Pharmacoepidemiology Pharmacological Treatment Population Practice Guidelines Prevalence Process Psychoses Publishing Quality of Care Recommendation Records Research Risk Risk Factors Risperidone Safety Schizophrenia Therapeutic Studies Translating Vulnerable Populations alcohol use disorder aripiprazole cardiometabolic risk clinical practice cognitive performance cohort comorbidity comparative comparative effectiveness comparative safety dementia risk ethnoracial disparity follow-up high risk hospitalization rates improved interest middle age modifiable risk mortality mortality risk olanzapine people of color personalized intervention precision medicine primary outcome quetiapine secondary outcome treatment group treatment strategy virtual ziprasidone

项目摘要

Individuals with schizophrenia are at disproportionally high risk of developing dementia with published estimates ranging from 2.1-fold to 5.8-fold increased risk across the lifespan. Yet despite this remarkably elevated risk, little is known about the factors that contribute to the co-occurrence of schizophrenia and dementia and the clinical consequences of this comorbidity. To ameliorate the increased risk of dementia among adults with schizophrenia, there is a great need to identify risk factors, especially potentially modifiable risk factors, for dementia in this population. In addition, there are no practice guidelines or even generally accepted standards of care to inform clinical assessment and treatment of patients with co-occurring schizophrenia and dementia. This proposed project addresses critical unanswered questions for people with schizophrenia at risk for dementia and for those with co-occurring dementia and schizophrenia. We will use national longitudinal claims records from Medicaid (2007-2022) and Medicare (2007-2022) representing >75% of people with schizophrenia in the US. Applying rigorous epidemiological and pharmacoepidemiological methods to national Medicare and Medicaid claims records will offer the opportunity to parse dementia risk factors within middle aged and older adults with schizophrenia. The analyses will include a specific focus on understanding risk factors for dementia among Black, Indiginous and People of Color (BIPOC) individuals with schizophrenia. We will also provide important new information on the safety of antipsychotic medications in people with co-occurring dementia and schizophrenia. Based on these results and using expert input and consensus methods, we will adapt and evaluate a Cognitive Health Toolkit to aid in the clinical assessment and treatment of cognitive impairments in middle aged and older adults with schizophrenia. This study will increase our understanding of dementia in schizophrenia by addressing pressing questions regarding risk factors, especially modifiable risk factors, and providing an urgently needed evaluation of the effects of alternative antipsychotic medications on the course of patients with schizophrenia and dementia. The project will also yield a clinical toolkit to aid in the evaluation and management of cognition health in this vulnerable population.

精神分裂症患者患痴呆症的风险高得不成比例