A life course approach to integrating trauma and cognitive aging: A cohort of 9/11 responders

 描述(申请人提供)：9/11那天，整整一代人受到创伤，一群英雄被创造出来，他们响应号召帮助曼哈顿的搜索、救援和清理工作。虽然我们了解这些人目前面临的麻烦，但我们对他们随着年龄的增长能期待什么却知之甚少。然而，这些急救员现在的平均年龄为52岁，可能已经经历了快速老龄化，24%的人报告记忆力不佳，14%的人轻度认知障碍筛查阳性，在超过80%的病例中，轻度认知障碍是痴呆症的先兆。应对人员并不是唯一经历痴呆症的人：目前有多达500万美国人患有痴呆症，而超过1500万人肩负着照顾认知受损的朋友和家人的责任。最近出现的一种理论是，严重的创伤经历会导致慢性形式的创伤后应激，对大脑老化有长期影响。特别是，这种创伤可能会严重降低大脑抵抗损伤和保持健康的能力。然而，到目前为止，研究一直受到样本量小和生命过程分析机会有限的阻碍。初步分析表明，支持创伤后应激障碍影响基线认知的观点，并支持创伤后应激障碍可能由影响复原力的类似因素决定的观点，认知老化也是如此。此外，初步证据还表明，创伤后应激障碍与较差的认知能力密切相关，即使在这一受过高等教育和普遍就业的队列中也是如此。对衰老的研究需要一个综合的生命过程发展框架，涉及跨学科合作和先进的方法学方法，以了解是什么改变了健康的衰老。考虑到这一点，该项目有四个具体目标。首先，它将考察个体特征和社会认知特征在影响认知储备中的作用。第二，它将评估两国之间的关系 WTC第一反应者队列中的创伤后应激障碍和认知老化。第三，它将研究创伤后应激障碍与认知老化之间的生物学机制。最后，它将研究将创伤后应激障碍与认知老化联系起来的社会和行为机制。

 DESCRIPTION (provided by applicant): On 9/11, a whole generation was traumatized and a cohort of heroes was created who responded to a call to help in the search, rescue, and cleanup efforts in Manhattan. While we understand the current troubles that such individuals face, we have very little knowledge about what they can expect as they age. Yet, these first responders now average age 52 and may already be experiencing rapid aging as 24% report having poor memories and 14% screen positive for mild cognitive impairment, which precedes dementia in over 80% of cases. Responders are not alone in experiencing dementia: as many as 5 million Americans currently live with Dementia, while over 15 million are charged with caretaking responsibilities for friends and family members who are cognitively impaired. One theory that has recently arisen is that severe traumatic experiences, leading to chronic forms of post-traumatic stress, have long-term implications for brain aging. In particular, it is possible tat such traumas severely decrease the ability for the brain to resist injury and to remain healthy. However, to date research has been hampered by small sample sizes and limited opportunity for life course analysis. Preliminary analyses show substantial support for the view that PTSD impacts cognition at baseline and provide support for the view that PTSD may be determined by similar factors influencing resilience as is cognitive aging. Furthermore, preliminary evidence is also suggestive that PTSD is strongly associated with poorer cognition, even in this highly educated and generally employed cohort. The study of aging demands an integrative life course developmental framework, involving interdisciplinary collaborations and advanced methodological approaches for understanding what modifies healthy aging. Taking this into account, this project has four specific aims. First, it will examine the role of individual and socal characteristics in influencing cognitive reserve. Second, it will evaluate the relationship between PTSD and cognitive aging in the WTC first-responder cohort. Third it will examine the biological mechanisms linking PTSD to cognitive aging. Finally, it will examine the social and behavioral mechanisms linking PTSD to cognitive aging.