Evaluating the Adverse Cognitive Effects of Medications

申请人：Noll Campbell，PharmD，FASCP，BCPP，通过两个驻院期间接受老年药物治疗的专业培训开始了他的职业生涯，并拥有10多年的临床经验。他对临床研究的兴趣影响了他与印第安纳大学的老年临床研究人员建立了关系。这种关系导致了几项活动和经验，这些活动和经验为 为坎贝尔博士未来在老年临床研究方面的职业生涯奠定了基础。为了努力保护 为了进行研究活动和追求自己的职业目标，他过渡到了普渡大学药学院的研究约会。在这个职业发展奖的支持下，他将通过教学和经验培训练习发展临床试验设计、药物流行病学和生物统计学方面的技能。在完成导师职业发展奖后，坎贝尔博士将与未来的项目竞争外部资金，将药物对老年人的不良认知影响降至最低。研究职业发展计划：这个应用程序建议课程工作、研究策略和由导师小组提供的指导活动。指导团队包括一名老龄脑健康服务研究专家(Malaz Boustani博士)、一名药物流行病学负责人(Mick Murray博士)、一名生物统计学和流行病学专家(Sujuan Gao博士)以及一名神经心理学专家(Fred Unverzagt博士)。职业发展计划旨在实现候选人的长期职业目标：(1)发展临床试验设计、药物流行病学和生物统计学方面的技能，以支持改善老化大脑健康的研究生涯；以及(2)获得在未来研究中使用这一宝贵资源所需的信息技术技能。研究项目：以前描述药物对认知障碍影响的文献受到药物暴露和认知障碍的不准确测量的限制。该项目建议通过使用持续和准确的药物暴露和神经心理评估措施来解决这些限制。这项分析中包括的人群包括认知障碍的老年人，他们由于可改变和不可改变的危险因素的重大负担而处于发展为痴呆症的高风险之中。这些人参加了一项旨在确定痴呆症风险因素的观察性研究。研究队列在一个大型医疗系统中接受护理，该系统捕获大型医疗记录数据库中的所有活动，包括药物分配数据。同样，在四年预期期间每年进行的神经心理评估将被用作认知功能的综合衡量标准。这些结果将为未来旨在减少药物的不良认知影响并最终改善老化大脑健康的干预提供初步证据。

DESCRIPTION (provided by applicant): The Applicant: Noll Campbell, PharmD, FASCP, BCPP began his career by pursuing specialty training in geriatric pharmacotherapy through two residencies and has over 10 years of clinical experience. His interests in clinical research influenced him to establish a relationship with the geriatric clinical researchers at Indiana University. This relationship resulted in several activities and experiences that have provided the foundation for Dr. Campbell's future career in geriatric clinical research. In an effort to protect time for research activity and pursue his career goals, he transitioned to a research appointment with the Purdue University College of Pharmacy. With the support of this career development award he will develop skills in clinical trial design, pharmacoepidemiology, and biostatistics through didactic and experiential training exercises. Upon completion of the mentored career development award, Dr. Campbell will compete for extramural funding with future projects minimizing the adverse cognitive effects of medications among older adults. The Research Career Development Plan: This application proposes course work, a research strategy, and mentored activities provided by a panel of mentors. The mentoring team includes an expert in aging brain health services research (Dr. Malaz Boustani); a leader in pharmacoepidemiology (Dr. Mick Murray); an expert in biostatistics and epidemiology (Dr. Sujuan Gao); and an expert in neuropsychology (Dr. Fred Unverzagt). The career development plan intends to achieve the candidate's long-term career goals of: (1) developing skills in clinical trial design, pharmacoepidemiology, and biostatistics to support a research career improving the health of the aging brain; and (2) obtaining information technology skills necessary to use this valuable resource in future research. The Research Project: Previous literature describing the impact of medications on cognitive impairment has been limited by inaccurate measurements of medication exposure and cognitive impairment. This project proposes to address these limitations by using continuous and accurate measures of medication exposure and neuropsychological assessments. The population included in this analysis consists of older adults with cognitive impairment who are at high risk of developing dementia due to a significant burden of modifiable and non-modifiable risk factors. This population was enrolled in an observational study aimed at identifying risk factors for dementia. The study cohort receives care within a large healthcare system that captures all activity in a large medical record database, including medication dispensing data. Similarly, neuropsychological assessments conducted annually during the four-year prospective period will be used as a comprehensive measure of cognitive function. These results will provide preliminary evidence for future interventions aimed at reducing the adverse cognitive effects of medications and ultimately improving the health of the aging brain.