Physical and Mental Fatigability in Late Life Clinical Populations

晚年临床人群的身体和精神疲劳

• 批准号: 9155091
• 负责人: Patrick J Brown
• 金额: $ 25.72万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2018-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9155091
• 关键词: Address; Adult; Back; Behavioral; Chronic Disease; Clinical; Cognitive; DSM-IV; Data; Depressed mood; Diagnosis; Digit structure; Disease; Dysthymic Disorder; Elderly; Episodic memory; Exertion; Fatigue; Functional disorder; Gait; Goals; Hamilton Rating Scale for Depression; Impaired cognition; Individual; Intervention; Investigation; Knowledge; Left; Major Depressive Disorder; Measures; Memory; Memory impairment; Mental Depression; Mental Fatigue; Metabolic; Motivation; Participant; Patient Self-Report; Performance; Physical Performance; Population; Psyche structure; Reaction Time; Recruitment Activity; Risk; Severities; Skeletal Muscle; Task Performances; Testing; Validation; Walking; aged; cognitive performance; cognitive task; depressive symptoms; discounting; executive function; improved; innovation; kinematics; mild cognitive impairment; mortality; neuropsychological; processing speed; prognostic; relating to nervous system; social; walking speed

Project Summary: The primary goal of this R21 application is to establish the concurrent and discriminant validity of physical and mental fatigability domains of the Pittsburgh Fatigability Scale (PFS) across disorders common in late life in which fatigue is most prevalent. Fatigue is a common complaint of older adults and is associated with chronic diseases, functional limitations,1-3 depressive symptoms,4 and mortality risk.5-11 Despite its prognostic importance, measuring fatigue has proven methodologically challenging.5,6,12,13 The concept of fatigability addresses these challenges by anchoring perceived exertion to a specific activity for a specific intensity and duration.6 Recent efforts to develop a self-report measure of physical and mental fatigability in healthy older adults have resulted in PFS.12 Higher PFS physical fatigability scores12 are associated with greater perceived exertion and poorer physical performance. To date, however, little is known about 1) the PFS mental fatigability domain, specifically its neuropsychological and behavioral correlates and how it relates to physical fatigability, and 2) the validity of the use of the PFS in clinical populations common in later life. In this R21 we will validate the PFS by testing associations of its physical and mental domains with physical and cognitive performance, neuropsychological functioning and depression severity in participants with depression, amnestic MCI, and/or fatigue. Cognitive performance decrements on sustained cognitive tasks have been ascribed to mental fatigue,16-20 a phenomenon associated with decrements in physical performance as well.21 Older adults, susceptible to physical fatigability,6,12-14 may also be susceptible to mental fatigability15 as a result of the increased neural activity required to maintain cognitive performance in later life.16,22-30 Understanding the relationship between mental and physical fatigability on the PFS and their relationships to cognitive and physical performance may help identify the pathophysiological mechanisms of these constructs. Validation of the PFS however requires an investigation of the measure's performance in clinical populations in whom fatigue is highly prevalent (Aim 2). Older adults with depressive illness31-35 and mild cognitive impairment (MCI)36,37 represent two such populations, yet little is known about fatigability in older adults with depression or CI. We will recruit 120 adults aged > 65 years with subjective complaints of fatigue (n = 40 with subjective complaints of fatigue and no depression or CI; n = 40 with aMCI and no depression; n = 40 with depression without aMCI). Participants will undergo an assessment of physical performance (measures of gait kinematics, EMG, force plate, and metabolic data with perceived exertion during a 16-min walk) and cognitive performance (N-back and effort-discounting tasks, episodic memory, executive functioning, and processing speed). Validation of the PFS is necessary to 1) investigate the underlying pathophysiological mechanisms of physical and mental fatigability across clinical populations and 2) to develop innovative interventions targeting these mechanisms.

项目概述：此R21应用程序的主要目标是建立并发和判别式 匹兹堡易疲劳性量表（PFS）的身体和精神疲劳领域在各种疾病中的有效性 常见于晚年，其中疲劳是最普遍的。疲劳是老年人的常见症状， 与慢性疾病、功能限制、1-3抑郁症状、4和死亡风险有关。 其预后的重要性，测量疲劳已被证明在方法上具有挑战性。5，6，12，13 疲劳性通过将感知的用力锚定到特定的活动来解决这些挑战， 6最近的努力，以开发一个自我报告的措施，身体和精神疲劳， 健康的老年人导致PFS。12较高的PFS身体疲劳评分12与 更大的感知消耗和更差的身体表现。然而，迄今为止，人们对1） PFS精神疲劳领域，特别是其神经心理学和行为相关性及其关系 身体易疲劳性，和2）PFS在晚年常见的临床人群中使用的有效性。在 在R21中，我们将通过测试PFS的物理和心理领域与物理和心理领域的关联来验证PFS， 抑郁症患者的认知表现、神经心理功能和抑郁严重程度， 遗忘型MCI和/或疲劳。持续认知任务的认知性能下降已经被 归因于精神疲劳，16-20这也是一种与体力下降有关的现象。 易受身体疲劳影响的老年人，6，12-14也可能因此易受精神疲劳影响15 在以后的生活中保持认知能力所需的增加的神经活动。16，22 -30了解 PFS上精神和身体疲劳之间的关系及其与认知和 物理性能可能有助于确定这些结构的病理生理机制。验证 然而，PFS需要在临床人群中调查该指标的性能， 疲劳是非常普遍的（目标2）。患有抑郁症31 -35和轻度认知障碍的老年人 （MCI）36，37代表了两个这样的人群，但对患有抑郁症或抑郁症的老年人的疲劳知之甚少。 CI.我们将招募120名年龄> 65岁的主观主诉疲劳的成年人（n = 40名主观主诉疲劳的成年人）。 主诉疲劳，无抑郁或CI; n = 40例aMCI患者，无抑郁; n = 40例抑郁 没有aMCI）。参与者将接受体能评估（步态运动学测量， EMG、测力板和代谢数据，以及16分钟步行过程中的感知用力）和认知表现 （N-back和努力折扣任务，情景记忆，执行功能和处理速度）。 PFS的验证是必要的，以1）研究物理治疗的潜在病理生理学机制， 和精神疲劳的临床人群和2）开发针对这些创新的干预措施 机制等