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.

项目摘要：此 R21 应用程序的主要目标是建立并发和判别式 匹兹堡疲劳量表 (PFS) 跨疾病的身体和精神疲劳域的有效性 常见于晚年，其中疲劳最为普遍。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 和死亡风险相关。5-11 由于其预后重要性，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努力锚定到特定的特定活动来解决这些挑战 强度和持续时间。6 最近努力开发一种身体和精神疲劳的自我报告测量方法 健康的老年人导致了 PFS。12 较高的 PFS 身体疲劳评分 12 与 感知到的消耗更大，体能表现更差。然而，迄今为止，人们对 1）知之甚少。 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联方式 身体疲劳程度，以及 2) 在晚年常见的临床人群中使用 PFS 的有效性。在 在这个 R21 中，我们将通过测试其身体和心理领域与身体和心理领域的关联来验证 PFS。 抑郁症参与者的认知表现、神经心理功能和抑郁严重程度， 遗忘性 MCI 和/或疲劳。持续认知任务的认知表现下降 归因于精神疲劳，16-20 这种现象也与身体机能下降有关。21 老年人容易出现身体疲劳，6,12-14 也可能容易出现精神疲劳15 维持晚年认知表现所需的神经活动增加。16,22-30 了解 PFS 中精神和身体疲劳之间的关系及其与认知和认知的关系 身体表现可能有助于识别这些结构的病理生理机制。验证 然而，PFS 需要调查该措施在临床人群中的表现，其中 疲劳现象非常普遍（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，但对于患有抑郁症或抑郁症的老年人的疲劳性知之甚少。 CI。我们将招募 120 名年龄 > 65 岁、有主观疲劳主诉的成年人（n = 40，有主观疲劳主诉） 主诉疲劳，无抑郁或 CI； n = 40 例 aMCI，无抑郁症； n = 40 患有抑郁症 没有 aMCI）。参与者将接受身体表现评估（步态运动学测量、 EMG、测力台和代谢数据（16 分钟步行期间感知的用力）和认知表现 （N-back 和省力任务、情景记忆、执行功能和处理速度）。 PFS 的验证对于 1) 调查身体疾病的潜在病理生理机制是必要的。 和临床人群的精神疲劳，2) 针对这些问题制定创新干预措施 机制。