Binge Eating Spectrum Treatment in Older Women (BESTOW): An Investigation and Intervention-Tailoring Project

项目摘要 这个Beeson新兴领导人在老龄化职业发展奖（K76）旨在装备博士。丽莎基尔佩拉与 成为饮食失调方面的领先老年学专家所需的专业知识和专业技能 和营养病理学，并推进这一新兴的重要领域。随着女性年龄的增长，生理上的， 心理和生活方式的改变会导致营养失调和相关的健康问题。 在老年妇女中，一个越来越被认识到的可能加剧这些担忧的因素是饮食失调 病理学，它构成了一组复杂的精神疾病，其特征是失调和 异常饮食行为如果不加以治疗，饮食失调会导致严重的发病率和死亡率。 在历史上被认为是青春期的疾病，一个迅速发展的研究机构表明， 紊乱症状在老年妇女中惊人地普遍。基尔佩拉博士作为佩珀人的初步研究 中心RL 5学者发现，老年妇女最常见的饮食失调形式是暴食 (BE;定义为在感到失去控制的同时吃大量食物），26.5%的女性 年龄60岁以上，至少每周报告一次BE发作。BE与肥胖和抑郁症密切相关， 独立于这些合并症，与代谢功能障碍、睡眠问题、残疾和 生活质量差。因此，BE似乎是老年妇女的一个重大健康问题， 比以前想象的更普遍。虽然对于年轻女性存在基于证据的BE治疗， 这些治疗需要为老年妇女量身定制，以解决与年龄有关的因素， 对治疗有影响的年轻女性（例如，认知能力下降、更年期症状）。因此，在本发明中， 拟议的研究旨在：（1）确定对老年女性BE产生独特影响的因素，（2） 利用目标1中收集的信息，指导制定理论驱动的、量身定制的行为干预措施 为老年妇女与BE和试点实施，以确定其可行性，以及（3）整合工作完成 在职业发展计划中的目标1和2，以提高Kilpela博士在以下方面的知识和专长： (a)临床老年学，（B）老年妇女的健康，以及（c）在BE背景下的整合，以支持 R 01申请进行全面试验。作为对拟议研究的补充，Kilpela博士将完成一项 职业发展计划，以获得科学和专业发展技能，过渡到一个 独立调查员这项建议得到了一个由老龄化领域著名科学家组成的导师团队的支持 研究（Musi和Espinoza博士）、妇女健康（LaCroix博士）和饮食失调（Keel博士），以及 老年医学教育顾问（Sanchez-Reilly博士）和生物统计学顾问（Gelfond博士）。这支队伍，沿着 通过圣安东尼奥胡椒中心和Barshop长寿和衰老研究所提供的资源 研究，包括一个理想的环境，基尔佩拉博士成功地达到她的目标，促进健康老龄化 通过解决饮食失调和营养病理学来治疗老年妇女。

PROJECT ABSTRACT This Beeson Emerging Leaders in Aging Career Development Award (K76) seeks to equip Dr. Lisa Kilpela with the expertise and professional skill set needed to become a leading gerontological expert in disordered eating and nutrition pathology, and to advance this emerging and important field. As women age, biological, psychological, and lifestyle changes can contribute to nutritional disorders and associated health problems. Among older women, an increasingly recognized factor that can exacerbate these concerns is eating disorder pathology, which constitutes a group of complex psychiatric disorders characterized by dysregulated and abnormal eating behaviors. When left untreated, eating disorders can cause significant morbidity and mortality. Historically conceptualized as disorders of youth, a rapidly evolving body of research suggests that eating disorder symptoms are surprisingly prevalent in older women. Dr. Kilpela’s preliminary research as a Pepper Center RL5 Scholar found that the most common form of disordered eating in older women is binge eating (BE; defined as eating an unusually large amount of food while feeling a loss of control), with 26.5% of women aged 60+ reporting at least weekly BE episodes. BE is closely linked to obesity and depression and, even independent of these comorbidities, is associated with metabolic dysfunction, sleep problems, disability, and poorer quality of life. Therefore, BE appears to represent a significant health problem for older women with greater prevalence than once thought. Although evidence-based treatments for BE exist for younger women, these treatments need to be tailored for older women in order to address aging-related factors not present in younger women that have implications for treatment (e.g., cognitive decline, menopausal symptoms). As such, the proposed research aims to: (1) identify factors that uniquely impact older women in relation to BE, (2) utilize information gathered in Aim 1 to guide development of a theory-driven, behavioral intervention tailored for older women with BE and pilot implementation to determine its feasibility, and (3) integrate work completed in Aims 1 and 2 within a career development program to advance the Dr. Kilpela’s knowledge and expertise in (a) clinical gerontology, (b) women’s health in aging, and (c) their integration in the context of BE, to support an R01 application for a full-scale trial. Complementary to the proposed research, Dr. Kilpela will complete a program of career development to gain the scientific and professional development skills to transition to an independent investigator. This proposal is supported by a mentorship team of renowned scientists in aging research (Drs. Musi and Espinoza), women’s health (Dr. LaCroix), and eating disorders (Dr. Keel), and advisors in geriatric medicine education (Dr. Sanchez-Reilly) and biostatistics (Dr. Gelfond). This team, along with resources available through the San Antonio Pepper Center and Barshop Institute for Longevity and Aging Studies, comprise an ideal environment for Dr. Kilpela to successfully reach her goal to promote healthy aging in older women by addressing disordered eating and nutrition pathology.