Cognition in Euthymic Older Adults with Bipolar Disorder

描述（由申请人提供）：该提案是针对K23指导的以患者为导向的职业发展奖，重点关注双相情感障碍老年人的认知功能。候选人计划成为一名独立的研究者，专注于认知功能障碍，以提高晚年双相情感障碍治疗的整体功能结局。候选人是匹兹堡大学的老年精神病学家和博士后研究员，他将获得认知科学方面的培训，包括神经科学和神经成像，以评估晚年双相情感障碍的认知功能。其他培训将包括干预研究方法，以根据拟议研究的结果制定干预措施。该申请提出了一项对80名50岁及以上的双相情感障碍患者进行的横断面研究（40例患者年龄为50 - 65岁，40例患者年龄为65岁及以上）和40例年龄和教育等同的对照受试者（每个年龄组20人）比较双相情感障碍患者和对照组之间的认知功能，并检查功能能力的差异（ADL，IADL）。候选人将检查认知状态与以下疾病变量之间的关系：发病年龄、病程、精神病症状史、物质使用、身体共病、药物副作用、APOE等位基因类型、结构性脑成像异常和锂或丙戊酸盐终身暴露。培训和研究将在匹兹堡大学老年情绪障碍干预和服务研究高级中心和宾夕法尼亚双相情感障碍中心的主持下进行。候选人的主要假设是：（1）老年双相情感障碍受试者的认知障碍比年龄和教育等同的对照组更大，在信息处理速度方面最明显;（2）认知表现与双相情感障碍的早期、更严重的病程和其他疾病变量呈负相关。

DESCRIPTION (provided by applicant): This proposal is for a K23 Mentored Patient-Oriented Career Development Award focused on cognitive functioning in older adults with bipolar disorder. The candidate plans to become an independent investigator focusing on cognitive dysfunction as a target to enhance overall functional outcomes in late-life bipolar disorder treatment. The candidate is a geriatric psychiatrist and post-doctoral research fellow at the University of Pittsburgh who will obtain training in cognitive science, including neuroscience and neuroimaging, to assess cognitive functioning in late-life bipolar disorder. Additional training will include intervention research methodology to develop interventions based on the findings of the proposed research. The application proposes a cross-sectional study of 80 euthymic patients with bipolar disorder ages 50 years and older (40 patients ages 50 - 65 years and 40 patients 65 years and older) and 40 age- and education- equated control subjects (20 for each age group) comparing cognitive functioning between bipolar patients and controls and examining differences in functional abilities (ADLs, lADLs) mediated by cognitive disturbances. The candidate will examine the relationship between cognitive status and the following illness variables: age of illness onset, illness course, history of psychotic symptoms, substance use, physical co-morbidity, medication side effect, APOE allele type, structural brain imaging abnormalities, and lifetime exposure to lithium or valproate. The training and research will be conducted under the auspices of the Advanced Center for Intervention and Services Research for Late-Life Mood Disorders and the Bipolar Disorder Center for Pennsylvanians at the University of Pittsburgh. The candidate's primary hypotheses are (1) older subjects with bipolar disorder will have greater cognitive disturbances than age- and education- equated controls, most pronounced in information processing speed, and (2) cognitive performance will be negatively associated with earlier, more severe course of bipolar disorder and additional illness variables.