Outcomes and Predictors in Mild Cognitive Impairment

描述(由申请人提供)：这是一份申请K24职业中期调查员奖的申请，该奖项涉及与老龄化相关的患者导向研究。这位候选人是匹兹堡大学的精神病学和流行病学教授，作为一名研究人员、临床医生和教育工作者，他有着既定的记录。这项拟议的研究集中在轻度认知障碍(MCI)上，这是一种定义多样的疾病，通常被认为是AIzheimer‘s和其他痴呆的前驱和/或风险状态。其基本前提是，目前MCI的“诊断”标准没有反映典型社区或临床环境中老年人的真实分布和结果。特别是，MCI可能是不稳定的和异质性的，特别是在有显著共病和服用多种药物的患者中。研究计划的目的是改进标准并提出新的标准，这些标准源于：(1)对已完成的15年基于社区的老年队列纵向研究的现有MCI数据进行分析，以及(2)在正在进行的老年初级保健患者研究中增加对MCI的关注。改进后的标准将应用于(3)一项新的多中心队列研究，其方法和标准将从前两个组成部分得出，并将在K24期间收集试点数据。 指导计划面向具有优秀临床和学术背景并致力于痴呆症和轻度认知障碍的临床研究的初级临床医生研究人员。学员将在K24获奖者的监督下，对参与正在进行的初级保健研究(上文第二部分)的患者进行研究评估，并参加多学科共识诊断会议，从而获得以患者为中心的研究的实践经验。他们还将获得分析、解释和报告来自已完成的社区研究(上文第1部分)的数据的监督经验，以供出版。根据他们的兴趣和以前的背景，还有一系列额外的教学和体验课程可供选择。作为培训的一部分，每个受训者将开发一个独立的研究项目申请，并根据获得的知识、技能和生产率进行评估。

DESCRIPTION (provided by applicant): This is an application for a K24 Midcareer Investigator Award in aging-related patient-oriented research. The candidate is a professor of psychiatry and epidemiology at the University of Pittsburgh with an established track record as a researcher, clinician, and educator. The proposed research is focused on Mild Cognitive Impairment (MCI), a variably defined condition generally regarded as a prodromal and/or risk state for AIzheimer's and other dementias. Its basic premise is that current "diagnostic" criteria for MCI do not reflect the real-world distribution and outcomes in older adults in the typical community or clinical setting. In particular, MCI may be unstable and heterogeneous especially in patients with significant comorbidity and on multiple medications. The aims of the Research Plan are to refine the criteria and propose new ones developed from: (1) analysis of existing data on MCI from a completed 15-year longitudinal community-based study of an aging cohort, and (2) an added focus on MCI in an ongoing study of older primary care patients. The refined criteria will be applied to (3) a new multicenter cohort study, for which methods and criteria will be derived from the preceding two components and pilot data will be collected during the K24. The Mentoring Plan is targeted towards beginning clinician investigators with excellent clinical and academic backgrounds and a commitment to clinical research in dementia and mild cognitive impairment. Trainees will obtain hands-on experience of patient-oriented research by conducting research assessments of patients participating in the ongoing primary care study (part 2 above), under supervision by the K24 awardee, and participating in the multidisciplinary consensus diagnosis conferences. They will also obtain supervised experience of analyzing, interpreting, and reporting data from the completed community study (part 1 above) for publication. A range of additional didactic and experiential programs is available depending on their interests and previous background. Each trainee will develop an independent research project application as part of the training and be evaluated on acquired knowledge, skills, and productivity.