Cognition in Euthymic Older Adults with Bipolar Disorder

描述（由申请人提供）：该提案是K23指导患者导向的职业发展奖，专注于老年双相情感障碍患者的认知功能。该候选人计划成为一名独立的研究者，专注于认知功能障碍，以提高老年双相情感障碍治疗的整体功能结果。该候选人是匹兹堡大学的老年精神病学家和博士后研究员，他将接受认知科学方面的培训，包括神经科学和神经成像，以评估老年双相情感障碍的认知功能。额外的培训将包括干预研究方法，以便根据拟议的研究结果制定干预措施。该申请提议对80名50岁及以上的双相情感障碍患者进行横断面研究（40名患者年龄在50 - 65岁之间，40名患者年龄在65岁及以上）和40名年龄和教育程度相等的对照受试者（每个年龄组20名），比较双相情感障碍患者和对照组之间的认知功能，并检查由认知障碍介导的功能能力（adl, ladl）的差异。候选人将研究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，药物使用，身体合共病，药物副作用，APOE等位基因类型，结构脑成像异常，终身暴露于锂或丙戊酸盐。培训和研究将在匹兹堡大学宾夕法尼亚人的老年情绪障碍干预和服务研究高级中心和双相情感障碍中心的主持下进行。候选人的主要假设是：(1)年龄较大的双相情感障碍受试者将比年龄和教育程度相等的对照组有更大的认知障碍，最明显的是信息处理速度；(2)认知表现将与更早、更严重的双相情感障碍病程和其他疾病变量负相关。

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.