Stress Reactivity and Low Back Pain in Older Adults: Influences on Disability (ReLOAD)

项目总结/摘要 保罗B的申请。Beeson Emerging Leaders Career Development Award in Aging（K76） 博士科里西蒙，物理治疗师和老年疼痛研究员专门从事腰痛。腰背 疼痛是世界上老年人最致残的疾病之一，超过75%的人报告说疼痛持续存在。 发病后1-2年残疾。一种新的残疾机制在老年人腰痛是高 应激反应，其是以血液中的异常变化为特征的急性生理反应， 压力后的生物标志物。高压力反应性与较差的健康结果有关， 残疾在其他慢性疾病;和积累的研究表明，高应激反应是介导的 异常的想法和感觉，并通过生物行为干预来改变。然而，压力 缺乏对患有腰痛的老年人的反应性研究。这是一项为期5年的创新研究， 该计划建立在西蒙博士的试点研究基础上，展示了令人兴奋的初步关联， 应激反应、身体功能和心理困扰。该提案将利用新的实验室压力 反应性测试、患者报告的结果和定性访谈，以：1）识别和量化压力 下背痛老年人的反应; 2）为了降低残疾风险，制定一个 生物行为干预，针对老年人腰痛的高应激反应。此程序将 测试他的中心假设，即患有腰痛和高应激反应的老年人患糖尿病的风险更大。 残疾是由于消极的思想和感情以及不良的应对策略。此外，该计划将 为西蒙博士提供压力反应科学，行为干预 发展和研究领导力。在这个项目完成后，西蒙博士将准备促进 一项由美国国立卫生研究院资助的临床试验（R34/R 01）的开发，以测试他的创新生物行为疗法的疗效。 针对高应激反应的老年腰痛患者的康复干预。总的来说，这 该计划是西蒙博士的长期目标的下一步，成为国际领先的发展， 有针对性的干预措施，以消除残疾的老年人腰痛。

PROJECT SUMMARY/ABSTRACT This application for the Paul B. Beeson Emerging Leaders Career Development Award in Aging (K76) is for Dr. Corey Simon, a physical therapist and geriatric pain researcher specializing in low back pain. Low back pain is one of the world’s most disabling conditions for older adults, with more than 75% reporting persistent disability 1-2 years after onset. A novel disability mechanism among older adults with low back pain is high stress reactivity, which is an acute physiologic response characterized by abnormal changes in blood biomarkers after stressful encounters. High stress reactivity is linked to poorer health outcomes including disability in other chronic conditions; and accumulating research suggests high stress reactivity is mediated by abnormal thoughts and feelings and is modifiable through biobehavioral interventions. However, stress reactivity research in older adults with low back pain is lacking. This proposal in an innovative 5-year research program that builds upon Dr. Simon’s pilot study demonstrating exciting preliminary associations between stress reactivity, physical function, and psychological distress. This proposal will utilize novel laboratory stress reactivity tests, patient-reported outcomes, and qualitative interviews to: 1) Identify and quantify stress reactivity in older adults with low back pain; and 2) For the purpose of reducing disability risks, develop a biobehavioral intervention that targets high stress reactivity in older adults with low back pain. This program will test his central hypothesis that older adults with low back pain and high stress reactivity are at greater risk for disability due to negative thoughts and feelings and poor coping strategies. In addition, this program will provide Dr. Simon with advanced career development in stress reactivity science, behavioral intervention development, and research leadership. Upon completion of this program, Dr. Simon will be poised to facilitate the development of an NIA-funded clinical trial (R34/R01) to test the efficacy of his innovative biobehavioral rehabilitation intervention for older adults with low back pain that targets high stress reactivity. Collectively, this program is the next step in Dr. Simon’s long-term goal to become an international leader in the development of targeted interventions to eradicate disability in older adults with low back pain.