Identifying Risk Factors and Treatment Strategies for Dementia in People with Schizophrenia

精神分裂症患者患痴呆症的风险高得不成比例 据估计，在整个生命周期内，患病风险增加了2.1倍到5.8倍。然而尽管如此，值得注意的是 风险增加，但对导致精神分裂症和精神分裂症共同发生的因素知之甚少 痴呆症和这种共病的临床后果。以改善患痴呆症的风险增加 在患有精神分裂症的成年人中，非常需要确定危险因素，特别是潜在的可改变因素。 危险因素，在这一人群中，痴呆症。此外，没有实践指南，甚至没有一般的 可接受的护理标准，以告知患者的临床评估和治疗 精神分裂症和痴呆症。这一提议的项目为以下人员解决了关键的未回答问题 精神分裂症有患痴呆症的风险，以及患有痴呆症和精神分裂症的人。我们将使用 医疗补助(2007-2022)和医疗保险(2007-2022)的全国纵向索赔记录占75% 美国精神分裂症患者的数字。应用严格的流行病学和药物流行病学 国家医疗保险和医疗补助索赔记录的方法将提供分析痴呆症风险的机会 中老年精神分裂症患者的影响因素。这些分析将包括对以下方面的具体关注 了解患痴呆症的黑人、印第安人和有色人种(BIPOC)的危险因素 精神分裂症。我们还将提供关于#年抗精神病药物安全性的重要新信息。 患有痴呆症和精神分裂症的人。基于这些结果，并使用专家输入和 共识方法，我们将改编和评估认知健康工具包，以帮助临床评估 以及治疗中老年精神分裂症患者的认知障碍。这项研究将 通过解决与风险有关的紧迫问题来增加我们对精神分裂症中痴呆症的理解 因素，特别是可更改的风险因素，并提供迫切需要的影响评估 精神分裂症和痴呆患者病程中的替代抗精神病药物。该项目 还将产生一个临床工具包，以帮助评估和管理这一脆弱的认知健康 人口。

Individuals with schizophrenia are at disproportionally high risk of developing dementia with published estimates ranging from 2.1-fold to 5.8-fold increased risk across the lifespan. Yet despite this remarkably elevated risk, little is known about the factors that contribute to the co-occurrence of schizophrenia and dementia and the clinical consequences of this comorbidity. To ameliorate the increased risk of dementia among adults with schizophrenia, there is a great need to identify risk factors, especially potentially modifiable risk factors, for dementia in this population. In addition, there are no practice guidelines or even generally accepted standards of care to inform clinical assessment and treatment of patients with co-occurring schizophrenia and dementia. This proposed project addresses critical unanswered questions for people with schizophrenia at risk for dementia and for those with co-occurring dementia and schizophrenia. We will use national longitudinal claims records from Medicaid (2007-2022) and Medicare (2007-2022) representing >75% of people with schizophrenia in the US. Applying rigorous epidemiological and pharmacoepidemiological methods to national Medicare and Medicaid claims records will offer the opportunity to parse dementia risk factors within middle aged and older adults with schizophrenia. The analyses will include a specific focus on understanding risk factors for dementia among Black, Indiginous and People of Color (BIPOC) individuals with schizophrenia. We will also provide important new information on the safety of antipsychotic medications in people with co-occurring dementia and schizophrenia. Based on these results and using expert input and consensus methods, we will adapt and evaluate a Cognitive Health Toolkit to aid in the clinical assessment and treatment of cognitive impairments in middle aged and older adults with schizophrenia. This study will increase our understanding of dementia in schizophrenia by addressing pressing questions regarding risk factors, especially modifiable risk factors, and providing an urgently needed evaluation of the effects of alternative antipsychotic medications on the course of patients with schizophrenia and dementia. The project will also yield a clinical toolkit to aid in the evaluation and management of cognition health in this vulnerable population.