Influence of Vision Impairments on Dementia in Stroke Survivors: A Longitudinal Analysis

项目总结/摘要 这是K 01指导研究科学发展奖的申请。建议的目标 项目是为候选人提供建立独立研究计划所需的高级技能 检查中风幸存者的视觉健康需求，同时也患有痴呆症。为了实现这一长期目标， 候选人提出一个全面的培训计划，结合正式的课程和会议监督 她的导师，参加应用培训经验和参与研讨会和讲习班。 具体培训目标包括：（1）获得卒中后流行病学和发病机制方面的先进知识 痴呆症，（2）学习痴呆症的神经心理学和临床评估，（3）获得以下方面的技能和培训 临床研究方法和统计分析，使用横截面和纵向数据，以及（4） 积极参与职业发展和领导力发展活动。培训计划将是 与上述一系列研究活动协调执行，这些活动是根据初步的 申请人收集的数据。初步数据显示，缺乏研究是否存在特定的 各种类型的视力障碍和眼部缺陷会增加中风后痴呆的风险。 候选人将通过使用社区中风中动脉粥样硬化风险的数据来扩展这些发现 队列完成以下目标：（1）描述与视力相关的患病率和结局 有和没有痴呆症的中风幸存者中的损伤;（2）确定预先存在的视力如何 损伤影响痴呆症的发展，在中风患者中;和（3）确定效果， 中风后视力损害的下游后果在没有预先存在的视力损害的人。 主要假设包括：（1）中风幸存者患痴呆症的几率较高， 与视力正常的卒中幸存者相比，既存视力障碍;（2）视力正常的卒中幸存者 与中风幸存者相比， 正常视力;和（3）中风后视力障碍对痴呆发展的影响对那些 与没有功能障碍的人相比，功能障碍。预期结果将提供 对中风后患者经历的视力障碍和眼部缺陷类型的重要见解 痴呆症，包括更多关于区分中风前和中风后视觉障碍的重要性的信息。 以及对痴呆症的预期差异影响。这项研究的结果将用于开发 随后的R 01研究计划，将促进候选人的过渡到一个独立的研究人员 重点分析现有数据和预期入组，以优化独立性和社区性 有视力障碍和痴呆的中风幸存者的参与。

PROJECT SUMMARY/ ABSTRACT This is an application for a K01 Mentored Research Scientific Development Award. The goal of the proposed project is to provide the candidate with the advanced skills needed to establish an independent research program examining the visual health needs of stroke survivors also living with dementia. To facilitate this long-term goal, the candidate proposes a comprehensive training plan, combining formal coursework and meetings overseen by her mentors, participation in applied training experiences and involvement in seminars and workshops. Specific training goals include: (1) gain advanced knowledge in the epidemiology and mechanisms of post-stroke dementia, (2) learn neuropsychological and clinical assessment of dementia, (3) acquire skills and training in clinical research methodology and statistical analysis, using both cross sectional and longitudinal data and (4) productively participate in career advancement and leadership development activities. The training plan will be executed in coordination with the set of research activities mentioned above, which are based on preliminary data collected by the applicant. The preliminary data show a lack of research on whether the presence of specific types of vision impairment and ocular deficits increase the risk of post-stroke dementia. The candidate will expand on these findings by using data from the Atherosclerosis Risk in Communities stroke cohort to complete the following aims: (1) characterize the prevalence and outcomes associated with vision impairment(s) among stroke survivors with and without dementia; (2) determine how pre-existing vision impairments impact the development of dementia, among those with stroke; and (3) determine the effect and downstream consequences of post-stroke vision impairment in persons without pre-existing vision impairment. The primary hypotheses include that: (1) the odds of developing dementia are higher for stroke survivors with pre-existing vision impairment, compared to stroke survivors with normal vision; (2) stroke survivors with vision impairment preceding the stroke are more likely to develop dementia earlier, compared to stroke survivors with normal vision; and (3) the impact of post-stroke vision impairment on dementia development is stronger for those with functional impairment, compared to those without functional impairment. The expected findings will provide critical insight into the types of vision impairment and ocular deficits experienced by people with post-stroke dementia, including more information on the significance of distinguishing between pre- and post-stroke visual impairments and the expected differential impact on dementia. Results from this research will be used to develop a subsequent R01 research proposal that will facilitate the candidate’s transition into an independent researcher focused on analysis of existent data and prospective enrollment to optimize the independence and community participation of stroke survivors with vision impairments and dementia.