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Principal Investigator: KAREN Ann LAWRENCE
Organization: UNIVERSITY OF KENTUCKY
Fiscal Year: 2024
Award: $125,795
Funding agency: National Institute on Aging
Dementia and the prodromal stages of cognitive decline, together, affect approximately 25-30% of older adults
across the United States (U.S.). Posttraumatic Stress Disorder (PTSD) has been linked to a 111% increased
risk of developing dementia of any type, even after controlling for potential confounders such as traumatic brain
injury (TBI). Therefore, PTSD may be an important target for early prevention of cognitive decline and potential
progression to dementia. Most studies on PTSD and cognition have used a cross-sectional study design and
have not examined important potential effect modifiers (e.g., sex and APOE4 carrier status), leaving a gap in
our fundamental understanding of the effect of PTSD on longitudinal trajectories of cognitive functioning.
Further, although PTSD is more prevalent in women, most research on PTSD and cognition has been
conducted in men. This proposal is of timely public health importance, as the pre-pandemic lifetime prevalence
of PTSD in the U.S. was 6%, but post-pandemic epidemiological findings have indicated a rise to
approximately 32% among young adults. COVID-19 events have also resulted in PTSD symptoms without
meeting Diagnostics and Statistical Manual of Mental Disorders, 5th edition (DSM-5) Criterion A. Therefore,
critical research gaps in our understanding of the effect of PTSD on cognitive aging include: 1) prospective
investigation wherein temporal sequencing and rate of cognitive decline can be evaluated in the context of
PTSD, 2) testing the potential modifying effects of sex and APOE4 carrier status on the relationship between
PTSD status and cognitive decline and, 3) understanding whether Criterion A is necessary when determining
the relationship between PTSD and cognitive decline. Aims 1 and 2 will leverage existing data from the
National Alzheimer's Coordinating Center (NACC). In adults aged 55+ years, multilevel modeling and
interaction analyses will determine the impact of PTSD status on trajectories, rate, and temporal sequence of
domain-specific cognitive decline and will test sex and APOE4 carrier status as potential effect modifiers. For
Aim 3, men and women participants, aged 65+, with and without Criterion A trauma, will be recruited and
multiple regression will be used to unambiguously clarify if PTSD severity (Criteria B through E) is associated
with cognitive functioning without meeting Criterion A. This K01 award will provide training and mentorship in
aging health, cognitive aging, sex-specific health effects of PTSD, neuropsychology of PTSD, longitudinal
study design, and advanced statistics and propel the PI to become an independent investigator with expertise
in the effects of traumatic stress and biopsychosocial factors on cognitive aging, with a sex-specific focus and
in alignment with Goals B-3, B-4, and F-4 of NIA’s Strategic Directions 2020-2025.
Terms: <21+ years old><65 and older><65 or older><65 years of age and older><65 years of age or more><65 years of age or older><65+ years><65+ years old><> 65 years><AD dementia><AD related dementia><ADRD><APOE e4><APOE-ε4><APOEε4><Accidents><Address><Adult><Adult Human><Affect><Aged 65 and Over><Aging><Alzheimer Type Dementia><Alzheimer disease dementia><Alzheimer sclerosis><Alzheimer syndrome><Alzheimer's><Alzheimer's Disease><Alzheimer's and related dementias><Alzheimer's disease and related dementia><Alzheimer's disease and related disorders><Alzheimer's disease or a related dementia><Alzheimer's disease or a related disorder><Alzheimer's disease or related dementia><Alzheimer's disease related dementia><Alzheimers Dementia><Amentia><Anxiety><Brain Trauma><COVID crisis><COVID epidemic><COVID pandemic><COVID-19><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><CV-19><Clinical><Clinical Sciences><Cognition><Cognitive><Cognitive Disturbance><Cognitive Impairment><Cognitive aging><Cognitive decline><Cognitive function abnormal><Coronavirus Infectious Disease 2019><Cross Sectional Analysis><Cross-Sectional Analyses><Cross-Sectional Studies><Cross-Sectional Survey><DSM-5><DSM-V><DSM5><Data><Data Collection><Dementia><Diagnosis><Diagnostic><Diagnostic and Statistical Manual><Diagnostic and Statistical Manual of Mental Disorders><Diagnostic and Statistical Manual of Mental Disorders, 5th edition><Diagnostic and Statistical Manual of Mental Disorders-V><Differences between sexes><Differs between sexes><Disasters><Disease Frequency Surveys><Disturbance in cognition><Drugs><Epidemiology><Episodic memory><Event><Funding><Goals><Health><History><Immediate Memory><Impaired cognition><Incidence><Intervention><Intervention Strategies><Investigation><Investigators><K01 Award><K01 Mechanism><K01 Program><Kentucky><Link><Longitudinal Studies><Medical><Medication><Mental Depression><Mentored Research Scientist Development Award><Mentored Training Award><Mentors><Mentorship><Modeling><Modification><NCATS><National Center for Advancing Translational Sciences><Neuropsychologies><Neuropsychology><PTSD><Participant><Pharmaceutical Preparations><Post-Traumatic Neuroses><Post-Traumatic Stress Disorders><Posttraumatic Neuroses><Prevalence><Prevention><Primary Senile Degenerative Dementia><Psychologist><Public Health><Recording of previous events><Research><Research Design><Research Personnel><Research Scientist Development Award><Researchers><Risk><Risk Factors><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Severities><Sex Differences><Sexual differences><Short-Term Memory><Shortterm Memory><Study Type><Survivors><Symptoms><Testing><Training><Translational Research><Translational Science><Trauma><Traumatic Brain Injury><United States><Universities><War><Woman><Women's prevalence><above age 65><adult youth><adulthood><after age 65><age 65 and greater><age 65 and older><age 65 or older><age > 65><age of 65 years onward><aged><aged 65 and greater><aged 65+><aged ≥65><apo E-4><apo E4><apo epsilon4><apoE epsilon 4><apoE-4><apoE4><apolipoprotein E epsilon 4><apolipoprotein E-4><apolipoprotein E4><assaulted sexually><biopsychosocial factor><biopsychosocial variable><carrier status><clinical center><co-morbid><co-morbidity><cognitive dysfunction><cognitive function><cognitive loss><cohort><comorbidity><coronavirus disease 2019><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><coronavirus infectious disease-19><decline in function><decline in functional status><dementia risk><depression><disability><drug/agent><epidemiologic><epidemiological><executive control><executive function><female prevalence><first responder><functional decline><functional status decline><histories><human old age (65+)><interventional strategy><long-term study><longitudinal outcome studies><longterm study><meeting><meetings><men><methods to study multiple-level influences><mild cognitive disorder><mild cognitive impairment><military veteran><multi-level analysis><multi-level model><multilevel analysis><multilevel model><multilevel modeling><neuropsychologic><old age><older adult><older adulthood><over 65 years><pandemic><pandemic disease><post-pandemic><post-trauma stress disorder><posttrauma stress disorder><pre-clinical><pre-pandemic><preclinical><prevalence among females><prevalence among women><prevalence in females><prevalence in women><prevalent among females><prevalent among women><prevalent in females><prevalent in women><primary degenerative dementia><processing speed><prospective><recruit><risk factor for dementia><risk for dementia><senile dementia of the Alzheimer type><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><sex><sex based differences><sex-dependent differences><sex-related differences><sex-specific differences><sexual assault><sexual attack><statistics><study design><translation research><translational investigation><traumatic brain damage><traumatic neurosis><traumatic stress><veteran population><working memory><young adult><young adulthood><≥65 years>