The primary objective of this Career Development Award application is to enable the applicant to develop the skills and expertise necessary to become an independent investigator focusing on the important role cognitive function plays in the course of medical illness in older adults. Cognitive impairment (CI) often occurs in the context of chronic medical conditions that are common in older adults and likely influences clinical and quality of life outcomes in these high- risk patients, potentially through impaired self-care. Heart failure (HF) is an ideal condition through which to study the impact of CI on disease self-care and long-term outcomes.
The specific aims of my research program are to: (1) prospectively examine cognitive function in patients aged e65 years from the time of hospitalization for HF through 3-months after hospital discharge;(2) prospectively examine the performance of self-care activities from the time of hospitalization for HF through 3-months after hospital discharge;(3) examine the relation between cognitive function and performance of self-care activities at selected time intervals following hospital discharge for HF;(4) develop and pilot test an intervention to enhance self- care practices for HF survivors that is tailored to a patient's cognitive status. A robust training plan will complement this research program and provide the applicant with the tools necessary to be successful as an independent investigator;it will include coursework and focused mentoring in the areas of clinical geriatrics, cardiovascular epidemiology, longitudinal research methodologies, and clinical trial design and implementation. The findings of the work conducted during the award period will have the potential to inform the development of self-care interventions that are tailored to the patient's cognitive status and to improve the health of cognitively impaired patients with chronic medical conditions.

Public Health Relevance

Evidence suggests that cognitively impaired older patients have poor health outcomes including reduced quality of life, repeat hospitalizations, and increased mortality, yet the pathways by which this occurs are not well understood. Understanding the role cognitive impairment plays in patient self-care has significant implications for the design of self-care interventions and for improving the care of older adults with chronic medical conditions. Relevance Evidence suggests that cognitively impaired older patients have poor health outcomes including reduced quality of life, repeat hospitalizations, and increased mortality, yet the pathways by which this occurs are not well understood. Understanding the role cognitive impairment plays in patient self-care has significant implications for the design of self-care interventions and for improving the care of older adults with chronic medical conditions.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01AG033643-05
Application #
8723015
Study Section
National Institute on Aging Initial Review Group (NIA)
Program Officer
Zieman, Susan
Project Start
2010-09-01
Project End
2015-05-31
Budget Start
2014-06-15
Budget End
2015-05-31
Support Year
5
Fiscal Year
2014
Total Cost
$126,342
Indirect Cost
$9,361
Name
University of Massachusetts Medical School Worcester
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
603847393
City
Worcester
State
MA
Country
United States
Zip Code
01655
Saczynski, Jane S; Kosar, Cyrus M; Xu, Guoquan et al. (2014) A tale of two methods: chart and interview methods for identifying delirium. J Am Geriatr Soc 62:518-24
Chen, Cheryl Chia-Hui; Chen, Chiung-Nien; Lai, I-Rue et al. (2014) Effects of a modified Hospital Elder Life Program on frailty in individuals undergoing major elective abdominal surgery. J Am Geriatr Soc 62:261-8
Spencer, Frederick A; Gurwitz, Jerry H; Schulman, Sam et al. (2014) Venous thromboembolism in older adults: A community-based study. Am J Med 127:530-7.e3
Inouye, Sharon K; Westendorp, Rudi G J; Saczynski, Jane S (2014) Delirium in elderly people. Lancet 383:911-22
Inouye, Sharon K; Kosar, Cyrus M; Tommet, Douglas et al. (2014) The CAM-S: development and validation of a new scoring system for delirium severity in 2 cohorts. Ann Intern Med 160:526-33
Hajduk, Alexandra M; Kiefe, Catarina I; Person, Sharina D et al. (2013) Cognitive change in heart failure: a systematic review. Circ Cardiovasc Qual Outcomes 6:451-60
Saczynski, Jane S; McManus, David D; Goldberg, Robert J (2013) Commonly used data-collection approaches in clinical research. Am J Med 126:946-50
Gurwitz, Jerry H; Magid, David J; Smith, David H et al. (2013) Contemporary prevalence and correlates of incident heart failure with preserved ejection fraction. Am J Med 126:393-400
Darling, Chad; Saczynski, Jane S; McManus, David D et al. (2013) Delayed hospital presentation in acute decompensated heart failure: clinical and patient reported factors. Heart Lung 42:281-6
McManus, David D; Hsu, Grace; Sung, Sue Hee et al. (2013) Atrial fibrillation and outcomes in heart failure with preserved versus reduced left ventricular ejection fraction. J Am Heart Assoc 2:e005694

Showing the most recent 10 out of 20 publications