This is an application to renew a K24 Mid-Career Investigator Award in aging-related patient-oriented research. The Awardee is a professor of psychiatry, neurology, and epidemiology with an established track record as a researcher, clinician, and educator. The Awardee's current research focus is on mild cognitive impairment (MCI), a variably defined condition generally regarded as a prodromal and/or risk state for Alzheimer's and other dementias. Her group's epidemiological work , like those of other population-based studies in North America and Europe, has demonstrated that current """"""""diagnostic"""""""" criteria for MCI do not reflect the real-world distribution and outcomes in the typical community or primary care clinical setting, where the majority of older adults are served. In the community at large, MCI is a unstable and heterogeneous entity, particularly in individuals with significant comorbidity. For the concept to be clinically useful, it must have better predictive value for different outcomes. Broadly, the Research Plan aims to refine the current MCI criteria based on predictive validity for dementia, using data from a new, ongoing, representative cohort study that was begun during the current K24 award period. A specific additional proposed activity is to expand the focus on vascular risk factors which are hypothesized to improve prediction of MCI outcomes. Health history and neurological exam, blood pressure, total and HDL cholesterol, and APOE genotype are already being measured on all participants. The proposed new research will obtain measurements on additional peripheral vascular markers (glycosylated hemoglobin, Apo A1, ApoB, homocysteine, C-Reactive Protein, and cystatin) from subgroups of participants with normal cognition and with subtypes of MCI. The renewed K24 will also permit the development of an application for a brain structural MRI project to determine the extent to which global and regional atrophy as well as evidence of cerebrovascular disease improve the predictive value of the clinical data, in a sample of the representative community cohort. The Mentoring Plan remains targeted towards early career investigators in clinical and epidemiological research into cognitive aging and mild cognitive impairment. As appropriate to their backgrounds and goals, trainees will enhance their experience of patient-oriented research;participate in multidisciplinary consensus diagnosis;obtain supervised experience of analyzing, interpreting, and reporting data from the Awardee's ongoing and completed community studies;participate in group interactions around individual research projects;and take advantage of additional educational opportunities available at the institution. Trainees'productivity will be monitored with regard to development of research proposals and publications and maturation as independent investigators. The Awardee will also continue to organize trainee workshops in neglected areas such as project management, principles of neuropsvcholoav for non-psvcholoaists. and scientific writing skills.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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National Institute on Aging Initial Review Group (NIA)
Program Officer
Anderson, Dallas
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University of Pittsburgh
Schools of Medicine
United States
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Snitz, Beth E; Wang, Tianxiu; Cloonan, Yona Keich et al. (2018) Risk of progression from subjective cognitive decline to mild cognitive impairment: The role of study setting. Alzheimers Dement 14:734-742
Ganguli, Mary (2017) The times they are a-changin': cohort effects in aging, cognition, and dementia. Int Psychogeriatr 29:353-355
Graziane, Julie A; Beer, Joanne C; Snitz, Beth E et al. (2016) Dual Trajectories of Depression and Cognition: A Longitudinal Population-Based Study. Am J Geriatr Psychiatry 24:364-73
Ganguli, Mary; Fu, Bo; Snitz, Beth E et al. (2014) Vascular risk factors and cognitive decline in a population sample. Alzheimer Dis Assoc Disord 28:9-15
Andreescu, Carmen; Teverovsky, Esther; Fu, Bo et al. (2014) Old worries and new anxieties: behavioral symptoms and mild cognitive impairment in a population study. Am J Geriatr Psychiatry 22:274-84
Ganguli, Mary (2014) The unbearable lightness of MCI. Int Psychogeriatr 26:353-9
Metti, Andrea L; Yaffe, Kristine; Boudreau, Robert M et al. (2014) Change in inflammatory markers and cognitive status in the oldest-old women from the Study of Osteoporotic Fractures. J Am Geriatr Soc 62:662-6
Ganguli, Mary (2013) Can the DSM-5 framework enhance the diagnosis of MCI? Neurology 81:2045-50
Karp, Jordan F; Lee, Ching-Wen; McGovern, Jonathan et al. (2013) Clinical and demographic covariates of chronic opioid and non-opioid analgesic use in rural-dwelling older adults: the MoVIES project. Int Psychogeriatr 25:1801-10
Ganguli, Mary; Fu, Bo; Snitz, Beth E et al. (2013) Mild cognitive impairment: incidence and vascular risk factors in a population-based cohort. Neurology 80:2112-20

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