This application is a revised version (A1) of a competing renewal for years 06 through 10 of program project grant POI AG020677 (""""""""Aging Well, Sleeping Efficiently""""""""). Insomnia in older adults is a widely prevalent health condition that is associated with significant distress, functional impairment, increased utilization of healthcare, and high financial costs. Insomnia in older adults is associated with significant distress, functional impairment, increased utilization of healthcare resources, and high financial costs. These will all increase as the baby-boomer generation ages. The relevance of this research on older adults derives from the massive prevalence of insomnia in this population, the age-related changes in physiology and brain morphology that are relevant to sleep-wake processes, and the many co-morbidities that advancing age is often heir to. REVIEW OF INDIVIDUAL COMPONENTS OF THE PROGRAM PROJECT CORE A - ADMINISTRATION;Dr. Timothy Monk, Core Leader (CL) DESCRIPTION (provided by applicant): Core A comprises the administrative core of the program project POI AG020677 """"""""Aging well, sleeping efficiently"""""""" (""""""""AgeWise""""""""). It will provide the intellectual, organizational, and fiscal support essential for the development and maintenance of an effective program of research which seeks to understand the correlates of insomnia and its treatment in older adults. Core A will lead and coordinate the research, review, educational, and information dissemination activities, addressing all of the major management issues (other than data management) related to the four component projects and three cores in the AgeWise program. These are its specific aims: Administrative functions: To ensure the smooth running of the AgeWise program, facilitating the science to be accomplished in the four component projects and in the program as a whole;To provide a forum for the discussion of management issues relating to the three cores and their interaction with the four component projects;To provide resources needed for the provision of timely reports, applications and certifications as required by various local and national entities. This will also involve handling all issues related to the program's Data and Safety Monitoring Board (DSMB) and Data Sharing Plan (DSP);To ensure fiscal responsibility in the AgeWise program, and to provide mechanisms for advertising, participant payments, travel, and the ordering of equipment and supplies. Scientific support functions: To supervise all functions relating to advertising for participants;To promote scientific quality control by facilitating peer-review within the program and also ensuring appropriate consultation with program;To provide weekly Tuesday afternoon meetings of AgeWise faculty at which scientific issues can be discussed;To organize bi-weekly project coordinator meetings (for staff only) to discuss operational issues. To organize an annual scientific review of the AgeWise program using three external consultants meeting for one-and-a-half days towards the end of each of the five grant years. Training and outreach functions: To provide a training opportunity for undergraduates, medical students, fellows and junior faculty;To provide outreach to the community both as a means of disseminating knowledge that would be useful for seniors and as a means of attracting potential participants, with particular attention to minorities. Core A resources will be used to publicize the AgeWise program in the community through media announcements and speaking engagements. In conclusion, Core A will comprise the intellectual and administrative hub of the AgeWise program. Insomnia in older adults is associated with significant distress, functional impairment, increased utilization of healthcare resources, and high financial costs. These will all increase as the baby-boomer generation ages The relevance of this research on older adults derives from the massive prevalence of insomnia in this population, the age-related changes in physiology and brain morphology that are relevant to sleep-wake processes, and the many co-morbidities that advancing age is often heir to.
The aim of the program is to identify novel physiological, electrophysiological, genetic and functional neuroanatomical correlates of insomnia in older adults. All projects will use treatment with Cognitive Behavioral Treatment of Insomnia (CBTI), as an """"""""intervention challenge"""""""" to determine how changes in insomnia symptoms affect these correlates of insomnia. The program has four inter-related projects and three cores examining a group of 120 Older Adults with Insomnia (OAI) all receiving CBTI, as well as a demographically balanced group of 100 good sleepers (GS). All participants will be 60y+;both genders will be studied. Projects 1-3 will each examine a subset of the participants. Advertising for participant recruitment will be provided by Core A {Administration - Monk). All participants will be recruited, telephone pre-screened, consented for screening and screened using Core B (Clinical core - Buysse/Germain) resources, and then assigned to one of three different projects using procedures provided by Core C {Data Management and Statistics - Mazumdar/Hall). All participants will contribute to Project 4 {Genetics - NimgaonlPublic Health Relevance
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