2003 — 2004 |
Gunstad, John J |
F32Activity Code Description: To provide postdoctoral research training to individuals to broaden their scientific background and extend their potential for research in specified health-related areas. |
Health and Perceived Cognition in Post-Cabg Patients
DESCRIPTION (provided by applicant): Coronary artery bypass grafting (CABG) is one of the most common surgical procedures in the United States, with nearly 600,00 performed annually. CABG patients often report cognitive decline post-operatively, with changes in memory, attention, and problem-solving being among the most frequent complaints. However, many CABG patients reporting cognitive problems do not exhibit cognitive decline or impairment on testing, suggesting other factors underline these complaints. One likely contributing factor is health status. Through CABG patients report benefit from surgery, they frequently experience pain, sleep disturbance, fatigue, and appetite loss post-operatively. Similar reports of poor health are associated with cognitive complaints in able elderly and non-cardiac surgical patients. No study has examined the possibility that health perception is associated with subjective cognitive complaints in CABG patients. Using a 2-group, Pretest-Posttest Control Group design, the proposed study aims to 1) confirm the increase in cognitive complaints post-CABG; and 2) determine the contribution of health status to cognitive complaints after controlling for the effects of neurocognitive performance, anxiety, and depression. A better understanding of the factors contributing to subjective cognitive complaints may lead to improved patient care and reduced health care costs.
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0.91 |
2006 — 2009 |
Gunstad, John J |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Cognitive Effects of Bariatric Surgery @ Kent State University At Kent
[unreadable] DESCRIPTION (provided by applicant): [unreadable] This proposal is submitted in response to RFA DK-03-022 "Ancillary Studies to Obesity-Related Clinical Trials." We are making application to prospectively examine the cognitive effects of bariatric surgery in participants from the Longitudinal Assessment of Bariatric Surgery (LABS) project. There is growing evidence that obesity is associated with adverse neurocognitive outcome. Recent studies demonstrate that elevated body mass index (BMI) is an independent risk factor for Alzheimer's disease, structural brain abnormalities, and cognitive dysfunction in older adults. Preliminary work from our lab extends these findings and shows structural brain differences and cognitive dysfunction also exist in obese young and middle-aged adults. Bariatric surgery is increasingly viewed as an effective intervention for morbid obesity, though its effects on cognition are unknown. Post-operative nutritional deficiencies are common and can adversely impact cognitive performance. However, substantial weight loss resolves or improves many medical conditions with reversible cognitive effects, suggesting bariatric surgery may provide cognitive benefits. No study to date has examined the cognitive effects of bariatric surgery. To do so, the proposed study will prospectively assess cognitive performance in 125 bariatric surgery patients enrolled in the LABS project and 125 matched controls. Bariatric surgery patients will complete a computerized cognitive test battery at four time points: pre-operatively, 12 weeks post-operatively, 12 months post-operatively, and 24 months post-operatively. Matched control participants will complete the test battery at similar intervals. Demographic, medical, and psychosocial information will be collected to elucidate possible mechanisms of change. We hypothesize that the substantial weight loss following bariatric surgery will be associated with improved cognitive performance. Findings from the proposed study will provide important information regarding: 1) the cognitive effects of bariatric surgery; 2) possible mechanisms for these effects; and 3) the contribution of cognitive performance to short- and long-term outcome of bariatric surgery. Determining these effects may impart key insight into the neurocognitive consequences of obesity and identify the most effective treatment options. [unreadable] [unreadable] [unreadable]
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0.97 |
2008 — 2012 |
Gunstad, John J |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Cognitive Benefits of Cardiac Rehabilitation in Heart Failure @ Kent State University At Kent
[unreadable] DESCRIPTION (provided by applicant): This application is submitted in response to PAR-07-046 Research on Mind-Body Interactions and Health. We are making application to prospectively examine the cognitive effects of cardiac rehabilitation (CR) in patients with heart failure (HF). Despite advances in treatment, more than 5 million Americans have HF and 500,000 more develop HF each year. Neurocognitive deficits are found in up to 80 percent of HF patients and these deficits are independent predictors of disability and mortality. This risk has been attributed to difficulty adhering to the prescribed medical regimen, which exacerbates HF symptoms. There is reason to believe that participation in CR may improve cognitive function in HF patients. CR provides many benefits to HF patients, including decreased severity of cardiac symptoms, improved functional abilities, and better quality of life. Preliminary work from our lab and others indicates that CR also improves cerebral blood flow and autonomic nervous system (ANS) function, factors that are associated with cognitive function in HF patients. Little is known about the possible cognitive benefits of CR in HF patients. The proposed study will examined cognitive function in 100 HF patients that participate in CR and 100 demographically- and medically-similar HF patients that do not. HF patients will undergo primary assessment at enrollment, 12 week completion of CR, and 12 month follow-up. Primary assessments will include measures of cardiac performance, ANS function, cerebral blood flow, physical function/activity, and cognitive function. Remote assessment of physical activity will also be completed at 6 and 9 month follow-up. Control participants will complete assessments at identical intervals. Finally, a subset of participants (70 in each group) will undergo magnetic resonance imaging at the primary assessments to determine the contribution of structural brain changes to cognitive function. Findings from the proposed study will provide important information regarding: 1) the possible cognitive benefits of CR; 2) mechanisms for these benefits; and 3) the relationship between cognitive function and treatment adherence and psychosocial outcomes. Public Health Relevance: Cognitive dysfunction is found in up to 80 percent of heart failure patients and is an independent predictor of disability and mortality. The proposed project will clarify the etiology and reversibility of cognitive dysfunction in persons with heart failure. [unreadable] [unreadable] [unreadable]
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0.97 |
2010 |
Gunstad, John J |
R56Activity Code Description: To provide limited interim research support based on the merit of a pending R01 application while applicant gathers additional data to revise a new or competing renewal application. This grant will underwrite highly meritorious applications that if given the opportunity to revise their application could meet IC recommended standards and would be missed opportunities if not funded. Interim funded ends when the applicant succeeds in obtaining an R01 or other competing award built on the R56 grant. These awards are not renewable. |
Extended Effects of Bariatric Surgery On Cognitive Function @ Kent State University At Kent
DESCRIPTION (provided by applicant): This application is submitted in response to PAR-07-024 (Ancilla Studies to Major Ongoing NIDDK and NHLBI Clinical Research Studies). We are making application to continue our currently-funded project (R01DK075119O) and examine the extended cognitive effects of bariatric surgery in participants from the Longitudinal Assessment of Bariatric Surgery(:LABS) project. There is growing evidence that obesity is associated with adverse neurocognitive outcome. Recent studies demonstrate that elevated body mass index (BMI) is an independent risk factor for Alzheimer's disease, structural brain abnormalities, and cognitive dysfunction. Bariatric surgery is viewed as an effective intervention for morbid obesity, though its effects on cognition are largely unknown. Data from our currently-funded project indicate that uncomplicated bariatric surgery does not adversely impact cognitive function. Even more interesting, findings suggest that bariatric surgery actually improves cognitive function at short (12-weeks) in intermediate (12- and 24-months) follow-up, including gains in memory and executive function. No study has examined the cognitive effects of bariatric surgery at extended follow-up. Doing so will determine whether: 1) bariatric surgery protects against the accelerated cognitive decline found in obese individuals;and 2) cognitive function predicts weight re-gain in surgery patients. To examine this possibility, the proposed study will follow the 125 bariatric surgery patients and 75 obese matched controls enrolled in the currently-funded project. Bariatric surgery patients would complete assessments identical to the current project at 36-, 48-, and 60-months post-operatively and obese matched controls would do so at equivalent intervals. Each assessment quantifies cognitive function and factors known to contribution to cognitive function in morbid obesity, including, demographic characteristics, medical conditions, physical activity, and psychological symptoms. These methods would provide the first evidence for: 1) Proactive cognitive effects of bariatric surgery at extended follow up;2) Mechanism for these effects;and 3) Contribution of cognitive function to weight re-gain. PUBLIC HEALTH RELEVANCE: Obesity is independently associated with adverse neurocognitive outcome, including elevated risk for Alzheimer's disease and cognitive decline. Our data indicate that bariatric surgery improves cognitive function at short-term follow- up. The proposed study will determine whether bariatric surgery helps to protect against cognitive decline and whether cognitive function predicts weight re-gain.
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0.97 |
2020 — 2021 |
Brickman, Adam M (co-PI) [⬀] Brickman, Adam M (co-PI) [⬀] Gunstad, John J. |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Spontaneous Speech and Health Disparities in Risk of Cognitive Decline: Whicap Offspring Ancillary Study
Project Summary/Abstract The proposed ancillary study looks to better understand racial/ethnic disparities in Alzheimer's disease (AD) by investigating spontaneous speech as part of the Washington Heights/Inwood Columbia Aging Project (WHICAP) Offspring Study. Limitations of existing cognitive screening instruments is a known contributor to racial/ethnic disparities in AD and recent work suggests that speech analysis may be a sensitive marker of cognitive decline and future AD. New technological advances raise the possibility that automated speech analysis could be conducted using smartphones in community settings, creating an inexpensive and scalable approach to early detection. However, many challenges remain in developing this method, including a very limited understanding of the biological underpinnings of spontaneous speech in at-risk individuals (e.g., hippocampal volume, amyloid deposition, contribution of executive function vs. language). We propose to examine spontaneous speech as part of the ongoing WHICAP Offspring Study (RF1AG054070, RF1AG058067). This large project is enrolling a diverse cohort (>70% minorities) of pre-clinical participants with varying degrees of risk for AD using medical, genetic, and neuropsychological testing (N = 3000), structural MRI (N = 1000), and amyloid and tau PET imaging (N = 150 for each). Both English and Spanish speakers are included. One measure of spontaneous speech has been included since study onset and a second brief measure would be added. We hypothesize that spontaneous speech will reflect a combination of both biological and sociocultural risk factors to AD and that bilingualism will show protective effects. By leveraging the rich data collection of the WHICAP Offspring Study, this application would generate substantial new insight into the basic underpinnings of spontaneous speech in diverse pre-clinical samples, as well as determine the feasibility of using speech analysis as a novel biomarker of AD risk. Additionally, should the cohort be followed longitudinally, the ability of spontaneous speech to predict future incidence of AD in racially/ethnically diverse samples over time could also be evaluated.
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0.97 |