Clinical Research Directory

Evaluation of the Efficiency of the PRPP (Perceive, Recall, Plan and Perform) Task Analysis System on Support and Orientation Decisions for People With Aging Psychiatric Disorders (PATPV) Living in Independent Housing.

Over the past 30 years, mental health policy has been geared towards increasing the number of people receiving care in the community, with a reduction of over 50% in the number of general psychiatric beds. The WHO recommends the implementation of alternatives to hospitalization, through the development of outpatient and home-based psychiatric care programs that support independent living. People suffering from psychiatric disorders show cognitive decline as they age, including deficits in perception, attention, memory and problem-solving. These cognitive problems affect the ability to carry out the tasks of daily life, and make it more difficult to remain at home. In order to avoid hospitalization for these psychiatrically-stabilized patients who are losing their autonomy, it is necessary to take into account their mental and cognitive handicap, and to provide them with appropriate compensation. Occupational therapy is a discipline concerned with the assessment, rehabilitation and integration of people with disabilities. Occupational therapists provide ecological assessments to support personalized care plans. The PRPP (Perceive, Recall, Plan and Perform) task analysis system is a validated, ecological tool that integrates an occupational therapy assessment and intervention model. The PRPP assessment measures occupational performance and the impact of cognitive impairments on information processing and on the cognitive strategies required to carry out activities. Research conducted in Canada illustrates the value of PRPP in supporting people with schizophrenia. To the best of our knowledge, no team has studied the use of PRPP in the decision-making process for maintaining people with aging psychiatric disorders (PATPV) at home.

Carbon Dioxide Administration and Brain Waste Clearance

The current study tests whether different exposures to carbon dioxide (CO2) can safely result in the increased movement of proteins from the brain into the blood. The investigators believe that this would be a proxy for the brain clearing waste products more effectively. The current study will use a counter-balanced design, in which individuals with and without a history of traumatic brain injury (TBI) will receive different levels of CO2 (targeted changes of approximately 5 or 10 mmHG in end-tidal CO2) approximately one week apart. The counter-balanced design means that each participant receives a single dose of CO2 at each visit, and different doses of CO2 at each visit. The order in which participants receive the dose is randomized, and the participant will not be informed of the dose.

Aging of the Vascular Wall

Demographic aging is predicted to be one of the most significant social changes of the 21st century. Aging is a slow, multifactorial process that progressively impacts the integrity of cells, tissues, and organs. This decline in function increases the risk of numerous diseases, including cancer, neurodegenerative disorders, and cardiovascular diseases (CVD). CVD, the leading global cause of death, becomes more prevalent with age. Aging contributes to endothelial dysfunction, vessel stiffness, thickening, and impaired platelet function. These changes disrupt hemostatic processes and increase the risk of cardiovascular complications. Despite preventive strategies CVD remain a major public health challenge. Cellular aging, or senescence, affects all cell types, particularly endothelial cells and platelets. However, little research has compared the aging rates of different blood vessel types, such as arteries and veins. Given their distinct compositions and developmental origins, it is likely that their aging processes differ at molecular, cellular, and physiological levels.

Prevalence, Determinants and Natural History of Frailty and Pre-frailty in Elderly People

Frailty syndrome (i.e. frailty) is a geriatric syndrome which relies on the reduction of multisystem reserve capacity. Frail people have a lower potential to respond to external stressors and various life incidents as well as they present a weak prognosis particularly in cardiovascular diseases. Yet, frailty is not only a set of physical deficits, but it also concerns psychological and social dimensions of human functioning. Hence, an approach to frailty should be multidimensional because such a concept more adequately reflects a functional degradation in the elderly. Frailty is usually associated with the impaired condition of circulatory system, and therefore, an identification of subclinical cardiovascular abnormalities is paramount in the frailty prevention and treatment. Another potential mechanism which may predispose to frailty is a dysfunction of the autonomic nervous system. This system plays a crucial role in the response to internal or external stressors such as diseases and activities of daily living. An impairment of the autonomic nervous system function may maintain or accelerate the frailty process. In this scientific project, a comprehensive echocardiography will investigate cardiac function with a particular attention to features which typically change with age, like flow parameters and chambers sizes. The activity of the autonomic nervous system will be explored with the analysis of heart rate, blood pressure and respiratory signals. The study participants will also undergo routine medical examination and a number of additional tests, including: assessment of cognitive function, psychological condition, nutrition status, activities of daily living, and risk of falls. The study group will comprise community dwelling elderly individuals over the age of 65 years who get around by themselves. After 2 years, the participants will be re-examined for their frailty and independence status, as well as their survival will be checked with the National Health Found electronic system. The aim of this project is to seek for factors determining frailty and to explore the frailty impact on the elderly people survival. Particular attention will be paid to the multidimensional frailty which is a new concept of the functional decline in the elderly. In addition, the prevalence of different modes of frailty in Polish community will be investigated. The results of this research should help to establish preventative and therapeutic strategies against frailty.

DC Longitudinal Study on Aging and Specimen Bank

The Georgetown University Memory Disorders Program, part of the Department of Neurology, is conducting pilot studies of the feasibility of various diagnostic tests for Alzheimer's disease, mild cognitive impairment and other neurodegenerative diseases. Further, this study is assessing longitudinal changes in biological, lifestyle, and cognitive assessment collection. The primary goal of this study is to examine the feasibility of biochemical assays, genetic testing, and cognitive and lifestyle assessments in the ante-mortem diagnosis of Alzheimer's disease, mild cognitive impairment and other neurodegenerative diseases. This research involves genetic and cognitive status testing but the findings will not be shared with research subjects. This will be accomplished ex vivo using blood, and/or cerebrospinal fluid (CSF) specimens from patients with a diagnosis of probable Alzheimer's disease, mild cognitive impairment, or other neurodegenerative diseases and from normal controls.