Gender Disparities in Pain and Treatment and their Association with Alzheimer's Disease and Related Dementias (ADRD)

University Of Texas Med Br Galveston, Galveston TX

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Abstract

PROJECT SUMMARY/ABSTRACT I am an Assistant Professor in the Department of Internal Medicine, Division of Geriatrics and Palliative Medicine, at the University of Texas Medical Branch. My long term-career goal is to become an independent researcher who identifies drivers and consequences of gender disparities in health among older adults with Alzheimer’s disease and related dementias (ADRD), blending life course social and health constructs with clinical details from medical claims. To accomplish this goal, I will complete the following four training objectives that build upon my prior training in the epidemiology of aging: (1) Understand the complex processes that impact pain and ADRD among older adults; (2) Learn context of sex/gender and techniques to analyze results by sex and gender, with a focus on sex and gender differences in pain and ADRD; (3) Develop statistical skills for analyzing Medicare claims data linked to survey data; and (4) Increase competencies required to function effectively as an independent extramurally-funded investigator, by developing mentoring and leadership skills and enhancing manuscript and, grant applications, and leadership skills. Training in these areas will include coursework, shadowing interdisciplinary teams in clinical settings, and experiences accessing, managing, and analyzing Medicare files. My training activities have been integrated with a research project in which I will use data from the Health and Retirement Study, a nationally representative longitudinal study of older adults in the US, linked to Medicare claims (2006-2018) to complete the following specific aims: (A) Evaluate gender differences in the underdiagnosis of pain by comparing self-reports of pain from survey data to the diagnosis of chronic pain from claims data in older adults, by ADRD status; (B) Examine gender disparities in the treatment of chronic pain among older adults with pain, by ADRD status; and (C) Assess gender disparities in the association of chronic pain and pain treatment with incident ADRD. The expected findings of this research will provide evidence for pain and pain treatment as a modifiable risk factor for ADRD and inform potential pain treatment interventions aimed at reducing the treatment gap between men and women and ultimately reducing the gender disparity in ADRD burden. Completion of the K01 mentored training and research plans will provide me with the knowledge, skills, and expertise required to understand disparities among older adults with ADRD, in order to develop a program of research that blends life course social and health constructs with clinical data, with the goal of reducing gender disparities among older adults with pain and ADRD.