Current Grants

Altered Pain Responsiveness in People with Alzheimer’s Disease and Cancer

NIH/NIA (R01 AG061325-01)

07/01/2019 – 06/30/2024

PI: Monroe MPI: Cowan

This project examines the impact of stage 4 breast and prostate cancer on psychophysical measures of pain sensitivity and unpleasantness in Alzheimer’s disease (AD). A considerable number of older adults will suffer from cancer and co-occurring AD placing them at great risk of suffering under treated cancer pain. Understanding the impact of cancer and AD on pain perception will provide key insights into cancer pain in AD. Unfortunately, the consequences of untreated cancer pain can be devastating. More than 50% of hospitalized patients with cancer described their pain as ‘distressing, horrible, or excruciating’. It remains unknown how cancer and Alzheimer’s disease alter pain processing. Altered pain processing may further increase the risk for reduced detection of pain upon injury, increase the risk for under treatment of metastatic cancer pain, and may predispose to increased suffering. If our results determine that cancer and co-occurring Alzheimer’s disease place these individuals at risk of increased suffering, targeted analgesic drug development strategies, and/or tailored interventions to maximize pain treatment can then be designed for this highly vulnerable and under studied population.

Sex Differences in Pain Reports and Brain Activation in Older Adults with Alzheimer’s Disease

NIH/NIA (R01 AG059861)

09/15/2018 – 09/30/2023

PI: Monroe

Poorly treated pain in older adults with Alzheimer’s disease (AD) is a critical public health problem and understanding sex and AD-related differences in pain function is an NIA priority area. When compared to healthy adults, and in the presence of similarly known painful conditions, older adults with AD receive less pain medication. The reasons for this discrepancy are poorly understood. Inadequately treated pain negatively impacts quality of life and increases health care costs. It is well documented that cognitively healthy males and females experience and report acute and chronic pain differently, however, it is unknown if these differences extend into the population of older adults with AD. Determining the biological reasons for sex-differences leading to alterations in pain processing is essential for increasing our understanding of pain in older adults with AD. In response to pain, evidence suggests that brain structure and brain function differ by sex and may be altered in AD. However, it is unknown how these structural and functional nervous system alterations differ by sex and how AD impacts psychophysical and neurophysiological responses to pain.

This R01 study will examine how verbal pain reporting patterns in responses to acute experimental thermal pain differs between older males and females with and without AD and how these sex-differences map onto regional and network brain functional changes. Experimental acute thermal pain delivery predicts well the response to painful medical conditions. We propose to examine the psychophysical and neurophysiological response to experimental thermal stimuli between healthy males and females (aged 65 or older) and aged match males and females with AD (aged 65 or older).

Family Caregiver Community Research Study

PI: Moss  Co-I: Dr. Celia Wills

The purpose of phase one of this study is to assess caregiver needs and preferences for advance care planning to develop a culturally-tailored advance care planning caregiver decision support prototype intervention to assist caregivers of lower socioeconomic status African American older adults living with dementia. This research will be conducted with current and former family caregivers, healthcare providers, and community stakeholders. The objective of phase two is to use a participatory design process to assess and develop enhanced approaches to optimize research recruitment and retention strategies for family caregivers of lower socioeconomic status African American older adults living with dementia for advance care planning research.

Differences in Pain Among Blacks and Whites Living with Alzheimer’s Disease: A Diversity Supplement Research and Training Program.

Finding Source: National Institute on Aging Diversity Supplement awarded to the study, Sex Differences in Pain Reports and Brain Activation in Older Adults with Alzheimer’s Disease (R01AG059861)

PI: Monroe  Applicant: Moss

This RO1 study aims to better understand the mechanistic differences in pain psychophysics and neuroimaging findings between Black and White older females living with Alzheimer’s disease.

Pain in Persons with Alzheimer’s Disease and Their Caregivers

PI: Moss Co-I: Monroe

The primary aims of this cross-sectional pilot study are to determine if higher pain in the person with Alzheimer’s disease is associated with higher pain in the caregiver and to determine if higher biologic stress (as measured via hair cortisol levels) is associated with higher pain in the caregiver.