Community-based approach to Early Identification of transitions to Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD) in African Americans

基于社区的方法早期识别非裔美国人向轻度认知障碍 (MCI) 和阿尔茨海默病 (AD) 的转变

• 批准号: 10372939
• 负责人: VOYKO KAVCIC
• 金额: $ 65.89万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10372939
• 关键词: African American; African American population; Age; Age-associated memory impairment; Aging; Alzheimer' s Disease; Alzheimer' s Disease Core Center; Alzheimer' s disease risk; Area; Behavioral; Binding; Blood Pressure; Brain; Caring; Cholesterol; Clinical; Cognition; Cognitive; Communities; Computers; Consensus; Data; Dementia; Detection; Development; Diagnosis; Diagnostic; Diagnostic Procedure; Disease; Early Diagnosis; Early identification; Economics; Elderly; Electroencephalography; Electrophysiology (science); Enrollment; Event-Related Potentials; Family; Funding; General Population; Genes; Gerontology; Glycosylated hemoglobin A; Impaired cognition; Institutes; Intervention; Longevity; Longitudinal Studies; Measures; Memory; Methodology; Methods; Michigan; Minority Groups; Modification; Monitor; Nerve Degeneration; Neurobiology; Participant; Patients; Persons; Pharmacologic Substance; Pharmacology; Population; Populations at Risk; Procedures; Process; Research; Risk; Site; Techniques; Technology; Testing; Time; Underserved Population; United States National Institutes of Health; Universities; base; behavioral pharmacology; caucasian American; cognitive change; cognitive function; cognitive performance; cognitive rehabilitation; cognitive testing; cohort; community based evaluation; community setting; comorbidity; computerized; cost; dementia risk; diagnostic accuracy; experimental study; health disparity; human old age (65+); improved; indexing; individual patient; metropolitan; mild cognitive impairment; novel; novel marker; novel strategies; novel therapeutic intervention; outreach; portability; recruit; risk prediction; screening; secondary analysis; social; socioeconomics; stem; symposium

With the rapid increase in longevity and considerable expansion of the share of elderly in the population, it is becoming ever important to understand the mechanisms underlying age-related cognitive declines in order to guide environmental and clinical interventions for older adults and for more accurate prediction of risk for dementia [e.g., Alzheimer’s disease (AD)]. A crucial challenge of aging research is improving understanding of the neurobiological basis of conditions leading to dementia, in order to refine the diagnostic procedures and to target new behavioral and pharmacological interventions. A main avenue for the neurobiological understanding of very early risk processes leading to dementia would be the screening of large populations at risk by means of quick, low-cost, and widely available procedures. The present proposal will test to what extent computerized cognitive tests and portable electroencephalography (EEG) can be used to easily, accurately and efficiently evaluate early cognitive decline in elderly at risk for developing AD. Health disparities represent a critical roadblock mitigating the social and fiscal benefits of early identification and care, not only to the individual patient and family, but also at the state and federal levels. Community-dwelling, African-American elders show faster rates of cognitive decline and are almost twice as likely to develop mild cognitive impairment (MCI) and AD as are older, white Americans. However, they are less likely to be diagnosed or receive treatment in the early stages of these disorders. Development of economically viable and culturally acceptable methods of early detection is critical in minority populations. We propose to identify the first signs of dementia in at risk African Americans with subjective memory complaints (SMC) in their communities within the Detroit metro area by using computerized cognitive tests CogState and NIH Toolbox and a portable EEG. We plan to combine cross-sectional with longitudinal studies: within the first two years, we will cognitively evaluate a total of 500 at risk African Americans with SMC. From these participants we will select 200 who at entry to the longitudinal study will not be diagnosed with either dementia or MCI but will, however, undergo repeated cognitive and EEG testing every 6 months over a 3 year period. We will compare these approaches of repeated cognitive and EEG/ Event-Related Potentials (ERP) testing in terms of their sensitivity of identifying persons already at risk who will progress to MCI and/or AD. Our proposed community based evaluation that combines behavioral and EEG/ERP methods will be used to generate profiles of at risk healthy elderly African-Americans, who may within a short period of time develop MCI or AD. We expect that with the combination of behavioral and EEG/ERP methods, we will be able to develop objective markers, which will reliably identify early signs of cognitive decline. Such markers will be used for identification of significant cognitive decline, and to evaluate efficiency of new pharmacological approaches, which will lead to the development of new therapeutic interventions and disease modification.

随着寿命的迅速增加和较早在人口中份额的大量扩大，它 了解与年龄相关的认知下降的基础机制变得越来越重要 指导老年人的环境和临床干预措施，并更准确地预测风险 痴呆[例如，阿尔茨海默氏病（AD）]。衰老研究的关键挑战是改善对 导致痴呆症的疾病的神经生物学基础，以完善诊断程序和 针对新的行为和药物干预措施。神经生物学理解的主要途径 导致痴呆症的早期风险过程中，将筛查有风险的大量人群 快速，低成本和广泛可用的程序。本提案将在何种程度上测试计算机 认知测试和便携式脑电图（EEG）可用于轻松，准确，高效 评估开发AD风险的基础风险的早期认知能力下降。 健康差异代表了减轻早期社会和财政利益的关键障碍 识别和关怀，不仅是对个体患者和家人，而且对州和联邦一级。 非裔美国人长者的社区居民表现出更快的认知能力下降速度，几乎是 与年龄较大的白人美国人一样，可能会发展轻度认知障碍（MCI）和广告。但是，它们是 在这些疾病的早期阶段不太可能被诊断或接受治疗。发展 在经济上可行且在文化上可接受的早期检测方法对于少数群体至关重要。 我们建议确定具有主观记忆的非裔美国人的痴呆症的第一个迹象 通过使用计算机认知测试 Cogstate和NIH工具箱以及便携式脑电图。我们计划将横截面与纵向研究相结合： 在头两年内，我们将认知评估有500名患有SMC的非洲裔美国人的风险。从 这些参与者我们将选择200名参与者，他们进入纵向研究将不会被诊断为 痴呆症或MCI，但是每6个月将每6个月进行一次重复认知和脑电图测试 时期。我们将比较这些重复认知和脑电图/事件相关电位的方法（ERP） 根据他们对已经有风险的人的敏感性进行测试，谁会发展为MCI和/或AD。 我们提出的基于社区的评估将使用行为和脑电图/ERP方法的结合 为了在短时间内开发时可能会产生健康老年非裔美国人的概况 MCI或广告。我们希望，通过行为和脑电图/ERP方法的结合，我们将能够 开发客观标记，这将可靠地确定认知能力下降的早期迹象。这样的标记将是 用于识别明显的认知下降，并评估新药物的效率 方法，这将导致新的治疗干预措施和疾病修饰的发展。