EXPLAINING DISPARITIES IN COGNITIVE FUNCTION IN SENIORS

解释老年人认知功能的差异

• 批准号: 6372563
• 负责人: BRIAN Seth SCHWARTZ
• 金额: $ 60.27万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6372563
• 关键词: African American; aging; apolipoprotein E; behavioral /social science research tag; blood pressure; caucasian American; clinical research; cognition disorders; disease /disorder proneness /risk; gastrointestinal absorption /transport; gene environment interaction; genotype; human middle age (35-64); human old age (65+); human subject; lead poisoning; longitudinal human study; neurotoxins; porphobilinogen synthase; racial /ethnic difference; social behavior; socioeconomics; sodium potassium exchanging ATPase; urban area; vitamin D receptors

DESCRIPTION (Taken from the Investigator's Abstract) Cognitive function (CF) is central to daily functioning and quality of life. The life course trajectory in CF is known to vary by race/ethnicity and socioeconomic status (SES), and this variation involves a complex causal web. Unpacking this causal web has important political, social, and public health implications, and provides a foundation for prevention and for ensuring social equity. However, we have only a rudimentary understanding of the factors that mediate these disparities in CF. The causal web is complex and involves such diverse and possibly interrelated domains as genetic, social, behavioral, environmental, contextual factors, and individual vascular health. The direct and indirect contributions of these diverse factors must be considered in trying to explain variation by race/ethnicity and SES, moving beyond the traditional but somewhat limiting exploration of "gene-environment interactions" by more broadly defining the underpinnings of these disparities. Ubiquitous potential causes of a decline in CF in older adults include lead exposure, apolipoprotein E (ApoE) genotype, vascular risk factors (i.e., blood pressure), and health-compromising behaviors (e.g., inactivity and smoking). Importantly, a number of genes known to differ by race/ethnicity appear to influence the toxicokinetics or toxicity of lead, including those for the 8-aminolevulinic dehydratase (ALAD), vitamin D receptor (VDR), Na/K ATPase (NKATP), and ApoE genes. Disparities in CF must be examined using next-generation data and methods that allow the modeling of the causal structure of these multiple domains, and to see how and to what extent social, behavioral, and contextual factors are important mediators and moderators along an extended causal pathway. Only by testing this more complete model, will it be possible to fully explicate the complex multilevel associations that pattern everyday life. The goal of this research is to understand the direct and indirect influences of lead absorption, four specific genes, individual social and behavioral factors, contextual factors, and blood pressure in accounting for the associations of race/ethnicity and SES with CF and cognitive decline. The investigators propose a five-year prospective study of 900 urban residents, aged 50 to 70 years, randomly selected from specific geographic areas with variation in race/ethnicity and SES. All study subjects will have three visits at 16-month intervals, with measurement of cognitive function, blood pressure, tibial lead, patellar lead, individual social and behavioral factors, current and past contextual factors, and ALAD, VDR, NKATP, and ApoE genotypes.

描述（取自研究者的摘要） 认知功能（CF）对于日常运作和生活质量至关重要。 众所周知，CF的生活轨迹因种族/种族而异 社会经济地位（SES），这种变化涉及一个复杂的因果网络。 解开该因果网络具有重要的政治，社会和公共卫生 含义，并为预防和确保社会奠定了基础 公平。 但是，我们对因素有基本的理解 调解CF中的这些差异。 因果网络很复杂，涉及这样的 多样化并可能相互关联的领域是遗传，社会，行为， 环境，情境因素和个体血管健康。 直接 必须考虑这些不同因素的间接贡献 试图解释种族/种族和SES的变化，超越 传统但有些限制了“基因环境” 相互作用”通过更广泛地定义这些差异的基础。 老年人CF下降的无处不行的潜在原因包括铅 暴露，载脂蛋白E（APOE）基因型，血管危险因素（即血液 压力）和卫生促进行为（例如，不活动和吸烟）。 重要的是，许多因种族/种族与种族/种族不同的基因似乎 影响铅或铅的毒性或毒性，包括 8-氨基乙烯脱氢酶（ALAD），维生素D受体（VDR），Na/K ATPase （NKATP）和APOE基因。 CF的差异必须使用 下一代数据和允许因果建模的方法 这些多个领域的结构，并查看如何以及在何种程度的社会 行为和上下文因素是重要的调解人和主持人 沿着延长的因果途径。 仅通过测试这个更完整的模型， 是否有可能充分说明复杂的多级关联 那种日常生活。 这项研究的目的是了解 铅吸收的直接和间接影响，四个特定基因， 个人社会和行为因素，背景因素和血液 在计算种族/民族与SES与CF的关联方面的压力 和认知能力下降。 调查人员提出了五年的预期 研究900名城市居民，年龄50至70岁，随机选择 特定的地理区域，种族/种族和SES的变化。 所有研究 受试者将以16个月的间隔进行三次访问，并测量 认知功能，血压，胫骨铅，pa骨铅，个体 社会和行为因素，当前和过去的上下文因素以及阿拉德， VDR，NKATP和APOE基因型。