CVD Predictors of Cognitive Function Trajectory over 20 Years

20 年来认知功能轨迹的 CVD 预测因素

基本信息

批准号：
7262849
负责人：
ELIZABETH L BARRETT-CONNOR
金额：
$ 34.65万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-05-15 至 2011-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7262849
关键词：
Address Adrenal hormone preparation Adult Age Apolipoprotein E Biological Markers Blood Pressure Body Size Body Weight Changes Body mass index Cardiovascular Diseases Cardiovascular system Categories Causations Cholesterol Clinic Clinic Visits Clinical Cognitive Cognitive aging Cohort Studies Communities Comorbidity Cox Proportional Hazards Models Cross-Sectional Studies Data Data Set Databases Dementia Depressed mood Diabetes Mellitus Diastolic blood pressure Education Elderly Factor Analysis Fasting Fatty acid glycerol esters Funding Genotype Glucose Goals Health Heart Diseases High Density Lipoprotein Cholesterol Hypertension Impaired cognition Individual Inflammatory Insulin-Like Growth Factor I Interleukin-6 Internet Laboratories Life Life Style Lipids Lipoproteins Literature Longitudinal Studies Low-Density Lipoproteins Maintenance Measures Mediating Medical History Memory Loss Metabolic syndrome Methods Modification Moods Morbidity - disease rate Numbers Osteoporosis Participant Performance Pharmaceutical Preparations Plasma Platelet Factor 4 Population Prevalence Study Prospective Studies Psyche structure Range Recording of previous events Reporting Research Research Personnel Risk Risk Factors Score Sex Education Socioeconomic Status Standards of Weights and Measures Stroke Testing Thick Triglycerides Update Visit Weight Woman aged apolipoprotein E-4 base cardiovascular disorder risk cognitive function cohort coronary artery calcification cysteine rich protein follow-up health related quality of life healthy aging interest intima media men performance tests programs satisfaction steroid hormone

项目摘要

DESCRIPTION (provided by applicant): Cognitive impairment and dementia preclude healthy aging. Several lines of evidence suggest that cardiovascular disease (CVD) and its risk factors (and related biomarkers) accelerate decline in cognitive function, but most studies are cross-sectional or have a < 5 year follow-up. We propose to use >20 years of CVD and cognitive function test (CFT) data from the Rancho Bernardo Study (RBS) of older community-dwelling adults to examine the association of baseline and changing CVD risk factors with change in CFT performance. The RBS was established as a Lipid Research Prevalence Study in 1972, when history of heart disease, diabetes, stroke, and hypertension was obtained, and body mass index, fasting plasma glucose, triglycerides and cholesterol were measured in 82% of adult residents. Beginning in 1984, 60-87% of surviving community-dwelling participants returned to our research clinic every four years, when CVD risk factors were measured, and lifestyle, medication, and medical history were updated. Beginning in 1988, 3 or more standard CFTs were completed at each of six clinic visits about 4 years apart. To date, 1172 men and women have been retested on at least three occasions, and 721 have had four or more CFT visits. We propose a prospective study of the association of CVD risk factors (4 risk factor groups and 3 composite risk factor scores) and clinical and subclinical CVD with successful cognitive aging. We define successful cognitive aging as survival without clinical dementia and maintenance of predefined performance on CFTs (3 standard tests assessing 3 cognitive domains). We will first establish whether favorable CVD risk factors are prospectively related to short term (4 year) maintained cognitive function, followed by longer term (20 year) trajectory studies which will include change in risk factors as well as change in CFTs. We will examine predictors of categorically-defined successful cognitive aging using Cox proportional hazard models. Associations will be examined in the context of education, depressed mood, weight and weight change, Apo E genotype, medications and comorbidities; mechanisms will be studied using measured biomarkers including CRP, IL-6, IGF-1, steroid hormones, and adipocytokines. All analyses will be based on specific a priori hypotheses. Our goal is to define a plausible web of causation for CVD risk factors and biomarkers as exposure variables, with more favorable attributes predicting less or no loss of cognitive function. Longitudinal studies are the strongest method for addressing the strength, independence, temporality, and effect modification of multiple observed associations. The rich RBS dataset, unique for its long-term repeated CVD & CFT measures, will allow us to determine how CVD exposure variables influence different domains of cognitive function. This information is important given the aging of the population, the fact that CVD risk factors are modifiable, and because the maintenance of cognitive function is an essential component of healthy aging.

描述（由申请人提供）：认知障碍和痴呆症排除健康衰老。几条证据表明，心血管疾病（CVD）及其危险因素（以及相关的生物标志物）加速认知功能的下降，但大多数研究是横断面的，或者的随访<5年。我们建议使用> 20年的CVD和认知功能测试（CFT）数据，来自老年社区居民成年人的Rancho Bernardo研究（RBS），以研究基线和CVD风险因素与CFT性能的变化的变化。苏格R在1972年作为脂质研究患病率研究成立，当时获得心脏病，糖尿病，中风和高血压的史，体重指数，禁食血浆葡萄糖，甘油三酸酯和胆固醇在82％的成人居民中测量。从1984年开始，有60-87％的尚存居民参与者每四年返回我们的研究诊所，衡量CVD风险因素，并更新了生活方式，药物和病史。从1988年开始，在相距约4年的六次诊所就诊中的每一个中，每次都完成了3个或更多标准的CFT。迄今为止，至少有三次重新测试了1172名男女，而721次进行了四次或更多的CFT访问。我们建议对CVD风险因素（4个风险因素组和3个综合风险因素得分）以及成功认知衰老的临床和亚临床CVD的相关性进行前瞻性研究。我们将成功的认知衰老定义为无临床痴呆症的生存，并维持CFT上预定义的表现（评估3个认知领域的3个标准测试）。我们将首先确定有利的CVD风险因素是否与短期（4年）保持认知功能有关，然后进行长期（20年）轨迹研究，其中包括风险因素的变化以及CFT的变化。我们将使用COX比例危害模型来检查明确定义的成功认知衰老的预测因子。协会将在教育，情绪低落，体重和体重变化，APO E基因型，药物和合并症的背景下进行检查；将使用测量的生物标志物（包括CRP，IL-6，IGF-1，类固醇激素和脂肪细胞因子）研究机制。所有分析将基于特定的先验假设。我们的目标是定义CVD风险因素和生物标志物的合理因果关系，作为暴露变量，更有利的属性可以预测认知功能的损失较小或没有丧失。纵向研究是解决多个观察到的关联的强度，独立性，时间性和效果修改的最强方法。 Rich RBS数据集是其长期重复重复CVD＆CFT测量的独特之处，它将使我们能够确定CVD暴露变量如何影响认知功能的不同领域。鉴于人口的衰老，该信息很重要，即CVD风险因素是可修改的事实，并且由于认知功能的维持是健康衰老的重要组成部分。