Community-Based Early Identification of MCI in at Risk African Americans

基于社区的非裔美国人 MCI 早期识别

• 批准号: 8929117
• 负责人: VOYKO KAVCIC
• 金额: $ 21.27万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-30 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8929117
• 关键词: African American; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease risk; Area; Behavioral; Brain; Caring; Clinical; Clinical Trials; Clinical assessments; Cognitive; Communities; Comorbidity; Computers; Consensus; Cross-Sectional Studies; Data; Data Set; Dementia; Development; Diagnosis; Diagnostic Services; Disease; Early Diagnosis; Early identification; Economics; Elderly; Electroencephalography; Emergency medical service; Ensure; Familiarity; Family; Feasibility Studies; Frequencies; Funding; Future; General Population; Gerontology; Health; Impaired cognition; Individual; Institutes; Intervention; Life; Longevity; Longitudinal Studies; Measurement; Measures; Medical; Memory; Memory impairment; Methodology; Methods; Michigan; Mind; Minority; Modality; Neurologic; Neuropsychological Tests; Participant; Patients; Pharmaceutical Preparations; Play; Population; Population Heterogeneity; Prevention trial; Recruitment Activity; Research; Risk; Role; Sampling; Savings; Signal Transduction; Staging; Structure; Testing; Time; United States National Institutes of Health; Universities; Variant; base; caucasian American; cognitive change; cognitive performance; cognitive rehabilitation; cognitive testing; cohort; community setting; computerized; demographics; diagnostic accuracy; experience; functional disability; health disparity; high risk; inpatient service; metropolitan; mild cognitive impairment; neuropathology; neurophysiology; neuropsychological; novel; novel strategies; outreach; research clinical testing; social; socioeconomics; symposium; treatment response

DESCRIPTION (provided by applicant): Community-dwelling, African-American elders show faster rates of cognitive decline than elderly white Americans and are almost twice as likely to develop mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, in the early stages of these disorders, African-American elders are less likely to be diagnosed or receive treatment. Such health disparities represent a critical roadblock to early identification and care for MCI and dementia, which not only diminishes the medical and social benefits to the individual patient and family, but also fiscal savings at the state and federal levels. Development of economically viable and culturally acceptable methods of early detection of cognitive change is critical in minority populations. With the increase in longevity and the rapid increase in the proportion of elderly in the population, it is important to evaluate the earliest risk for dementia more accurately in order to guide environmental and clinical interventions for older adults. MCI, characterized by cognitive difficulties without clear functional impairment, is a daily-life-limitig condition that in most cases is a precursor to AD. Access to well characterized elderly who are at risk for MCI (e.g., memory complaint, but otherwise healthy) provides a unique opportunity to study the earliest signs of accelerated cognitive decline in individuals at highest risk for developing dementia. The proposed cross-sectional study will test to what extent computerized cognitive tests and portable electroencephalography (EEG/ERP) methodology can be used to easily, accurately and efficiently identify early cognitive decline and MCI in elderly African-Americans within their community setting. Additionally, we will also evaluate feasibility and acceptability of these computer-based and electrophysiological methods. We propose to accomplish the above aims by recruiting a total of 200 at risk African Americans (age e 65 years) from among the 1,100 participants in the Healthier Black Elders Center (HBEC) in their communities within the Detroit metro area. We will use an MCI-enriched sampling by recruiting only those older African Americans who in the recent past expressed subjective memory complaints. These 200 at risk elder African Americans will be extensively evaluated with two computerized tests (i.e., CogState and NIH Toolbox), EEG/ERP recordings, and a structured medical/neuropsychological exam and consensus. Our community based proposal, combining behavioral and EEG/ERP methods, will be used to establish the utility and acceptability of these measures and to potentially generate profiles of at risk healthy, elderly African-Americans, who may, within a short period of time, develop MCI (participants will be longitudinally followed after this project). We predict that a combination of behavioral and EEG/ERP methods will allow development of objective markers that will reliably identify early signs of cognitive decline. Such markers, in addition to identification of significant cognitive decline, may also play a significan role in the recruitment of larger, more diverse populations in order to evaluate the efficiency of new pharmacological approaches.

描述（由申请人提供）：社区居民，非裔美国人长者的认知能力下降速度比老年人的美国人更快，并且出现轻度认知障碍（MCI）和阿尔茨海默氏病（AD）的可能性几乎是两倍。但是，在这些疾病的早期阶段，非洲裔美国人的长者不太可能被诊断或接受治疗。这种健康差异代表了对MCI和痴呆症的早期识别和护理的关键障碍，这不仅减少了对个别患者和家庭的医疗和社会福利，而且还减少了州和联邦一级的财政节省。发展 在经济上可行且具有文化上可接受的认知变化的方法中，在少数群体中至关重要。 随着人口中老年人比例的寿命和迅速增加，评估痴呆症的最早风险很重要 更准确地指导老年人的环境和临床干预措施。 MCI的特征是没有明显的功能障碍的认知困难，这是日常生活的条件，在大多数情况下，它是AD的先驱。进入有MCI风险的良好特征的老年人（例如，记忆投诉，但健康）为研究最早加速痴呆症风险最高风险认知能力下降的迹象提供了一个独特的机会。 拟议的横断面研究将在多大程度上测试计算机化的认知测试和便携式脑电图（EEG/ERP）方法，可用于在社区环境中轻松，准确，准确有效地识别非裔美国人的早期认知下降和MCI。此外，我们还将评估这些基于计算机和电生理方法的可行性和可接受性。 我们建议通过在底特律都会区域内的社区中较健康的黑人长老中心（HBEC）中的1,100名参与者中招募共有200名在风险的非洲裔美国人（E 65岁）的风险中实现上述目标。我们将仅通过招募那些最近表达主观记忆投诉的年长的非洲裔美国人来使用富含MCI的样本。这200个处于危险中的非洲裔美国人将通过两项计算机测试（即Cogstate和NIH工具箱），EEG/EEG/ERP记录以及结构化的医学/神经心理学考试和共识，对非裔美国人长老。 我们基于社区的建议将行为和脑电图/ERP方法结合在一起，将用于建立这些措施的实用性和可接受性，并有可能产生AT风险健康的非裔美国人的概况，他们可能会在很短的时间内发展MCI（参与者将在漫长的范围内遵循 这个项目）。我们预测，行为和脑电图/ERP方法的结合将允许开发客观标记，这些标记将可靠地确定认知能力下降的早期迹象。这样的 除了确定认知能力大幅下降外，标记还可能在招募较大，更多样化的人群中发挥重要作用，以评估新的药理学方法的效率。

项目成果

Cortical configuration by stimulus onset visual evoked potentials (SO-VEPs) predicts performance on a motion direction discrimination task.

• DOI: 10.1016/j.ijpsycho.2015.04.004
• 发表时间: 2015-06
• 期刊: International journal of psychophysiology : official journal of the International Organization of Psychophysiology
• 作者: B. Zalar;T. Martin;V. Kavcic