Dementia Prevalence over Time: Proximate Causes and Consequences

痴呆症患病率随时间的变化：直接原因和后果

• 批准号: 9193220
• 负责人: MICHAEL D HURD
• 金额: $ 88.41万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-15 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9193220
• 关键词: Affect; Age; Alzheimer' s Disease; American; Attention; Caring; Clinical assessments; Cognition; Communities; Data; Dementia; Demographic Aging; Development; Diabetes Mellitus; Education; Elderly; Ethnic Origin; Etiology; Europe; Evaluation; Exposure to; Family; Family member; Future; Gender; Genetic; Genetic Markers; Health; Hypertension; Impaired cognition; Incidence; Individual; Interview; Measures; Memory; Modeling; Nursing Homes; Obesity; Outcome; Population; Prevalence; Prevalence Study; Probability; Probability Samples; Protocols documentation; Proxy; Race; Research; Respondent; Retirement; Risk; Risk Factors; Role; Sampling; Smoking; Socioeconomic Status; Statistical Models; Surveys; Testing; Time; United States; abstracting; aging population; base; cognitive testing; cohort; cost; genetic information; health data; improved; informal care; mortality; physical inactivity; tool; trend

Abstract As older adults make up a growing share of the population, the prevalence of dementia will likely increase, but the magnitude of the increase will depend on the course of age-specific rates. Most projections of Alzheimer's disease and dementia assume that age-specific prevalence rates do not change and that population aging alone will drive dementia prevalence trends. There is some recent evidence, however, that age-specific prevalence may be declining Europe and possibly in the United States. This study will use data from the Health and Retirement Study to estimate the trajectory of dementia prevalence and to examine risk factors. Since 1992, the HRS has surveyed biennially a panel of Americans over age 50, including about 8000 over 70. Data collected include assessments of cognition, health, socioeconomic status, family background, and now genetic information and biomarkers. A sub-study in the early 2000s administered an in-depth cognitive assessment covering dementia to 856 HRS respondents, and now a new sub-study to begin in 2016 will assess dementia status in a subsample of about 3000. This study has five specific aims. First, it will estimate the age-adjusted prevalence of dementia from 1998 to 2016 in the population over age 70 based on an improved model of dementia probability, including the use of genetic information; it will also estimate age-adjusted trends in dementia incidence (onset) and dementia mortality. Second, it will analyze subpopulations such as by gender or by race/ethnicity to document differences in dementia risk by groups. It will test whether any such differences can be explained by differences in exposure to risk factors such as diabetes or education and whether group-specific trends in risk factors affect group-specific trends in dementia. Third, where risk factors are found to be associated with dementia prevalence, the study will seek to determine whether these associations reflect causality. Fourth, using the models of the probability of dementia, the evidence about causality, and forecasts of risk factors, the study will predict dementia prevalence for the population and for important subpopulations to 2040. Fifth, the study will forecast the use and availability of informal care, e.g., care by family members, and how it will affect nursing home use and costs.

抽象的 随着老年人占人口的份额越来越大，痴呆症的患病率可能会增加，但 增加的大小将取决于特定年龄的率。大多数阿尔茨海默氏症的预测 疾病和痴呆假设年龄特异性的患病率不会改变，并且人口单独衰老 将推动痴呆症患病率趋势。但是，最近有一些证据表明特定年龄的流行率 可能正在下降欧洲，甚至可能在美国。 这项研究将使用健康和退休研究的数据来估计痴呆症患病率的轨迹 并检查风险因素。自1992年以来，人力资源组织已经对50岁以上的美国人小组进行了调查， 收集的数据包括大约8000人。包括认知，健康，社会经济地位的评估， 家庭背景，以及现在的遗传信息和生物标志物。 2000年代初期的一个子研究 深入的认知评估涉及856个小时受访者的痴呆症，现在是一个新的子研究 开始于2016年将评估大约3000个子样本中的痴呆状态。 这项研究具有五个具体目标。首先，它将估计从1998年到1998年的痴呆症患病率 2016年的70岁以上人口基于改善的痴呆概率模型，包括使用 遗传信息；它还将估计痴呆发病率（发病）和痴呆症的年龄调整趋势 死亡。 其次，它将分析诸如性别或种族/种族之类的亚种群，以记录 痴呆症风险群体。它将测试是否可以通过暴露差异来解释任何此类差异 诸如糖尿病或教育之类的风险因素以及危险因素的特定群体趋势是否影响群体特定 痴呆症的趋势。第三，在发现风险因素与痴呆症患病率有关的情况下，该研究将 寻求确定这些关联是否反映因果关系。 第四，使用痴呆症的概率模型，有关因果关系的证据和风险预测 该研究将预测人口的痴呆症患病率和2040年的重要亚群。 第五，该研究将预测非正式护理的使用和可用性，例如，家庭成员的护理以及它将如何 影响疗养院的使用和成本。