Lifecourse Pathways to Racial Disparities in Late-Life Cognitive Impairment

晚年认知障碍种族差异的生命历程路径

• 批准号: 8334030
• 负责人: Zhenmei Zhang
• 金额: $ 7.45万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-15 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8334030
• 关键词: Achievement; Adult; Age-Years; Alzheimer' s Disease; American; Childhood; Cognition; Cognitive; Data; Data Set; Degenerative Disorder; Dementia; Demographic Aging; Development; Diagnosis; Diagnostic; Distal; Education; Educational Background; Elderly; Epidemic; Future; Gender; Goals; Health; Health Professional; Health Resources; Health behavior; Healthcare; Home environment; Impaired cognition; Impairment; Incidence; Investigation; Life; Life Cycle Stages; Life Expectancy; Life Table Models; Life Tables; Long-Term Care; Longitudinal Studies; Longitudinal Surveys; Measurement; Measures; Memory; Modeling; Pathway interactions; Persons; Policy Maker; Population; Prevalence; Protocols documentation; Public Health; Race; Reporting; Research; Research Personnel; Resources; Respondent; Retirement; Risk; Risk Factors; Screening procedure; Sensitivity and Specificity; Shapes; Statistical Models; Stratification; Time; United States; aged; base; cognitive function; design; effective intervention; insight; lens; mild neurocognitive impairment; population based; population survey; racial difference; socioeconomics; tool

DESCRIPTION (provided by applicant): The racial gap in cognitive impairment and dementia has emerged as a serious public health problem. Researchers using nationally representative data estimated that among those aged 71 years and older Blacks were approximately two times more likely to have dementia than Whites. Blacks also had four times greater risk of having mild cognitive impairment than Whites. The epidemic of cognitive impairment and dementia among older Blacks will worsen in future years as the number of Blacks aged 65 and over will more than double by 2030, increasing from 2.8 million in 2000 to 7.2 million by 2030. Despite developments in understanding the risk factors associated with cognitive impairment and dementia in recent years, very few population-based studies have investigated the origins, mechanisms, and consequences of the racial gap in cognitive impairment. The proposed investigation will carefully define the magnitude of the gap in cognitive impairment, the proximal and distal factors associated with the gap, and the consequences of the gap for cognitive-impairment-free life expectancy for older Blacks and Whites. Data come from the Health and Retirement Study (HRS), an ongoing nationally representative, longitudinal survey of Americans 51 years of age and older and Aging, Demographics, and Memory Study (ADAMS). ADAMS is part of the HRS in that a subset of HRS respondents aged 70 years and older were clinically assessed and assigned a diagnosis of dementia, cognitive impairment but not demented (CIND), or normal cognition. Specifically, we aim to 1) examine the sensitivity and specificity of the HRS cognitive functioning measures as a screening tool for cognitive impairment and dementia for Blacks and Whites respectively; 2) examine life course pathways associated with the racial gap in cognitive impairment; 3) estimate life expectancy with and without cognitive impairment for Blacks and Whites by gender and childhood conditions. The analysis will be based on the 1998-2008 waves of HRS. Models of both prevalence and incidence of cognitive impairment will be estimated for persons aged 70 years and older. The findings from this research will advance our understandings of the origins, mechanisms, and consequences of racial gaps in cognitive impairment and can help policy makers and public health professionals design effective interventions to reduce racial disparities in cognitive impairment and make plans for the associated health care and long-term care needs of those suffering from cognitive impairment.

描述（由申请人提供）：认知障碍和痴呆症的种族差距已成为一个严重的公共卫生问题。研究人员使用全国代表性数据估计，在 71 岁及以上的人群中，黑人患痴呆症的可能性大约是白人的两倍。黑人患轻度认知障碍的风险也是白人的四倍。未来几年，老年黑人中认知障碍和痴呆症的流行将会恶化，因为到 2030 年，65 岁及以上的黑人人数将增加一倍以上，从 2000 年的 280 万增加到 2030 年的 720 万。近年来，与认知障碍和痴呆症相关的研究很少有基于人群的研究来调查认知障碍种族差异的起源、机制和后果。拟议的调查将仔细界定认知障碍差距的大小、与差距相关的近端和远端因素，以及差距对老年黑人和白人无认知障碍预期寿命的影响。数据来自健康与退休研究 (HRS)，这是一项正在进行的针对 51 岁及以上美国人的全国代表性纵向调查，以及老龄化、人口统计和记忆研究 (ADAMS)。 ADAMS 是 HRS 的一部分，因为对 70 岁及以上的 HRS 受访者子集进行了临床评估，并分配了痴呆、认知障碍但非痴呆 (CIND) 或正常认知的诊断。具体来说，我们的目标是 1) 检查 HRS 认知功能测量作为黑人和白人认知障碍和痴呆症筛查工具的敏感性和特异性； 2）检查与认知障碍种族差距相关的生命历程路径； 3) 按性别和儿童状况估计黑人和白人有或没有认知障碍的预期寿命。分析将基于 1998-2008 年的 HRS 波。将对 70 岁及以上人群的认知障碍患病率和发病率模型进行估计。这项研究的结果将增进我们对认知障碍种族差异的起源、机制和后果的理解，并可以帮助政策制定者和公共卫生专业人员设计有效的干预措施，以减少认知障碍的种族差异，并为相关的医疗保健制定计划以及患有认知障碍的人的长期护理需求。