Factors Influencing Decline in AD Trends in a Biracial Population Study

混血人口研究中影响 AD 趋势下降的因素

基本信息

批准号：
9422107
负责人：
Kumar B. Rajan
金额：
$ 9.28万
依托单位：
RUSH UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-15 至 2018-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9422107
关键词：
Address African American Age Aging Algorithms Alzheimer&apos s Disease American Antihypertensive Agents Attention Body mass index Cardiovascular Diseases Characteristics Chicago Chronic Clinical Cognition Cognitive Complex Data Sources Development Diabetes Mellitus Diagnosis Elderly Employee Strikes Episodic memory Ethnic Origin European General Population Health Hypertension Incidence Income Individual Intervention Studies Interview Longitudinal cohort Measures Mental Health Methodology Minority Multivitamin Neighborhoods Neuropsychological Tests Neurotic Disorders Neurotics Outcome Participant Pattern Pharmaceutical Preparations Physical activity Population Population Study Prevalence Prevention strategy Preventive Probability Public Health Race Recurrence Risk Risk Factors Sampling Sampling Studies Stress Stroke Testing Time Time trend Translating base biracial clinical Diagnosis cognitive function cognitive testing depressive symptoms epidemiology study executive function falls improved interest neurocognitive test pre-clinical racial difference research clinical testing research study sex social engagement stress symptom trend

项目摘要

Several research studies suggest a secular decline in AD trends. However factors influencing negative secular trend in AD are unknown. Besides, racial differences in these secular trends also need to be established for African American minorities. To address these issues, we propose to use a large population-based study with cognitive tests of executive functioning, episodic memory, and overall global cognition and orientation in 10,801 participants, and clinical diagnosis of AD in 2,839 participants of African American and European American ethnicity to study age, race, and sex-specific decline in AD trends between 1993 and 2012, and reasons for a negative secular trend in AD. More specifically, the five objectives of this proposal are: (1) Demographic differences in AD trends aim: evaluate age-, sex-, and race-specific trends in AD using composite and individual tests of cognition, ADLS, and clinical diagnosis in prevalent and incident Alzheimer’s AD from 1993 to 2012; (2) Risk factors aim: understand the association of demographic characteristics, hypertension, stroke, diabetes, Body Mass Index (BMI), perceived stress, and depressive symptoms on AD trends using composite and individual tests of cognition, ADLS, and clinical diagnosis of prevalent and incident AD between 1993 and 2012. (3) Protective factors aim: examine the association of educational attainment, income, social engagement, neuroticism, extraversion, physical activity, and cognition enriching activities on AD trends using composite and individual tests of cognition, ADLS, and clinical diagnosis of prevalent and incident AD between 1993 and 2012. (4) Medications use aim: Examine how anti-hypertensive, statin, and diabetes medication, and multi-vitamin supplement use may be associated with incident AD, and how change in hypertension, statin, and diabetes medication use may be associated with AD trends using composite and individual tests of cognition, ADLS, and clinical diagnosis of AD between 1993 and 2012. In this proposal, we use a newly developed AD likelihood score (ADLS) to translate clinical diagnosis of AD in clinical sample that uses 19 neuropsychological tests to likelihood of AD in our population sample that uses 4 short-battery neuropsychological tests. Such an approach will drastically improve our power to detect potential reasons for secular decline in AD trends. In addition, our proposal examines demographic differences in AD trends, and putative risk factors and preventive factors that might influence AD trends. This proposal has the potential to make a large public health impact in potentially identifying factors that could be influencing AD trends leading to intervention studies that could be geared towards improving the identified factors in the general population.

多项研究表明 AD 趋势长期下降，但影响负面长期的因素。此外，这些长期趋势的种族差异也需要确定。为了解决这些问题，我们建议对非裔美国人进行大规模的研究。执行功能、情景记忆以及整体认知和定向的认知测试 10,801 名参与者，以及 2,839 名非洲裔美国人和欧洲人的 AD 临床诊断美国种族研究 1993 年至 2012 年间 AD 趋势中年龄、种族和性别的下降趋势，以及 AD 长期负面趋势的原因更具体地说，该提案的五个目标是：(1) AD 趋势中的人口统计差异旨在：使用以下方法评估 AD 中年龄、性别和种族特定的趋势对流行性和偶发性阿尔茨海默氏症进行认知、ADLS 和临床诊断的综合和个体测试 AD从1993年到2012年；（2）风险因素目标：了解人口特征的关联， AD 中的高血压、中风、糖尿病、体重指数 (BMI)、感知压力和抑郁症状使用认知、ADLS 的综合和个体测试以及患病率和事件的临床诊断来得出趋势公元1993年至2012年间。（3）保护因素目标：考察教育程度、收入、社会参与、神经质、外向性、身体活动和认知丰富活动 AD 趋势使用认知、ADLS 的综合和单独测试以及流行病和慢性病的临床诊断 1993 年至 2012 年间发生的 AD 事件。 (4) 药物使用目的：检查抗高血压、他汀类药物和糖尿病事件药物治疗和多种维生素补充剂的使用可能与 AD 相关，以及如何变化高血压、他汀类药物和糖尿病药物的使用可能与 AD 趋势相关 1993 年至 2012 年间对认知、ADLS 和 AD 临床诊断进行的个体测试。在本提案中，我们使用新开发的 AD 可能性评分 (ADLS) 来转化临床样本中 AD 的临床诊断，使用 19 项神经心理学测试来评估我们使用 4 个短电池的人群样本中患 AD 的可能性这种方法将极大地提高我们发现潜在原因的能力。此外，我们的提案还研究了 AD 趋势的人口差异，以及可能影响 AD 趋势的假定风险因素和预防因素。潜在地确定可能影响 AD 趋势领先的因素，从而对公共卫生产生重大影响旨在改善一般人群中已确定因素的干预研究。