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

• 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
• 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' 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

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.

几项研究表明，AD趋势的世俗下降。但是因素影响负面的世俗 广告的趋势未知。此外，还需要建立这些世俗趋势的种族差异 非裔美国人少数民族。为了解决这些问题，我们建议与 执行功能，情节记忆以及整体全球认知和方向的认知测试 10,801名参与者以及2,839名非裔美国人和欧洲参与者的AD临床诊断 1993年至2012年期间，美国研究年龄，种族和性别特定性别趋势下降的美国种族， 广告中存在负面趋势的原因。更具体地说，该提案的五个目标是：（1） AD趋势的人口统计学差异目的：评估使用年龄，性别和种族特定趋势的广告 在阿尔茨海默氏症患者和事件中的认知，ADL和临床诊断的综合和个人测试 从1993年到2012年的广告； （2）风险因素目的：了解人口特征的关联， 高血压，中风，糖尿病，体重指数（BMI），感知的压力和AD的抑郁症状 使用复合材料和个人测试的认知，ADL和临床诊断的趋势 1993年至2012年之间的广告。（3）保护因素的目的：检查教育成就的关联， 收入，社会参与，神经质，外向性，体育锻炼和认知丰富的活动 使用综合和个人测试的认知，ADL和临床诊断的AD趋势 1993年至2012年之间的事件广告。（4）药物使用目的：检查抗高血压，他汀类和他汀类药物如何 糖尿病药物和多种维生素补充剂的使用可能与事件AD有关，以及如何改变 在高血压中，他汀类药物和糖尿病药物的使用可能与使用复合材料和 1993年至2012年之间的AD认知，ADL和临床诊断的个人测试。在此提案中，我们 使用新开发的广告似然评（ADL）在临床样本中翻译AD的临床诊断 在我们的人群样本中使用19个神经心理学测试来使用4个短门 神经心理学测试。这种方法将大大提高我们检测潜在原因的权力 广告趋势的世俗下降。此外，我们的提案考试在AD趋势上存在人口统计学差异， 推定的风险因素和可能影响AD趋势的预防因素。该提议有可能 对可能影响广告趋势的潜在识别因素产生巨大的公共卫生影响 可以旨在改善普通人群中确定的因素的干预研究。