Incident Vascular Brain Injury, Probable Alzheimer's Disease, and Cognitive Change in Elderly American Indians

老年印第安人的血管性脑损伤、可能的阿尔茨海默病和认知变化

基本信息

批准号：
9894705
负责人：
Astrid M Suchy-Dicey
金额：
$ 12.56万
依托单位：
WASHINGTON STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-07-01 至 2023-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9894705
关键词：
Address African American Alzheimer&apos s Disease American Indians Brain Brain Pathology Cephalic Cerebrovascular Disorders Cerebrovascular Trauma Cessation of life Clinical Cluster Analysis Cognitive Cohort Studies Data Data Collection Data Set Dementia Development Plans Diagnostic Disease Disease Progression Educational workshop Elderly Elements Environment Ethnic Origin Ethnic group Etiology Evaluation Event Evidence based intervention Exclusion Frequencies Functional Magnetic Resonance Imaging Funding Future General Population Geography Grant Health Healthcare Systems Image Impaired cognition Incidence Individual Knowledge Longitudinal cohort study Magnetic Resonance Imaging Measures Medical Genetics Memory Mental Depression Mentors Methods Minority Minority Groups Monitor National Institute of Neurological Disorders and Stroke National Institute on Aging Nerve Degeneration Neuroepidemiology Neurological observations Neuropsychological Tests Neuropsychology Not Hispanic or Latino Outcome Participant Pathology Patient risk Pattern Population Positioning Attribute Prevalence Prevention Protocols documentation Quality of life Race Recording of previous events Research Research Personnel Resources Risk Risk Factors Sampling Severities Social Environment Standardization Stroke Subgroup Targeted Research Thinking Time Tribes Ursidae Family aged aging brain analytical method burden of illness cardiovascular health cardiovascular risk factor career development caucasian American cerebral atrophy clinical examination clinical risk cognitive change cognitive testing cohort disability disorder prevention environmental stressor experience follow-up health disparity high risk innovation mild cognitive impairment neuroimaging neuropathology novel population based pre-clinical preservation prevent psychosocial recruit rural residence skills social stressor socioeconomics success vascular contributions

项目摘要

PROJECT SUMMARY / ABSTRACT A workshop convened in 2013 by National Institute of Aging and the National Institute of Neurological Diseases and Stroke prioritized research on cognitive impairment of multiple etiologies, contributions of vascular brain injury (VBI) to neurodegeneration and Alzheimer's Disease (AD), and disparities involving race, ethnicity, socioeconomics, and rural residence. VBI is a leading cause of accelerated brain aging and a major risk factor for stroke, cognitive decline, depression, and probable Alzheimer's disease (AD). However, few studies have evaluated VBI, cognitive impairment, and AD in American Indians (AIs), who bear a heavy burden of risk factors for these conditions. This exclusion is unfortunate, since the distinctive history, risk profiles, environmental stressors, social environments, and healthcare systems of AIs likely result in patterns of disease that differ substantially from other populations. Our research team has conducted the only cohort study to date of covert VBI in AIs. In 2010-2013, Cerebrovascular Disease and its Consequences in American Indians study completed standardized clinical examinations, neuropsychological testing, and cranial MRI on more than 1,000 AIs aged 64-95 years from 10 tribes in 3 states. In 2016, we began re-examination of surviving participants using the same protocols, augmented by assessment for probable AD. However, the particular grant mechanism from the National Institute on Aging that provides funding for this follow-up examination is limited to data collection, with no resources allocated for analysis. In this proposal, we will capitalize on the accumulated longitudinal data to apply sophisticated imaging and analysis methods to quantify and evaluate associations for incident VBI, neurodegeneration, and changes in cognitive status in this elderly minority population. Our Specific Aims are to: (1) establish normative and diagnostic standards for mild cognitive impairment and dementia in elderly AIs, and evaluate associations and determinants for incident VBI, cerebral atrophy, cognitive decline, and probable AD; (2) conduct cluster analyses to identify novel neuroimaging profiles that predict subgroups of elderly AIs at highest risk for cerebral atrophy, cognitive decline, and probable AD; and (3) complete a rigorous career development plan that will position the applicant as an independent investigator and leader in innovative neuroepidemiology research with minority populations. This proposal leverages a timely opportunity to generate the first population-based estimates of and address novel scientific questions on VBI and cognitive impairment in AIs, a minority population with pervasive health disparities.

项目摘要 /摘要美国国家老化研究所和美国国家神经病学院于2013年召集的研讨会中风优先研究多种病因的认知障碍，血管脑的贡献神经变性和阿尔茨海默氏病（AD）的伤害（VBI），以及涉及种族，种族，社会经济学和农村住宅。 VBI是加速大脑衰老和主要危险因素的主要原因对于中风，认知能力下降，抑郁和可能的阿尔茨海默氏病（AD）。但是，很少有研究在美国印第安人（AIS）中评估了VBI，认知障碍和广告，他们承担着危险因素的重担对于这些条件。不幸的是，这种排除是不幸的，因为独特的历史，风险概况，环境 AIS的压力源，社交环境和医疗系统可能导致疾病模式不同大量来自其他人群。我们的研究团队已经进行了截至秘密的唯一队列研究 AIS中的VBI。在2010 - 2013年，脑血管疾病及其在美洲印第安人研究中的后果完成标准化的临床检查，神经心理学测试和1000多名AIS的颅MRI 在3个州的10个部落中，有64 - 95年的时间。 2016年，我们开始使用同样的人重新检查幸存的参与者协议，通过评估可能的AD进行增强。但是，来自为此后续考试提供资金的国家老化研究所仅限于数据收集没有分配分析的资源。在此提案中，我们将利用累积的纵向数据应用复杂的成像和分析方法来量化和评估事件VBI的关联，神经变性，以及这个老年人人口的认知状况的变化。我们的具体目标是至：（1）在老年AIS中建立轻度认知障碍和痴呆症的规范和诊断标准，评估事件VBI，脑萎缩，认知能力下降和可能的关联和决定因素广告; （2）进行聚类分析以识别预测老年AIS亚组的新型神经影像学特征大脑萎缩，认知能力下降和可能的AD风险最高；（3）完成严格的职业开发计划将把申请人定位为创新的独立研究者和领导者少数族裔人群的神经ePidemiology研究。该建议利用及时的机会来产生关于VBI和认知障碍的新型科学问题的首个基于人群的估计值在AIS中，少数人口普遍存在健康差异。