Multisystem risk profile of older adults to predict cognitive function and impairment

老年人的多系统风险概况可预测认知功能和损伤

• 批准号: 9902305
• 负责人: Suzi Hong
• 金额: $ 15.75万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9902305
• 关键词: Address; Age; Age-Years; Aging; Agreement; Alzheimer disease prevention; Alzheimer' s Disease; Alzheimer' s disease care; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Attention; Behavior Therapy; Biological Markers; CCL7 gene; Cardiovascular system; Clinic; Clinical; Clinical Trials; Cognitive; Complex; Data; Data Science; Data Scientist; Diagnosis; Disease; Disease Outcome; Early Diagnosis; Education; Elderly; Functional disorder; Funding; Goals; Impaired cognition; Individual; Individual Differences; Inflammation; Interdisciplinary Study; Investigation; Knowledge; Measurement; Measures; Memory; Metabolic; Metabolic Diseases; Modeling; Neuropsychological Tests; Neuropsychology; Outcome; Participant; Pathogenesis; Pathway interactions; Physical Function; Play; Population; Prevalence; Prevention strategy; Research; Research Personnel; Risk; Risk Factors; Risk Marker; Role; Scientist; Socioeconomic Status; Testing; Time; Translational Research; Wood material; biomarker identification; care costs; cognitive function; cognitive testing; comorbidity; data infrastructure; experience; follow-up; hemodynamics; high risk; improved; innovation; interest; mild cognitive impairment; multidisciplinary; neuroimaging; neuroinflammation; neuropsychiatry; patient oriented research; prevent; prospective; psychosocial; recruit; resilience; response; sex; sociodemographic variables; therapy development

PROJECT SUMMARY/ABSTRACT Pathogenesis and pathophysiology of AD and ADRD are multifaceted and complex. Varying individual factors further complicate the onset, progression and outcomes of the disease. For example, in spite of great interests and progress made in uncovering the association between cognitive decline and cardiovascular (CV) conditions, it largely remains unclear what other factors that are comorbid with CV conditions such as (neuro)inflammation, metabolic disorders and declined physical function, play a role and to what extent. With these often concurring conditions, it is challenging to disentangle independent or relative effects of those risk factors further confounded by individual differences. This RFA states one of the important topics as “… cardiovascular, metabolic and other risk factors; neuroinflammation; neuroimaging and other biomarkers…”, signifying the need for more comprehensive investigations on risk factor and marker identification to move the field forward and by engaging “new” workforce. Furthermore, it is paramount to pay more attention to identifying composite as well as independent risk for a cognitive decline by simultaneously investigating multi- system risk factors (“MRFs”) especially, among the high-risk individuals such as those with a cognitive function decline or mild cognitive impairment (MCI) or even those who are currently asymptomatic with identifiable risk factors in order to mobilize efforts in prevention of AD/ADRD. Thus, we propose to scrutinize multisystem risk factors categorized into following five domains in predicting cognitive function and impairment status: neuroinflammatory, metabolic, hemodynamic, psychosocial and physical functioning. Leveraging an ongoing R01 study of a behavioral intervention among elderly individuals (65 – 89 years of age) and recruiting additional participants (to include more individuals with a formal diagnosis of MCI using neuropsychological test) from Co-I, Dr. Delano-Woods’ clinic (UCSD Memory, Aging and Resilience Center, MARC), we will be able to utilize the existing and newly acquired data of proposed risk factors in five domains as well as cognitive outcomes. The cognitive function and impairment will be assessed and defined by using Montreal Cognitive Assessment (MoCA) and a neuropsychological (NP) battery for which the levels of ‘agreement’ between the two measures will be examined in the context of predictability of MRFs. The cross-sectional and prospective predictability of MRFs will be investigated and the sex and sex by age interaction effects will be tested.

项目概要/摘要 AD 和 ADRD 的发病机制和病理生理学是多方面且复杂的，因人而异。 例如，尽管有很大的影响，但一些因素使疾病的发病、进展和结果进一步复杂化。 在揭示认知能力下降与心血管（CV）之间的关联方面取得的兴趣和进展 条件，目前仍不清楚与心血管疾病共存的其他因素，例如 （神经）炎症、代谢紊乱和身体机能下降，发挥作用以及到什么程度。 这些经常同时发生的情况，很难理清这些风险的独立或相对影响 个体差异进一步混淆了这些因素。这份 RFA 将重要主题之一表述为“……” 心血管、代谢和其他危险因素；神经影像学和其他生物标志物……”， 表明需要对风险因素和标记物识别进行更全面的调查，以推动 此外，最重要的是要更多地关注“新”劳动力。 通过同时调查多个因素来识别认知能力下降的复合风险和独立风险 系统风险因素（“MRF”），特别是在高风险个体中，例如具有认知功能的个体 衰退或轻度认知障碍（MCI），甚至目前无症状但具有可识别风险的人 因此，我们建议仔细审查多系统风险。 预测认知功能和损伤状态的因素分为以下五个领域： 利用神经炎症、代谢、血流动力学、心理社会和身体功能。 正在进行的 R01 研究，针对老年人（65 – 89 岁）进行行为干预并招募 其他参与者（包括更多使用神经心理学正式诊断为 MCI 的个体） 测试）来自 Co-I，Delano-Woods 博士诊所（UCSD 记忆、衰老和恢复中心，MARC），我们将 能够利用五个领域中拟议风险因素的现有和新获得的数据以及认知 认知功能和损伤将通过蒙特利尔认知进行评估和定义。 评估 (MoCA) 和神经心理学 (NP) 电池组之间的“一致性”水平 将在 MRF 的可预测性背景下审查两项措施：横截面和前瞻性。 我们将研究 MRF 的可预测性，并测试性别和性别与年龄的相互作用效应。