The Voices of our Elders

我们长辈的声音

基本信息

批准号：
10223041
负责人：
Patrik Lennart Johansson
金额：
$ 58.77万
依托单位：
WABANAKI HEALTH AND WELLNESS
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-16 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10223041
关键词：
Age Alzheimer&apos s Disease Alzheimer&apos s disease care Alzheimer&apos s disease related dementia Alzheimer&apos s disease risk American Indians Area Caring Chronic Clinical Cognitive Communities Contracts Country Data Dementia Development Diagnosis Direct Costs Elderly Evaluation Facilities and Administrative Costs Failure Funding Future General Population Gold Health Health Status Healthcare Heterogeneity Human Subject Research Hypertension Impaired cognition Intervention Interview Life Expectancy Life Style Light Literature Maine Measures Morbidity - disease rate Native American Research Center for Health Native-Born Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino PF4 Gene Participant Population Population Study Prevalence Provider Public Health Research Research Design Research Personnel Research Project Grants Risk Factors Screening Result Services System Tribes United States Indian Health Service Universities Voice Washington aged base billing data care burden case control clinical database clinical diagnostics cognitive function cost dementia risk disparity elimination economic cost economic evaluation epidemiology study ethnic minority population exhaustion experience health care availability health care quality health data health economics human old age (65+)human very old age (85+)informal caregiver mild cognitive impairment population based prevent public health intervention racial minority response screening service delivery systematic review trend tribal community tribal health tribal member validation studies

项目摘要

RESEARCH PROJECT: ABSTRACT The number of American Indians aged 65 and older will triple to 1,624,000 by 2050, while the number of those aged 85 and older will increase 7-fold to 300,000. These demographic trends raise concerns about the population prevalence of Alzheimer’s disease and related dementias (ADRD) and its prodrome, mild cognitive impairment, and the need for health care for ADRD. American Indians also experience a disproportionate burden of ADRD risk factors, such as hypertension and type 2 diabetes. Available data on cognitive impairment and ADRD among American Indian elders remain limited. Furthermore, the few existing studies on dementia in American Indians have been limited to the midwestern and western US. There exists a need for studies that can estimate, track, prevent, and, eventually treat ADRD. We also need to weigh the economic costs of appropriate public health interventions for American Indians in the eastern half of the US. Accordingly, we propose the first population- based study designed to systematically characterize ADRD among American Indian communities in the eastern US. This effort will be a partnership between Washington State University, the University of Miami, and Wabanaki Public Health, a tribally founded and directed public health district serving all 4 federally recognized tribes in Maine, collectively known as the Wabanaki tribes. Approximately 875 American Indians aged 55 and older reside in the service delivery areas of the 4 tribes, yet nothing is known about their cognitive function or clinical prevalence ADRD or multiple cognitive impairment. We will use tribal rolls to invite all American Indians aged 55 and older to participate in a population-based epidemiologic study (n = 650, assuming 75% participation based on prior Wabanaki response rates) to assess cognitive function and ADRD risk factors, and to identify people with probable cognitive impairment or ADRD. We will also conduct a case-control validation study with a subset of participants (n = 260) to validate our cognitive screening results against the results of a clinical diagnostic interview, the gold standard in ADRD. Finally, we will conduct a health economics analysis of current and future costs associated with ADRD. Our Specific Aims are to: 1) Conduct an epidemiologic study of health and lifestyle risk factors for ADRD and cognitive decline, and screen for prevalent ADRD and mild cognitive impairment among Wabanaki tribal members aged 55 and older; 2) Conduct a case-control validation study comparing screening results from Aim 1 to a clinical diagnostic interview; and 3) Use data from Aims 1 and 2 to estimate current and future direct and indirect costs associated with ADRD and mild cognitive impairment morbidity and treatment. Our study will contribute invaluable public health data for Wabanaki Public Health and American Indians nationally, and contribute to the development of ADRD-related health interventions tailored to the needs of Wabanaki communities and other American Indian populations.

研究项目：摘要到 2050 年，65 岁及以上的美洲印第安人人数将增加两倍，达到 1,624,000 人，而 85 岁及以上的人口将增加 7 倍，达到 30 万。这些人口趋势引起了人们对人口的担忧。阿尔茨海默氏病和相关痴呆症 (ADRD) 及其前驱症状、轻度认知障碍、 ADRD 患者的医疗保健需求也承受着不成比例的负担。危险因素，例如高血压和 2 型糖尿病，有关认知障碍和 ADRD 的现有数据。此外，关于美洲印第安人痴呆症的现有研究仍然有限。仅限于美国中西部和西部，需要进行能够估计、跟踪、预防并最终治疗 ADRD 我们还需要权衡适当的公共卫生的经济成本。因此，我们建议对美国东半部的美洲印第安人进行干预。旨在系统地描述东部美洲印第安人社区 ADRD 特征的研究这项工作将由华盛顿州立大学、迈阿密大学和 Wabanaki 合作完成。公共卫生，一个由部落建立和指导的公共卫生区，为所有 4 个联邦认可的部落提供服务缅因州居住着大约 875 名 55 岁及以上的印第安人，统称为瓦巴纳基部落。在 4 个部落的服务提供领域，但对其认知功能或临床状况一无所知 ADRD 或多种认知障碍的患病率我们将使用部落名册邀请所有 55 岁的美国印第安人。及以上参加基于人群的流行病学研究（n = 650，假设 75% 的参与基于先前的 Wabanaki 反应率）评估认知功能和 ADRD 风险因素，并确定我们还将与可能患有认知障碍或 ADRD 的人进行病例对照验证研究。一部分参与者（n = 260）根据临床结果验证我们的认知筛查结果诊断访谈，ADRD 的黄金标准最后，我们将对当前的健康经济学进行分析。以及与 ADRD 相关的未来成本我们的具体目标是： 1) 进行健康流行病学研究。 ADRD 和认知能力下降的生活方式风险因素，并筛查常见的 ADRD 和轻度认知能力下降 55 岁及以上的 Wabanaki 部落成员的损伤；2) 进行病例对照验证研究；将目标 1 的筛查结果与临床诊断访谈进行比较；以及 3) 使用目标 1 和 2 的数据估计当前和未来与 ADRD 和轻度认知障碍相关的直接和间接成本我们的研究将为 Wabanaki 公共卫生和治疗提供宝贵的公共卫生数据。全国范围内的美洲印第安人，并为制定与 ADRD 相关的健康干预措施做出贡献瓦巴纳基社区和其他美洲印第安人的需求。