The Voices of our Elders

我们长辈的声音

• 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
• 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' s Disease; Alzheimer' s disease care; Alzheimer' s disease related dementia; Alzheimer' 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

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65岁及65岁以上的美国印第安人人数将三倍至1,624,000，而其中的数量将 85岁及以上的年龄将增加7倍至300,000。这些人口趋势引起了人们对人口的关注 阿尔茨海默氏病和相关痴呆症（ADRD）的患病率及其前代，轻度认知障碍， 以及对ADRD的医疗保健需求。美洲印第安人也经历了ADRD的不成比例 危险因素，例如高血压和2型糖尿病。有关认知障碍和ADRD的可用数据 美洲印第安人长者仍然有限。此外，美国印第安人的少数现有研究 仅限于中西部和西方​​。存在可以估计，跟踪， 预防，并最终治疗ADRD。我们还需要加大适当公共卫生的经济成本 美国东半部的美洲印第安人的干预措施。彼此之间，我们提出了第一个人群 - 基于基于的研究旨在系统地表征东部美洲印第安人社区的ADRD 我们。这项工作将是华盛顿州立大学，迈阿密大学和瓦巴纳基的合作伙伴关系 公共卫生是一个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，统称为Wabanaki部落。大约875名55岁及以上的美洲印第安人 在四个部落的服务交付领域，但对其认知功能或临床方面一无所知 患病率ADRD或多重认知障碍。我们将使用部落卷来邀请所有55岁的美国印第安人 及以年龄的时间参加基于人群的流行病学研究（n = 650，假设参与75％ 基于先前的Wabanaki响应率）评估认知功能和ADRD风险因素，并确定 患有有问题的认知障碍或ADRD的人。我们还将与 参与者的一部分（n = 260），以根据临床的结果来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分析 以及与ADRD相关的未来成本。我们的具体目的是：1）对健康的流行病学研究 以及ADRD和认知能力下降的生活方式风险因素，以及普遍的ADRD和轻度认知的筛选 55岁及以上的瓦巴纳基部落成员的损害； 2）进行病例对照验证研究 将AIM 1的筛查结果与临床诊断访谈进行比较； 3）使用目标1和2的数据 估计与ADRD和轻度认知障碍相关的当前和未来直接和间接成本 发病率和治疗。我们的研究将为Wabanaki公共卫生提供宝贵的公共卫生数据，并 在全国 瓦巴纳基社区和其他美洲印第安人人口的需求。