Lifecourse health, cerebral pathology and ethnic disparities in dementia (KHANDLE Study)

痴呆症的生命周期健康、脑病理学和种族差异（KHANDLE 研究）

基本信息

批准号：
10666493
负责人：
Paola Gilsanz
金额：
$ 362.01万
依托单位：
UNIVERSITY OF CALIFORNIA AT DAVIS
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-06-01 至 2026-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10666493
关键词：
Acceleration Acculturation Address Adult Age Aging Alzheimer&apos s Disease Alzheimer&apos s disease related dementia Alzheimer&apos s disease risk Amyloid Asian population Behavioral Biological Markers Black Populations Black race Blood Vessels Brain Brain imaging COVID-19 pandemic Cerebrovascular Trauma Cerebrum Childhood Clinical Clinical Protocols Cognitive Cognitive aging Cohort Studies Community Health Consent Data Data Collection Data Linkages Dementia Development Discrimination Disparity Education Elderly Enrollment Epidemiologic Methods Ethnic Origin Ethnic Population Exposure to Face Family member Female Future Goals Health Heterogeneity Image Impaired cognition Incidence Individual Infrastructure Investigation Latino Latino Population Life Life Cycle Stages Life Experience Life Style Longitudinal cohort Magnetic Resonance Imaging Measures Medical Medical Records Mothers Nerve Degeneration Outcome Outcome Study Participant Pathology Phase Population Heterogeneity Positioning Attribute Positron-Emission Tomography Prevalence Psychometrics Public Health Recording of previous events Reporting Research Risk Risk Reduction Role Security Sex Differences Stress Time United States Visit Woman aged aging brain cardiovascular risk factor checkup examination childhood adversity clinical phenotype cognitive change cohort comorbidity disparity reduction early onset ethnic disparity ethnoracial experience health disparity healthy aging high risk high school interest lifetime risk men middle age mild cognitive impairment mortality neuroimaging neuroimaging marker neuropathology predictive marker programs prospective psychosocial racial disparity racial diversity racial population recruit vascular injury β-amyloid burden

项目摘要

The KHANDLE (Kaiser Healthy Aging and Diverse Life Experiences [2R01AG052132-06] Study initiated in 2017 is a lifecourse cohort study of disparities in cognitive ageing and Alzheimer's disease and related dementias (ADRD) in diverse elderly individuals. KHANDLE is one of the largest lifecourse cohorts with diverse racial/ethnic composition and prospective clinical, lifestyle, and behavioral data from 1964 -present. In Cycle 1, we enrolled 1712 individuals aged 65+ (mean age 76, range 65-103; 60% female) with representation of Blacks, Asians, Latinos, and Whites and 3 assessment waves. We have completed 2 assessment waves, and Wave 3 will finish May 2021. All waves include comprehensive, psychometrically sophisticated cognitive outcomes, psychosocial measures such as discrimination, stress, residential history, a robust clinical protocol to assess prevalent and incident mild cognitive impairment (MCI) and ADRD and a 25% subsample with amyloid PET and MRI imaging. KHANDLE participants encompasses an array of life experiences; 25% born outside the US, 63% with mothers ≤ high school education, 28% reporting financial problems in childhood, 17% born in Southern States, and 24.8% cognitive impairment at baseline. In this competitive renewal we extend our studies to investigate lifecourse factors related to cognitive trajectories, brain imaging changes, and brain donation based neuropathology with a new focus on sex differences. We will continue investigations of incident ADRD, MCI, vascular brain injury changes and amyloid PET taking advantage of imaging in Cycle 1 and repeating in Cycle 2. We will enhance KHANDLE with recruitment of 500 new individuals from diverse backgrounds and will investigate sex differences leveraging retrospective data to account for selective survival. KHANDLE is uniquely positioned to address timing of lifecourse exposures and the spectrum of cognitive and cerebropathological aging in a diverse cohort with increased ADRD incidence and cognitive changes in the next 5 years (mean age 81 at start of Cycle 2). Our aims are: Aim 1: Evaluate how life experiences, early- midlife health and development of comorbidities influence ADRD incidence and cognitive trajectories over 9 years. We will use a diverse cohort to evaluate timing of cumulative exposures and will address racial/ethnic group differences. Aim 2: Examine how lifecourse health impacts amyloid PET and structural MRI changes and how neuroimaging biomarkers predict cognitive decline in diverse elderly. Aim 3: Investigate sex differences in ADRD incidence and cognitive decline in a diverse cohort while investigating the role of selective survival and competing risk of vascular mortality. Aim 4: Initiate a brain donation program for KHANDLE, characterize the spectrum of neuropathology in a diverse cohort and evaluate predictors of interest, consent, and participation. Findings from KHANDLE Cycle 2 will uncover mechanisms for reducing disparities in ADRD and cognitive aging.

Khandle（Kaiser健康衰老和多样化的生活经历[2R01AG052132-06]于2017年启动的研究IS 生命阶段的同类研究研究认知衰老和阿尔茨海默氏病和相关痴呆症（ADRD）的差异研究多元化的老年人。 Khandle是最大的生命式人群，具有潜水员种族/种族组成， 1964年的前瞻性临床，生活方式和行为数据。在周期1中，我们招募了1712个年龄在65岁以上的人（平均年龄76岁，范围65-103; 60％女性）与黑人，亚洲人，拉丁裔和白人的代表以及3个评估波浪。我们已经完成了2个评估波，第3波将完成2021年5月。所有波都包括综合，精神法法上复杂的认知结果，歧视，压力等心理社会措施，居民历史，是一种稳健的临床方案，用于评估普遍和事件的轻度认知障碍（MCI）和ADRD和25％淀粉样蛋白宠物和MRI成像的子样本。 Khandle参与者涵盖了一系列生活经历； 25％出生于美国以外的人，有63％的母亲≤高中教育，有28％的童年报告财务问题，17％出生于南部各州，基线时的认知障碍为24.8％。在这种竞争性更新中，我们将研究扩展到研究与认知轨迹，大脑成像变化和基于大脑捐赠有关的生命力因素神经病理学，新的重点是性别差异。我们将继续调查事件ADRD，MCI，血管脑损伤变化，淀粉样蛋白宠物利用成像在周期1中，并在周期2中重复。我们将增强 Khandle与来自潜水员背景的500名新个人的招募，并将调查性别差异利用回顾性数据来说明选择性生存。 khandle是独特的定位，可以解决生命的暴露以及在潜水员队列中的认知和脑病学衰老的范围随着增加而增加未来5年的ADRD发病率和认知变化（第2周期开始时平均81岁）。我们的目标是：目标1：评估生活经验，早期生活健康和合并症的发展如何影响ADRD发病率和认知轨迹9年。我们将使用潜水员队列评估累积暴露时间，并将解决种族/族裔差异。目标2：检查生命力健康如何影响淀粉样蛋白宠物和结构性MRI 变化以及神经影像学如何预测潜水员的认知能力下降。目标3：调查性别差异在研究选择性生存和竞争血管死亡的风险。 AIM 4：为Khandle启动大脑捐赠计划，表征频谱在多样性队列中的神经病理学和感兴趣，同意和参与的评估预测指标。来自 Khandle周期2将发现减少ADRD和认知衰老差异的机制。

项目成果

期刊论文数量（27）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Lifecourse socioeconomic changes and late-life cognition in a cohort of U.S.-born and U.S. immigrants: findings from the KHANDLE study.

DOI：
10.1186/s12889-021-10976-6
发表时间：
2021-05-13
期刊：
BMC public health
影响因子：
4.5
作者：
Peterson RL;George KM;Gilsanz P;Mayeda ER;Glymour MM;Meyer OL;Mungas DM;DeCarli C;Whitmer RA
通讯作者：
Whitmer RA

Association of Early Adulthood Hypertension and Blood Pressure Change With Late-Life Neuroimaging Biomarkers.

DOI：
10.1001/jamanetworkopen.2023.6431
发表时间：
2023-04-03
期刊：
JAMA NETWORK OPEN
影响因子：
13.8
作者：
George, Kristen M.;Maillard, Pauline;Gilsanz, Paola;Fletcher, Evan;Peterson, Rachel L.;Fong, Joseph;Mayeda, Elizabeth Rose;Mungas, Dan M.;Barnes, Lisa L.;Glymour, M. Maria;DeCarli, Charles;Whitmer, Rachel A.
通讯作者：
Whitmer, Rachel A.

Rural residence across the life course and late-life cognitive decline in KHANDLE: A causal inference study.

DOI：
10.1002/dad2.12399
发表时间：
2023-01
期刊：
Alzheimer's & dementia (Amsterdam, Netherlands)
影响因子：
0
作者：
通讯作者：

The role of nativity in heterogeneous dementia incidence in a large cohort of three Asian American groups and white older adults in California.

DOI：
10.1002/alz.12563
发表时间：
2022-08
期刊：
ALZHEIMERS & DEMENTIA
影响因子：
14
作者：
Hayes-Larson, Eleanor;Fong, Joseph;Mobley, Taylor M.;Gilsanz, Paola;Whitmer, Rachel A.;Gee, Gilbert C.;Brookmeyer, Ron;Mayeda, Elizabeth Rose
通讯作者：
Mayeda, Elizabeth Rose

Neuropathology Studies of Dementia in US Persons other than Non-Hispanic Whites.