Epidemiology of Alzheimer's Disease and Cognition: Innovative Approaches to Global Harmonization

阿尔茨海默病的流行病学和认知：全球协调的创新方法

• 批准号: 9344783
• 负责人: LISA F BERKMAN
• 金额: $ 70.62万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9344783
• 关键词: Adult; Africa; Age; Aging; Alleles; Alzheimer disease screening; Alzheimer' s Disease; Apolipoprotein E; Assessment tool; Brain; Calibration; Cereals; Clinical; Clinical Data; Clinical assessments; Cognition; Cognitive; Cognitive aging; Collaborations; Communities; Community Health; Complement; Country; Cues; Data; Dementia; Developed Countries; Disease; Education; Educational Background; Epidemiologic Studies; Epidemiology; Evaluation; Floor; Genetic; Goals; Health; International; Interview; Interviewer; Ireland; Knowledge; Language; Lead; Longitudinal Studies; Low Income Population; Magnetic Resonance Imaging; Measurement; Measures; Medical; Medical Genetics; Methods; Modeling; Older Population; Pathway interactions; Population Heterogeneity; Prevalence; Process; Property; Protocols documentation; Proxy; Psychometrics; Research Personnel; Retirement; Risk; Sampling; Sensitivity and Specificity; Sister; South Africa; South African; Tablet Computer; Tablets; Testing; Training; United States; Universities; Validation; Variant; Walking; Woman; Writing; age related cognitive disorder; base; brain health; clinical Diagnosis; cognitive control; cognitive function; cognitive testing; cohort; conditioning; genetic analysis; health data; indexing; informant; information gathering; innovation; instrument; literacy; low and middle-income countries; low income country; men; neuroimaging; neuropsychological; next generation; novel; novel strategies; research clinical testing; response; socioeconomics

Developing sensitive and valid indicators of Alzheimer's Disease (AD), dementia and cognitive function in low literacy and low income countries is challenging and requires creative approaches to complement standard neuropsychological batteries. In this proposal, we aim to incorporate an innovative approach to assessing cognition and to validate it against standard cognitive batteries, medical and informant assessments, brain function assessed from MRI's and genetic analyses of APOE in 3 HRS sister countries: South Africa (HAALSI), United States (HRS/COG), and Ireland (TILDA). South Africa has a low literacy rate in older people, varying degrees of use of written language and different cultural cues compared to Western industrialized countries. In order to assess cognition in this setting, we assess cognitive function leveraging non-verbal and minimally numeric assessments for a range of cognitive domains. Through administration via tablets, responses are recorded and scored immediately. The tablet- based assessments will be validated in relation to the Harmonized Cognitive Assessment Protocol (HCAP) developed by HRS across HAALSI, TILDA and HRS/COG (Aim 1). Additional information from MRI's and genetic analyses increase validity. Clinical and informant interviews are added to develop an AD and dementia risk score (Aim 2). We conduct the validations and harmonization in age and education stratified samples of 300 men and women 50 -79 years old in each of the three cohorts (n=900). Novel `next generation' instruments are being developed and we now need information regarding their validity compared to standard cognitive assessments. Additional psychometric evaluation in collaboration with PITCH (R01AG051170, Jones PI) will aid in refining these measures. Developing cross-walks between these measures and other commonly used indices is of special importance in the set of sister studies related to the Health and Retirement Study where the explicit goals are to permit comparisons across countries, especially with regard to AD and dementia. TILDA and HAALSI offer specific advantages in calibration because they have had rich additional neuropsychological and health data from earlier waves across an educationally diverse older population. We have two aims in our proposal: Aim 1. To assess the validity of the Oxford based language controlled cognitive measures in relation to the HCAP measures using identical platforms for HRS/COG, TILDA and HAALSI 1.a. to evaluate content, criterion and construct validity of Oxford assessments against 1.b. to develop a refined battery of items based on the psychometric analyses 1.c. to develop a shorter and harmonized set of items that have good psychometric properties Aim 2. To develop a common dementia risk score in each country based on the additional information gathered from proxy/informants and a clinical evaluation. This risk score will be harmonized and validated.

开发阿尔茨海默病 (AD)、痴呆症和认知功能的敏感且有效的指标 识字率低和收入低的国家面临着挑战，需要创造性的方法来补充 标准神经心理学电池。在本提案中，我们的目标是采用一种创新方法 评估认知并根据标准认知电池、医疗和线人对其进行验证 3 HRS 姐妹的 APOE 评估、MRI 脑功能评估和 APOE 遗传分析 国家：南非 (HAALSI)、美国 (HRS/COG) 和爱尔兰 (TILDA)。南非的水平较低 老年人的识字率、不同程度的书面语言使用和不同的文化线索 与西方工业化国家相比。为了评估这种情况下的认知能力，我们评估 认知功能利用非语言和最低限度的数字评估来进行一系列认知 域。通过平板电脑给药，反应会被立即记录并评分。平板电脑- 基于协调认知评估协议 (HCAP) 的评估将得到验证 由 HRS 跨 HAALSI、TILDA 和 HRS/COG 开发（目标 1）。来自 MRI 的附加信息和 遗传分析提高了有效性。添加临床和知情者访谈以制定 AD 和 痴呆症风险评分（目标 2）。我们对年龄和教育程度进行分层验证和协调 三个队列各抽取 300 名 50 -79 岁的男性和女性样本 (n=900)。 新型“下一代”仪器正在开发中，我们现在需要有关其的信息 与标准认知评估相比的有效性。合作进行额外的心理测量评估 PITCH（R01AG051170，Jones PI）将有助于完善这些措施。发展人行横道 这些措施与其他常用指数之间的关系在姐妹组中特别重要 与健康和退休研究相关的研究，其明确目标是允许比较 各国之间的合作，特别是在 AD 和痴呆症方面。 TILDA 和 HAALSI 具有独特的优势 进行校准，因为他们从早期波浪中获得了丰富的额外神经心理学和健康数据 跨越受教育程度多样化的老年人口。我们的提案有两个目标： 目标 1. 评估基于牛津的语言控制认知测量的有效性 与使用相同平台的 HRS/COG、TILDA 和 HAALSI 的 HCAP 措施相关 1.a.评估牛津评估的内容、标准和构建有效性 1.b.根据心理测量分析开发一系列精致的项目 1.c.开发一套更短、更协调、具有良好心理测量特性的项目 目标 2. 根据附加信息制定每个国家共同的痴呆症风险评分 从代理人/线人那里收集并进行临床评估。该风险评分将得到协调和验证。