Hypertensive Disorders of Pregnancy and Subsequent Risk of Vascular Dementia, Alzheimer's Disease, or Related Dementia: A Retrospective Cohort Study Taking into Account Mid-Life Mediating Factors.

妊娠期高血压疾病和随后的血管性痴呆、阿尔茨海默氏病或​​相关痴呆的风险：一项考虑中年中介因素的回顾性队列研究。

• 批准号: 9892855
• 负责人: Karen C. Schliep
• 金额: $ 12.42万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9892855
• 关键词: Affect; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease care; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; Applications Grants; Area; Award; Blood Vessels; Chronic Disease; Classification; Clinical; Cognitive; Cohort Studies; County; Data; Data Analyses; Data Set; Databases; Dementia; Diagnosis; Disease; Eclampsia; Elderly; Epidemiology; Etiology; Family; Fertility; Fostering; Frontotemporal Dementia; Future; Goals; Gold; Health; Health Status; Image; Individual; Inflammatory; International; Intervention; Knowledge; Lead; Lewy Body Dementia; Life Cycle Stages; Life course epidemiology; Link; Longevity; Machine Learning; Maternal-fetal medicine; Mediating; Medical; Medical Records; Memory; Menopause; Mental Depression; Mentored Research Scientist Development Award; Mentors; Methods; Modeling; Neurologic; Neurological outcome; Neurologist; Neuropsychology; Outcome; Patients; Population; Population Database; Population Research; Population Study; Positioning Attribute; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Prevalence; Principal Investigator; Psychosocial Factor; Public Health; Recording of previous events; Records; Reproductive Health; Research; Research Methodology; Research Personnel; Retrospective Studies; Retrospective cohort study; Risk; Risk Factors; Sensitivity and Specificity; Sex Differences; Social Environment; Testing; Training; Universities; Utah; Validation; Vascular Dementia; Woman; Women' s Health; administrative database; aging population; base; biomedical informatics; career; clinical diagnostics; cohort; comorbidity; cost; dementia risk; epidemiology study; experience; family genetics; health assessment; health difference; high risk; hypertension treatment; improved; improved outcome; lifetime risk; men; middle age; mortality risk; normotensive; novel; population based; predictive modeling; pregnancy disorder; pregnancy hypertension; prevent; professor; programs; prospective; reproductive; sex; skills; sociodemographics

PROJECT SUMMARY/ABSTRACT This is an application for a K01 award for Dr. Karen Schliep, a tenure-line Assistant Professor of Public Health at the University of Utah. Dr. Schliep is establishing herself as a young investigator in women’s life-course epidemiology, specifically in a novel area of aging research—to improve our understanding of women’s increased risk of Alzheimer’s disease (AD) and related dementias (RD) and create women-specific interventions to mitigate risk and improve outcomes. This award will allow Dr. Schliep to achieve her goal of research independence by providing her support to accomplish the following training aims: 1) develop expertise in biomedical informatics and population-based research methods; 2) gain experience in the conduction of clinical cognitive health assessments; 3) enhance knowledge of modifiable factors affecting women’s mid- and late-life cognitive health; and 4) expand skills to independently lead and manage a successful research program. Dr. Schliep has assembled a mentoring team comprising a primary mentor, Dr. Michael Varner, an obstetrician and nationally renowned maternal-fetal medicine investigator with expertise in pregnancy complications including hypertensive disorders of pregnancy (HDP), and two co-mentors: Dr. Norman Foster, a cognitive neurologist and geriatric neurologist and recognized leader in dementia research, and Dr. Ken Smith, an internationally known expert in population-based analyses and genetic/family epidemiology. Dr. Schliep has five advisors with expertise in classification modeling, ADRD neuropsychology, mid-life women’s health, longitudinal and survival data analysis, and chronic disease epidemiology. Little is known regarding the association between HDP, estimated to complicate 2–8% of all pregnancies, and long-term adverse maternal neurological outcomes with similar inflammatory vascular etiologies, including ADRD. An estimated 5.4 million Americans currently suffer from ADRD, two-thirds of whom are women. As the US aging population increases, prevalence of dementia is expected to approach 13.2 to 16.0 million cases by 2050. Why ADRD disproportionately affects women is not known. Dr. Schliep’s research objective is to develop classification models for the various dementia subtypes (including AD, vascular dementia, Lewy body dementia, and frontotemporal dementia) to analyze longitudinal, individual-level data to better understand how HDP may increase a woman’s risk for ADRD. Dr. Schliep will accomplish this through the following research aims: 1) increase accuracy of ADRD diagnoses within health administrative databases; and 2) investigate the association between HDP and ADRD, and mid-life mediating factors. The proposal’s expected outcomes include 1) a novel method to accurately capture dementia cases within large linked health administrative databases; 2) clarity on how HDP may be linked with specific dementia subtypes; and 3) skills, experience, and preliminary data for Dr. Schliep to support future studies identifying other sex-specific risk factors for dementia and mediating factors amenable to interventions.

项目概要/摘要 这是公共卫生系终身教授助理教授 Karen Schliep 博士的 K01 奖申请 犹他大学的施利普博士正在将自己定位为女性生命历程的年轻研究者。 流行病学，特别是在衰老研究的一个新领域——提高我们对女性健康状况的了解 阿尔茨海默病 (AD) 和相关痴呆症 (RD) 的风险增加，并创造了女性特有的症状 该奖项将使 Schliep 博士能够实现她的目标： 通过提供支持来实现以下培训目标，以实现研究独立性：1）发展 生物医学信息学和基于人群的研究方法方面的专业知识；2）获得以下方面的经验： 进行临床认知健康评估；3）增强对影响可改变因素的了解； 女性中晚年的认知健康；4) 拓展独立领导和管理的技能 Schliep 博士组建了一个由主要导师 Dr. 组成的指导团队。 迈克尔·瓦尔纳 (Michael Varner) 是一位产科医生和全国知名的母胎医学研究者，在 妊娠并发症，包括妊娠期高血压疾病 (HDP)，以及两位共同导师：Dr. 诺曼·福斯特（Norman Foster）是一位认知神经学家和老年神经学家，也是痴呆症研究领域公认的领导者， 肯·史密斯博士是国际知名的人口分析和遗传/家庭专家 Schliep 博士有五位在分类模型、ADRD 神经心理学、 中年女性健康、纵向和生存数据分析以及慢性病流行病学。 人们对 HDP 之间的关系知之甚少，HDP 估计会使 2-8% 的妊娠变得复杂， 以及具有类似炎症血管病因的长期不良产妇神经系统结果，包括 据估计，目前有 540 万美国人患有 ADRD，其中三分之二是女性。 美国人口老龄化加剧，痴呆症患病率预计到 2020 年将接近 13.2 至 1600 万例 2050. Schliep 博士的研究目标是开发为何 ADRD 对女性影响更大，这一点尚不清楚。 各种痴呆亚型的分类模型（包括 AD、血管性痴呆、路易体痴呆 痴呆和额颞叶痴呆）来分析纵向、个体层面的数据，以更好地了解如何 HDP 可能会增加女性患 ADRD 的风险。Schliep 博士将通过以下研究来实现这一目标。 目标：1) 提高卫生管理数据库中 ADRD 诊断的准确性；2) 调查 HDP 和 ADRD 之间的关联以及中年中介因素该提案的预期结果。 包括 1) 一种在大型关联卫生管理机构中准确捕获痴呆病例的新方法 数据库；2) 明确 HDP 如何与特定痴呆亚型联系起来；以及 3) 技能、经验、 以及 Schliep 博士的初步数据，以支持未来的研究，以确定其他性别特异性风险因素 痴呆和适合干预的中介因素。