Alzheimer's Disease and Related Dementias and Cognitive Impairment

阿尔茨海默氏病及相关痴呆症和认知障碍

• 批准号: 10188355
• 负责人: LISA F BERKMAN
• 金额: $ 14.22万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10188355
• 关键词: AIDS/HIV problem; Adult; Adverse effects; Affect; Africa; African; Age; Age-Years; Aging; Alleles; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Biological Aging; Biological Markers; Blood Vessels; Cardiometabolic Disease; Clinical; Cognition; Cognitive; Cognitive aging; Communities; Consumption; Country; Data; Dementia; Disadvantaged; Disease; Economic Factors; Economics; Education; Educational Background; Elderly; Epidemiology; Etiology; Gender; Genetic Markers; Goals; HIV; HIV antiretroviral; Health; Health and Retirement Study; Household; Hypertension; Impaired cognition; Incidence; Income; Individual; Interview; Language; Life Expectancy; Link; Longitudinal Studies; Measures; Morbidity - disease rate; Neurologic; Neuropsychology; Obesity; Pattern; Population; Prevalence; Protocols documentation; Public Health; Research; Risk; Risk Factors; Role; Schools; Sister; Social Network; South Africa; South African; Structure; Tablets; Vascular Cognitive Impairment; Vascular Diseases; Woman; age related; antiretroviral therapy; base; clinical examination; cognitive function; cognitive reserve; cognitive testing; cohort; dementia risk; design; experience; follow-up; frailty; genetic predictors; health application; health data; improved; informant; insight; low and middle-income countries; men; mild cognitive impairment; mortality; multiple chronic conditions; novel; population based; prevent; programs; protective factors; resilience; social; social engagement; socioeconomics; telomere; virtual

Project 1 Abstract The burden of age-related dementias, including Alzheimer’s disease and related dementias (ADRD), remains understudied in much of Africa, with a few notable exceptions.1-4 By 2040, an estimated 70% of the 80 million people with dementia globally will reside in low and middle income countries.5 Dementia is a particular issue for these countries, such as South Africa, where life expectancies are expected to rise dramatically.6-9 7-9 Within virtually all countries, cognitive decline has shown strong disparities with household income and educational attainment.10, 11 South Africa is no exception and the associations with low levels of education and lifelong disadvantage are substantial. Our long-term goal is to understand the epidemiologic patterns and projected public health burden of ADRD in South Africa, as well as to identify factors that either reduce or increase ADRD risk. With this renewal application for the Health and Aging in Africa: Longitudinal Studies of an INDEPTH Community (HAALSI) Program, we propose to take a major step towards this goal by conducting longitudinal cognitive and dementia-related assessments in HAALSI , a population-based community cohort of adults ≥40 years of age. Project 1 is integrated with Projects 2 (Cardiometabolic Disease) and 3 (HIV) to optimize goals. We have cognitive measures harmonized with the Health and Retirement Study and sister studies for the HAALSI cohort of 5,059 adults ≥40 years of age. We propose the following aims: AIM 1: Obtain information on the incidence and prevalence of ADRD as well as mild cognitive impairment (MCI). By year 05, we will have three cognitive assessments over three waves with six years of longitudinal information on cognitive function, mortality follow-up and clinical and informant assessments. These data will permit us to (1A) identify rates of all-cause dementia and MCI; and (1B) evaluate impacts of vascular conditions and HIV on all-cause dementia and MCI and calculate attributable risk. To accomplish this, we will use information from our neuropsychological batteries, clinical examination, and biomarkers of risk related to HIV, antiretroviral therapy (ART), and vascular disorders. AIM 2: Identify social and economic risk and resilience factors affecting cognitive decline and ADRD. We hypothesize that educational attainment and social networks help older adults maintain high cognitive functioning as they age (cognitive reserve).12-16 We determine whether social engagement drawn from network structures protects against decline.12, 17-24 We examine moderating conditions related to gender and age. AIM 3: Evaluate associations of Apoliprotein E (APOE) and markers of biological aging related to telomeres with cognitive decline and ADRD. In a subsample of 2,000 we will investigate the role of these genetic markers and ADRD and identify risks and interactions with educational attainment and ADRD.

项目1摘要 与年龄相关的痴呆症的负担，包括阿尔茨海默病和相关痴呆症（ADRD）， 除少数明显例外外，非洲大部分地区仍没有得到充分研究。1-4 到 2040 年，估计 80 个国家中的 70% 全球 100 万痴呆症患者将居住在低收入和中等收入国家。5 痴呆症是一种特殊的疾病 这些国家面临的问题，例如南非，这些国家的预期寿命预计将大幅提高。6-9 7-9 在几乎所有国家中，认知能力下降都与家庭收入和家庭收入存在巨大差异。 10, 11 南非也不例外，教育水平低和 我们的长期目标是了解流行病学模式和 预计南非 ADRD 的公共卫生负担，并确定可减少的因素 或增加 ADRD 风险。 根据 INDEPTH 社区 (HAALSI) 计划，我们建议朝着这一目标迈出重要一步： 在 HAALSI 中进行纵向认知和痴呆相关评估 项目 1 与项目 2（心脏代谢疾病）相结合。 3（艾滋病毒）以优化目标。我们有与健康和退休研究相协调的认知措施。 以及针对 5,059 名 40 岁以上成年人的 HAALSI 队列的姐妹研究，我们提出以下目标： 目标 1：获取 ADRD 的发病率和患病率以及轻度认知障碍的信息 到 05 年，我们将在六年内分三轮进行三项认知评估。 有关认知功能、死亡率随访以及临床和信息评估的纵向信息。 这些数据将使我们能够 (1A) 确定全因痴呆和 MCI 的发生率；以及 (1B) 评估以下因素的影响： 血管状况和 HIV 对全因痴呆和 MCI 的影响，并计算可归因的风险。 我们将使用来自神经心理学电池、临床检查和风险生物标志物的信息 与 HIV、抗逆转录病毒治疗 (ART) 和血管疾病有关。 目标 2：确定影响认知能力下降和 ADRD 的社会和经济风险和复原力因素。 我们越来越认为教育程度和社交网络有助于老年人保持高认知能力 随着年龄的增长（认知储备）。12-16 我们确定社交参与是否来自网络 结构可以防止衰退。12, 17-24 我们研究了与性别和年龄相关的调节条件。 目标 3：评估载脂蛋白 E (APOE) 与生物衰老相关标志物的关联 我们将在 2,000 个子样本中研究端粒与认知能力下降和 ADRD 的作用。 遗传标记和 ADRD，并识别风险以及与教育程度和 ADRD 的相互作用。