Explaining Disparities in Cognitive Function in Seniors

解释老年人认知功能的差异

• 批准号: 7617592
• 负责人: BRIAN Seth SCHWARTZ
• 金额: $ 56.83万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7617592
• 关键词: Accounting; Address; Adult; Age; Alcohols; Alleles; Anxiety; Apolipoprotein E; Baltimore; Behavioral; Blood; Blood Pressure; Blood Vessels; Brain; C-reactive protein; Cardiovascular system; Characteristics; Clinical; Cognition; Cognitive; Cohort Studies; Communities; Complex; Data Collection; Diet; Dimensions; Disease; Distal; Enrollment; Environmental Exposure; Ethnic Origin; Etiology; Evaluation; Funding; Future; Genes; Genetic; Genetic Polymorphism; Genotype; Grant; Habits; Health; High Density Lipoprotein Cholesterol; Homocysteine; Homocystine; Hydrocortisone; Hypertension; Impaired cognition; Intercellular adhesion molecule 1; Internet; Intervention; Interview; Knee bone; Knowledge; Lead; Lipids; Lung; Malignant Neoplasms; Manuscripts; Measures; Mediating; Mediation; Mediator of activation protein; Memory; Mercury; Metric; Modeling; Modification; Neighborhoods; Neurotoxins; Outcome; Participant; Performance; Persons; Phase; Physical activity; Polychlorinated Biphenyls; Prevalence; Proxy; Public Health; Race; Recording of previous events; Renal Glycosuria; Research; Risk Factors; Role; Salivary; Scientist; Serum; Social Conditions; Social Environment; Social Network; Social support; Socioeconomic Status; Stress; Study Subject; Testing; Time; Tobacco; Uncertainty; Visit; Work; aged; aging brain; cognitive function; cohort; depressive symptoms; functional status; hazard; hypothalamic-pituitary-adrenal axis; insight; interest; lead dose; longitudinal analysis; low density lipoprotein triglyceride; mild neurocognitive impairment; neurobehavioral test; novel; novel strategies; population based; prevent; psychosocial; sex; social; success; therapy development; tibia; trend

DESCRIPTION (provided by applicant): This is the first resubmission of renewal application to address new fundamental questions regarding the complex web of causes of cognitive decline. The Baltimore Memory Study is a multilevel longitudinal cohort study of the causes of cognitive decline in persons aged 50 to 70 years at enrollment. During Phase I we enrolled 1,140 subjects with diversity by sex, race/ethnicity, and SES and followed 943 (82.7%) of them to the third study visit an average (SD) of 2.5 (0.2) years later. Study subjects completed an extensive cognitive test battery at each of three study visits, and completed other health assessments and an extensive interview. We have a very broad set of measures of risk factors and potential causes, including lead in blood, patella, and tibia, blood mercury, serum PCBs, serum lipids and homocysteine, salivary cortisols across the study visit, detailed SES assessment, health-related habits (i.e., tobacco, alcohol, diet, physical activity), social networks, social support, and 10 genetic polymorphisms in 8 genes relevant to neurotoxicants, brain function, or stress. Finally, we developed a rigorous metric for assessment of the social environment in neighborhoods, termed the Neighborhood Psychosocial Hazards (NPH) scale, to evaluate how the neighborhood conditions can interact with other causes to impact cognitive function. In the first five years we have made a number of novel observations. These include that cumulative lead dose was associated with decrements in cognitive function and with amnestic mild cognitive impairment; NPH was associated with decrements in cognitive function; cortisol metrics that summarized four salivary cortisol measures across the study visit were associated with decrements in cognitive function (and this effect was worse among those with the APOE-e4 allele); NPH was associated with the cortisol metrics; and NPH modified relations of tibia lead with cognitive test scores. We now want to follow 800 subjects into Phase II, for two additional study visits over 32 months and new measures of vascular health (CRP, sICAM-1) and the HPA axis (six salivary cortisol measures). This will allow us to determine if the Phase I effects are persistent or progressive, and to examine relations among cognitive function, neurotoxicant exposures, the social environment, the HPA axis and "stress," vascular health, and aging, knowledge that will contribute to understanding etiology and mechanism and thus lead to public health and clinical interventions in the future.

描述（由申请人提供）：这是续订申请的首次重新提出，以解决有关认知能力下降的复杂原因的新基本问题。巴尔的摩记忆研究是一项多层次纵向队列研究，研究了50至70岁时认知能力下降的原因。在第一阶段，我们通过性别，种族/民族和SES招募了1,140名受试者，并随后943（82.7％）参加了第三项研究，平均（SD）为2.5（0.2）年后。研究对象在三次研究访问中的每一次完成了广泛的认知测试电池，并完成了其他健康评估和广泛的访谈。我们拥有一系列非常广泛的危险因素和潜在原因，包括血液，曲调和胫骨，血液汞，血清PCB，血清脂质和同型半胱氨酸，研究访问中的唾液皮质醇，详细的SES评估，详细的SES评估，与健康相关的HABITS（I.E.与神经毒性，脑功能或胁迫有关的基因。最后，我们开发了一个严格的指标，用于评估社区中社区的社会环境，称为社区心理危害（NPH）量表，以评估邻里条件如何与其他原因相互作用以影响认知功能。在头五年中，我们进行了许多新颖的观察结果。其中包括累积铅剂量与认知功能的降低以及柔和的轻度认知障碍有关。 NPH与认知功能的降低有关。在整个研究访问中总结了四个唾液皮质醇测量的皮质醇指标与认知功能的降低有关（在APOE-E4等位基因的患者中，这种效果较差）； NPH与皮质醇指标相关； NPH修改了胫骨与认知测试分数的关系。现在，我们想在32个月内进行另外两次研究访问以及血管健康的新措施（CRP，SICAM-1）和HPA轴（六个唾液皮质醇测量）进行两次研究。这将使我们能够确定I期效应是持久的还是渐进的，并检查认知功能，神经毒性暴露，社会环境，HPA轴和“压力”，血管健康以及衰老之间的关系，这将有助于理解病因和机制，从而导致公共卫生和未来的临床干预措施。