Leveraging the Electronic Health Record and Integrating Social and Biological Data to Expand Dementia Research in Understudied Populations in Los Angeles County

利用电子健康记录并整合社会和生物数据，扩大洛杉矶县未受研究人群的痴呆症研究

• 批准号: 10729950
• 负责人: Keith Alan Vossel
• 金额: $ 54.98万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10729950
• 关键词: Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Asian Americans; Behavior Therapy; Biological; Biological Markers; Black American; Black race; Blood; Caring; Clinical; Cognitive deficits; Communities; County; Data; Dementia; Diagnosis; Disease; Education and Outreach; Electronic Health Record; Enrollment; Environmental Risk Factor; Funding; Genetic; Genomics; Goals; Health; Health system; Heterogeneity; Hispanic; Individual; Infrastructure; Latinx; Link; Los Angeles; Neurobiology; Pacific Islander; Patient Recruitments; Phase; Population; Population Heterogeneity; Primary Care; Request for Proposals; Research; Research Infrastructure; Risk; Risk Factors; Site; Syndrome; United States; Work; cohort; comorbidity; design; disability; effective therapy; endophenotype; genomic data; improved; innovation; mortality; multidisciplinary; neuroimaging; neurophysiology; primary care clinic; programs; recruit; screening; social; social culture; social health determinants; tool

PROJECT SUMMARY This proposal requests UH2/UH3 funding to build a collaborative research program to study Alzheimer’s disease (AD) and AD related dementias (ADRD) in diverse populations through the UCLA Health System in Los Angeles County. This program is led by a multi-disciplinary team with expertise in AD/ADRD clinical and neurobiological (PI Vossel, Co-I Chang); social and environmental (PI Mayeda); sociocultural (Co-I Díaz-Santos, Adrissi); and genomic (Co-I Chang, Deters) research. The program is based in the Mary S. Easton Center for Alzheimer’s Research and Care (Director Vossel), which has robust ties with greater L.A. communities and ongoing education and outreach activities. AD and ADRD comprise syndromes with a spectrum of environmental, social, genomic, and clinical mechanisms. To improve our understanding of the heterogeneity of AD/ADRD, individuals from all groups, including traditionally understudied groups, must be studied. The UCLA Health System serves one of the largest Hispanic/Latinx (HL), Black, and Asian American/Pacific Islander (AAPI) populations in the United States. Traditional AD/ADRD recruitment of these understudied populations has been challenging. Leveraging electronic health records (EHR) tools to recruit understudied populations and analyzing routinely collected EHR data would lower the barrier to entry. Our objective is to recruit HL, Black, and AAPI AD/ADRD cohorts via EHR tools and partnerships with primary care clinics and communities. Next, we will evaluate recruitment efficiency of EHR tools and partnerships, followed by augmentation of EHR with social determinants of health (SDOH), genetic, blood biomarker, neuroimaging, and neurophysiology data to study mechanisms of AD/ADRD in these understudied populations. Our long-term goal is to develop and scale an EHR-linked AD/ADRD research infrastructure in L.A. County through UCLA Health’s network sites, allowing integration of SDOH, neurobiological and genomic data. We will improve recruitment and retention of understudied ADRD populations in research by enrolling 160 HL, 160 Black, and 100 AAPI AD/ADRD individuals and controls. In preliminary work, our team has integrated dementia screening in the EHR to improve AD and ADRD diagnosis in primary care and studied genomic, social, and environmental risk factors of AD and ADRD from the EHR. During the UH2 phase we will 1) utilize EHR tools in HL, Black, and AAPI AD/ADRD participant recruitment, 2) engage HL, Black, and AAPI community partners to improve study recruitment and design, and 3) share clinical, social, and genomic data on NIA-supported infrastructures. During the UH3 phase we will 4) evaluate dementia screening and EHR tools on AD and ADRD recruitment in HL, Black, and AAPI individuals, 5) identify AD endophenotypes from social determinants of health, blood biomarker, neurophysiologic, and comorbidity factors in HL, Black and AAPI individuals, and 6) predict AD among HL, Black, and AAPI individuals using polygenic risk, SDOH, and comorbidities. This innovative program will support our goal is to discover personalized risk factors that will yield early behavioral interventions and precise therapies.

项目概要 该提案请求 UH2/UH3 资助建立一个合作研究项目来研究阿尔茨海默病 通过洛杉矶加州大学洛杉矶分校医疗系统在不同人群中治疗 AD 和 AD 相关痴呆症 (ADRD) 该项目由具有 AD/ADRD 临床和神经生物学专业知识的多学科团队领导。 （PI Vossel、Co-I Chang）；社会和环境（PI Mayeda）； 基因组（Co-I Chang，Deters）研究该项目基于玛丽·S·伊斯顿阿尔茨海默病中心。 研究与护理（Vossel 总监），与更大的洛杉矶社区有着密切的联系，并且正在进行 AD 和 ADRD 包括一系列环境、社会、 为了提高我们对 AD/ADRD 个体异质性的理解。 必须对所有群体（包括传统上研究不足的群体）进行研究。 世界上最大的西班牙裔/拉丁裔 (HL)、黑人和亚裔美国人/太平洋岛民 (AAPI) 人口之一 美国。对这些被研究人群进行传统的 AD/ADRD 招募一直具有挑战性。 利用电子健康记录 (EHR) 工具招募未充分研究的人群并进行常规分析 收集的 EHR 数据将降低进入门槛，我们的目标是招募 HL、黑人和 AAPI AD/ADRD。 接下来，我们将通过 EHR 工具以及与初级保健诊所和社区的合作来评估队列。 电子病历工具和伙伴关系的招聘效率，然后通过社会决定因素增强电子病历 健康 (SDOH)、遗传、血液生物标志物、神经影像学和神经生理学数据来研究机制 我们的长期目标是开发和扩展与 EHR 相关的 AD/ADRD。 通过 UCLA Health 的网络站点在洛杉矶县建立 AD/ADRD 研究基础设施，允许整合 SDOH、神经生物学和基因组数据我们将改善正在研究的 ADRD 的招募和保留。 通过招募 160 名 HL、160 名黑人和 100 名 AAPI AD/ADRD 个体和对照来进行研究。 前期工作中，我们的团队已将痴呆症筛查纳入 EHR，以改善 AD 和 ADRD 诊断 从事初级保健工作，并通过 EHR 研究了 AD 和 ADRD 的基因组、社会和环境风险因素。 在 UH2 阶段，我们将 1) 在 HL、黑人和 AAPI AD/ADRD 参与者招募中使用 EHR 工具，2) 让 HL、黑人和 AAPI 社区合作伙伴参与改进研究招募和设计，以及 3) 分享临床、 NIA 支持的基础设施上的社会和基因组数据 在 UH3 阶段，我们将 4) 评估痴呆症。 针对 HL、黑人和 AAPI 个体 AD 和 ADRD 招募的筛查和 EHR 工具，5) 识别 AD 来自健康社会决定因素、血液生物标志物、神经生理学和共病因素的内表型 在 HL、黑人和 AAPI 个体中，6) 使用多基因预测 HL、黑人和 AAPI 个体中的 AD 这一创新计划将支持我们发现个性化风险的目标。 将产生早期行为干预和精确治疗的因素。