Pregnancy complications and the development of Alzheimer's disease and related dementias in women in the Adult Changes in Thought study

成人思维变化研究中女性妊娠并发症以及阿尔茨海默病和相关痴呆症的发展

• 批准号: 10055554
• 负责人: Eliza C Miller
• 金额: $ 31.7万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10055554
• 关键词: Address; Adult; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Autopsy; Back; Brain; Brain Diseases; Cardiovascular system; Caring; Cerebral small vessel disease; Chronic; Clinical; Data; Data Aggregation; Databases; Dementia; Development; Diagnosis; Discipline of obstetrics; Disease; Early Intervention; Enrollment; Fetal Growth Retardation; Goals; Gynecology; Health; Healthcare Systems; Heart failure; Hospitalization; Hypertension; Image; Impaired cognition; Integrated Delivery of Health Care; Laboratories; Learning; Lesion; Life; Life Cycle Stages; Longitudinal Studies; Longitudinal cohort study; Magnetic Resonance Imaging; Measures; Medical; Medical Records; Outcome; Outpatients; Participant; Pharmacy facility; Phenotype; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Histories; Premature Birth; Prevention strategy; Primary Health Care; Recording of previous events; Records; Research; Research Personnel; Resources; Risk Factors; Running; Source; Spontaneous abortion; Stroke; Structure; System; Testing; Vascular Diseases; Visit; Vulnerable Populations; Washington; Woman; Work; adjudicate; cardiovascular risk factor; clinical development; cohort; comorbidity; early onset; effective therapy; emerging adult; experience; fetal loss; high risk; human old age (65+); interest; men; middle age; neuroimaging; neuropathology; obstetrical complication; older women; phenotypic data; pregnancy disorder; reproductive; sex; stillbirth

PROJECT SUMMARY Alzheimer's disease and its related dementias (ADRD) are diseases with extended latency periods and no effective treatments. Vascular disease from midlife is recognized as a major contributor to ADRD, and represents a promising target for early intervention. Sex-specific risk factors are of particular interest, since older women are more likely to experience ADRD onset and live more years with dementia than men. Preeclampsia (PEC) and other pregnancy complications (PC), including preterm birth, fetal growth restriction, and stillbirth, are early adulthood markers of maternal cardiovascular risk. A history of PEC has been associated with a higher risk of chronic hypertension, stroke, heart failure and cognitive impairment later in life, and a higher burden of cerebral small vessel disease (CSVD) on MRI 5 to 15 years after pregnancy in these women. However, data are lacking regarding the effects of PEC and other PC on the development of clinical ADRD and ADRD-related neuroradiological and neuropathological lesions. The Adult Changes in Thought (ACT) study has enrolled participants since 1986 and is a living, learning laboratory of aging research, set within an integrated health care delivery system in Western Washington. ACT's unique setting allows for unparalleled linkages to administrative, pharmacy, clinical laboratory, billing, and abstracted medical records data, extending back as far as 1950. In the US, ACT is unmatched in its ability to combine detailed life-course exposure data with world-class clinical dementia diagnoses, neuroradiological, and neuropathology measures. Our overall goals are to: 1) augment existing reproductive phenotypic data in the ACT study with detailed obstetric phenotyping, and 2) explore the association between mid-life PC and development of ADRD in women. This would be the first longitudinal study to explore the association of PC with clinical ADRD and related neuroradiological and neuropathological lesions in women. We will create a new, unparalleled resource for researchers to test a wide range of hypotheses regarding the effects of sex-specific exposures, from early adulthood to midlife, on ADRD in women. Identifying functional and structural ADRD-related changes in women with a history of PC could help us identify women early in life who are at risk of ADRD, and develop preventive strategies to thwart or slow the progression of cognitive decline in this vulnerable population.

项目摘要 阿尔茨海默氏病及其相关痴呆症（ADRD）是具有延长潜伏期的疾病 有效的治疗方法。来自中年的血管疾病被认为是ADRD的主要贡献者， 代表了早期干预的有希望的目标。性别特定的风险因素特别感兴趣，因为 老年女性比男性更有可能体验ADRD的发病，并且在痴呆症中生活的岁月更多。 先兆子痫（PEC）和其他妊娠并发症（PC），包括早产，胎儿生长 限制和死产是母体心血管风险的成年早期标记。 PEC的历史 与慢性高血压，中风，心力衰竭和认知障碍的风险更高有关 在生命中，在怀孕后5至15年的MRI脑部小血管疾病（CSVD）负担更高 这些女人。但是，缺乏有关PEC和其他PC对开发的影响的数据 临床ADRD和与ADRD相关的神经放射学和神经病理病变。 自1986年以来，成人的思想变化（ACT）研究已招募参与者，并且是一个生活， 衰老研究的学习实验室，位于西方的综合医疗保健提供系统中 华盛顿。 ACT的独特设置允许无与伦比的行政，药房，临床 实验室，计费和抽象的医疗记录数据，一直延伸到1950年。在美国，ACT是 将详细的生命曝光数据与世界一流的临床痴呆相结合的能力无与伦比 诊断，神经放射学和神经病理学指标。我们的总体目标是：1）增加现有 ACT研究中具有详细的产科表型的生殖表型数据，2）探索 中年PC与女性ADRD的发展之间的关联。 这将是首次探索PC与临床ADRD和相关的纵向研究 女性的神经放射学和神经病变病变。我们将为 研究人员从早期开始检验有关性别特异性暴露影响的广泛假设 在女性中，成年对中年。确定功能和结构ADRD相关的变化 有PC史的女性可以帮助我们确定有ADRD风险并发展的妇女 在这种脆弱人群中阻碍或减缓认知下降的进展的预防策略。