Socioeconomic and Cardiovascular Sources of Cross-National Variation in Cognitive Health Among Older Adults

老年人认知健康跨国差异的社会经济和心血管来源

• 批准号: 10586126
• 负责人: Alden L. Gross
• 金额: $ 49.2万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10586126
• 关键词: Accounting; Address; Aging; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Cardiovascular system; Cognitive; Cognitive aging; Collaborations; Consumption; Country; Data; Data Analyses; Dementia; Detection; Documentation; Education; Elderly; England; Funding; Goals; Health; Health and Retirement Study; Household; Hypertension; Income; India; Individual; International; Intervention; Leadership; Life; Life Cycle Stages; Measurement; Measures; Methods; Mexico; Modernization; Non-Insulin-Dependent Diabetes Mellitus; Occupations; Older Population; Outcome; Parents; Population; Prevention strategy; Productivity; Protocols documentation; Psychometrics; Recording of previous events; Research; Research Personnel; Role; Socioeconomic Factors; Socioeconomic Status; Source; South Africa; Stroke; Structure; Surveys; Testing; Time; Variant; Woman; Work; cardiovascular risk factor; cognitive function; cognitive testing; comparative; data harmonization; dementia risk; evidence base; high risk population; improved; innovation; low and middle-income countries; men; middle age; multilevel analysis; prevent; response; social; socioeconomic disparity; socioeconomics; theories; web site

PROJECT SUMMARY Although nearly 75% of global Alzheimer’s disease and related dementias (ADRD) cases will occur in lower- and middle-income countries (LMICs) by 2050, little ADRD research includes data from these regions. This is a major missed opportunity to identify individual-level and contextual influences on later-life cognitive function. Evidence from high-income countries suggests ADRD is partly attributable to socioeconomic factors, such as education, and cardiovascular factors, such as hypertension. Whether these same factors contribute to cognitive health outcomes to a similar degree in LMICs with rapidly aging populations is unknown. Comparative research across LMICs and high-income countries could help to unlock important drivers of ADRD and identify key differences between countries that could be leveraged for prevention strategies to reduce the global ADRD burden. The NIA-funded Harmonized Cognitive Assessment Protocol (HCAP) was recently introduced into the US Health and Retirement Study (HRS) and its International Partner Studies (IPS) as a comparable cross-national cognitive assessment. Critically, no work has demonstrated that HCAP data from the various countries are in fact directly comparable. Any observation of country-level differences may thus be an unknown mixture of actual differences in the distribution of cognitive function and bias attributable to incommensurate measurement. Our overarching goal is to estimate the contributions of key socioeconomic and cardiovascular ADRD risk factors to later-life cognitive function between individuals and between countries in the US HRS and IPS in South Africa, Mexico, India, and England. We have assembled HCAP and main HRS/IPS survey data on N=10,642 older adults from these five countries. To accomplish our goal, we aim to: 1) statistically harmonize HCAP measures across HRS/IPS countries using modern psychometrics to enable us to identify and address any differential item functioning of HCAP measures across countries in order to facilitate valid cross-national comparisons; 2) investigate and quantify the contributions of life course socioeconomic factors to variation in later-life cognitive function between individuals and between countries; and, 3) investigate and quantify the contributions of cardiovascular factors to variation in later-life cognitive function between individuals and between countries. Key innovations are: 1) adaptation of sophisticated psychometric methods to harmonize HCAP data across economically, socially, and culturally diverse country contexts; 2) inclusion of cross-national data to diversify and expand representation of global populations in the ADRD evidence base; and, 3) use of multi-level models to partition variance in later-life cognitive function to differences between individuals and differences between countries. We will make our harmonized data available through the established Gateway to Global Aging Data website. Our results will set the stage to identify intervention targets for high-risk individuals as well as whole populations, with the ultimate goal of preventing and/or delaying the onset of ADRD from a global perspective.

项目概要 尽管全球近 75% 的阿尔茨海默病及相关痴呆 (ADRD) 病例发生在低收入和低收入人群中 到 2050 年，中等收入国家 (LMIC) 的 ADRD 研究很少包含来自这些地区的数据。 错过了识别个人水平和背景对晚年认知功能影响的机会。 来自高收入国家的研究表明 ADRD 部分归因于社会经济因素，例如教育、 心血管因素，例如高血压，这些因素是否有助于认知健康。 人口迅速老龄化的中低收入国家是否会出现类似程度的结果尚不清楚。 中低收入国家和高收入国家可以帮助揭示 ADRD 的重要驱动因素并确定关键差异 国家之间可以利用这些资源制定预防战略，以减轻全球 ADRD 负担。 NIA 资助的协调认知评估协议 (HCAP) 最近被引入美国卫生和健康部门 退休研究（HRS）及其国际合作伙伴研究（IPS）作为可比较的跨国认知 至关重要的是，没有任何工作证明来自不同国家的 HCAP 数据实际上是直接的。 因此，任何对国家层面差异的观察都可能是实际差异的未知组合。 认知功能的分布和由于我们的总体测量不相称而产生的偏差。 目标是估计关键的社会经济和心血管 ADRD 危险因素对晚年生活的贡献 美国HRS和南非、墨西哥的IPS中个人之间和国家之间的认知功能 我们收集了来自印度和英国的 N=10,642 名老年人的 HCAP 和主要 HRS/IPS 调查数据。 为了实现我们的目标，我们的目标是： 1) 在技术上协调各个国家的 HCAP 措施。 HRS/IPS 国家/地区使用现代心理测量学使我们能够识别和解决任何差异项目 HCAP 措施在各国的运作，以促进有效的跨国比较 2) 研究并量化生命历程因素对晚年认知变化的贡献 个人之间和国家之间的职能；3) 调查并量化各方的贡献 心血管因素对个人和国家之间晚年认知功能的变化至关重要。 创新包括： 1) 采用复杂的心理测量方法来协调 HCAP 数据 2) 纳入跨国数据以实现多样化 扩大 ADRD 证据库中全球人口的代表性；3) 使用多层次模型 将晚年认知功能的差异划分为个体之间的差异和个体之间的差异 我们将通过已建立的全球老龄化数据门户提供我们的统一数据。 我们的结果将为确定高风险个人以及整体的干预目标奠定基础。 人口，最终目标是从全球角度预防和/或延迟 ADRD 的发生。