At-home computerized assessment of normal cognitive aging and age-related cognitive decline in older African Americans, Hispanics, and rural non-Hispanic whites

对老年非裔美国人、西班牙裔和农村非西班牙裔白人的正常认知衰老和与年龄相关的认知衰退进行家庭计算机化评估

• 批准号: 10606447
• 负责人: Peter Pebler
• 金额: $ 49.71万
• 依托单位: NEUROBEHAVIORAL SYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10606447
• 关键词: Address; Adult; Affect; African American; African American population; Age; Age-associated memory impairment; Alzheimer' s Disease; American; Benchmarking; Black American; Black race; COVID-19; California; Clinical Trials; Cognition; Cognitive; Cognitive aging; Consensus; Country; Data; Data Set; Dementia; Diagnosis; Diagnostic; Diagnostic and Statistical Manual of Mental Disorders; Disease; Disease Progression; Domiciles; Education; Elderly; Enrollment; Ensure; Ethnic Origin; Factor Analysis; Future; Gender; Genetic Transcription; Healthcare; Hispanic; Hispanic Americans; Hispanic Populations; Home; Impaired cognition; Individual; International; Interruption; Language; Language Tests; Learning; Manuals; Materials Testing; Measures; Medical; Methodology; Minority; Minority Access; Minority Groups; Modernization; National Institute on Aging; Neighborhoods; Neuropsychology; Not Hispanic or Latino; Participant; Patients; Pattern; Performance; Phase; Population; Population Heterogeneity; Psychometrics; Quality of Care; Questionnaires; Research; Risk; Rural; Rural Community; Sampling; Small Business Innovation Research Grant; South Texas; Speech; Statistical Methods; Statutes and Laws; Technology; Testing; Text; Training; Translations; Transportation; Underserved Population; United States; Voice; automated speech recognition; base; care burden; clinical development; cognitive function; cognitive testing; cohort; comparison group; computerized; cost; design; digital; ethnoracial minority; health disparity; hispanic community; improved; indexing; innovation; minority communities; neglect; novel therapeutics; peer; performance tests; racial and ethnic; racial and ethnic disparities; recruit; research study; response; rural dwellers; sex; suburb; symposium; testing access; theories; underserved community

Although by 2060 African Americans, Hispanics, and residents of rural communities will constitute the majority of US patients with Alzheimer’s disease (AD), these populations have long been neglected in AD research studies and clinical trials. In this large scale fast-track SBIR application, we propose to gather normative longitudinal California Cognitive Assessment Battery (CCAB) data from 300 healthy older (ages 60 to 89) individuals in each of four underserved populations: (1) African Americans: (2) English-speaking US Hispanics; (2) Spanish-speaking US Hispanics; and (4) non-Hispanic white (nHW) residents of rural communities. Participants will be recruited in California and South Texas. We will compare the results from each group with existing normative data from a primarily suburban white population. The CCAB includes 34 innovative computerized cognitive tests and questionnaires that utilize cellphone networks to enable telemedical testing in patients’ homes. CCAB test introductions and test materials are delivered with AI-enhanced text-to-speech voices and verbal responses are analyzed with consensus automatic speech recognition (CASR) with unexcelled transcription accuracy. Recruitment is facilitated and testing throughput is increased because CCAB tests are administered in participants’ homes. The CCAB has been designed to facilitate translation into other languages. Here, we will test Spanish-speaking US residents with CCAB-Español, a Spanish version of the CCAB optimized for US Spanish dialects. During Phase I, we will recruit African American and Hispanic examiners, assure that the Spanish translation of the CCAB is adapted for the US Hispanic population, and begin testing. During Phase II we will continue enrollment testing and thereafter test participants at one-year intervals to gather longitudinal norms and identify performance patterns that predict subsequent cognitive decline. Ethnoracial norms for each CCAB test will be developed using traditional analysis and supplemented with Item response theory factor analysis to improve scoring sensitivity and eliminate score bias. The acquisition of normative CCAB data will lower access barriers to neuropsychological assessment among ethnoracial minorities for six reasons: (1) At-home CCAB Testing will not be interrupted by COVID-19 lockdowns; (2) At-home CCAB testing minimizes mobility and transportation challenges; (3) CCAB-Español will address the lack of well-normed, scalable Spanish-language tests for the US Hispanic population and facilitate access to Spanish-speaking examiners; (4) CCAB telemedical testing will provide access to cognitive assessments in neglected urban and rural neighborhoods; (5) CCAB testing can reduce cost barriers to cognitive assessment by more than 70%; (6) The CCAB will reduce cultural barriers to research participation by testing participants in their familiar home surroundings and by using ethnoracially sensitive African American and Hispanic examiners.

尽管到2060年，非裔美国人，西班牙裔和农村社区的居民将构成 美国大多数阿尔茨海默氏病（AD）患者，这些人群长期以来一直在AD中被忽略 研究和临床试验。在这个大规模快速轨道SBIR应用程序中，我们建议收集 来自300个健康较老的正常纵向加利福尼亚认知评估电池（CCAB）数据（60岁 到89）四个服务不足的人群中的每个人：（1）非裔美国人：（2）说英语 西班牙裔（2）讲西班牙语的西班牙裔； （4）农村的非西班牙裔白人（NHW）居民 社区。参加者将在加利福尼亚和南德克萨斯州招募。我们将比较 每个组都有来自主要郊区白人人口的现有正常数据。 CCAB包括34个使用手机的创新计算机认知测试和问卷 网络可以在患者家中进行远程医疗测试。 CCAB测试介绍和测试材料是 用AI增强的文本到语音声音和口头回应通过共识分析 具有未删除的转录精度的自动语音识别（CASR）。准备招聘，并 由于CCAB测试是在参与者的家中进行的，因此测试吞吐量增加了。 CCAB具有 我们旨在便于翻译成其他语言。在这里，我们将测试说西班牙语的美国居民 与CCAB-ESPAñol一起，它是西班牙语方言优化的西班牙语版本。 在第一阶段，我们将招募非裔美国人和西班牙裔审查员，并确保西班牙 CCAB的翻译适用于美国西班牙裔人口，并开始测试。在第二阶段，我们将 继续注册测试，此后以一年的间隔进行测试参与者，以收集纵向规范 并确定预测随后认知能力下降的绩效模式。每个CCAB的民族规范 测试将使用传统分析开发，并补充项目响应理论因素分析 提高评分灵敏度并消除得分偏差。正常CCAB数据的获取将降低访问权限 民族少数民族之间神经心理评估的障碍，原因有六个：（1）在家CCAB COVID-19锁定将不会中断测试； （2）在家CCAB测试可最大程度地减少活动能力和 运输挑战； （3）CCAB-ESPAñol将解决缺乏良好的，可扩展的西班牙语 对美国西班牙裔人口进行测试，并促进与讲西班牙语的考试人员的接触； （4）CCAB 远程医疗测试将在被忽视的城市和粗糙社区中访问认知评估； （5）CCAB测试可以将认知评估的成本障碍降低超过70％； （6）CCAB将 通过测试参与者在熟悉的家庭环境中测试参与者的文化障碍和 通过使用民族敏感的非裔美国人和西班牙裔审查员。