Project 1 - Cognitive Function and Dementia

项目 1 - 认知功能和痴呆症

• 批准号: 10627332
• 负责人: LISA F BERKMAN
• 金额: $ 64.43万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10627332
• 关键词: Address; Affect; Africa South of the Sahara; African; Age Years; Aging; Algorithms; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Alzheimer’s disease biomarker; Biological; Biological Markers; Birth; Blood; Calibration; Categories; Characteristics; Child; Cognition; Cognitive; Collaborations; Communities; Consensus; Country; Credentialing; Data; Dementia; Diagnosis; Education; Educational process of instructing; Elderly; Epidemiology; Generations; Glial Fibrillary Acidic Protein; Goals; Health; Health and Retirement Study; Health system; Incidence; Income; International; Linguistics; Longitudinal Studies; Magnetic Resonance Imaging; Measurement; Measures; Nerve Degeneration; Neurobehavioral Manifestations; Neurobiology; Neuropsychological Tests; Neuropsychology; Outcome; Parents; Participant; Pathway interactions; Pattern; Performance; Phenotype; Plasma; Population; Population Study; Prevalence; Prevention strategy; Protocols documentation; Psychometrics; Research; Resources; Respondent; Risk; Risk Factors; Role; Sampling; Severities; Shapes; Sister; Social Change; Social Conditions; Social Network; Social support; South Africa; South African; Surveys; Symptoms; Techniques; Translating; Validity and Reliability; Variant; Woman; Work; aging brain; aging population; blood-based biomarker; cognitive change; cognitive function; cognitive reserve; cognitive testing; cohort; data harmonization; dementia risk; diagnostic algorithm; epidemiologic data; experience; global health; informal learning; innovation; insight; life history; literacy; low and middle-income countries; magnetic resonance imaging biomarker; men; mild cognitive impairment; neuroimaging; neuropathology; novel; skills; social; social determinants; social factors; tau-1

Project 1: Cognitive Function and Dementia—Abstract The greatest impact of Alzheimer’s disease and related dementias (ADRD) is likely to be experienced in low- and middle-income countries (LMICs). Sub-Saharan Africa, in particular, is projected to encounter a dramatic increase in dementia prevalence and there is a growing need for rigorous population-based studies of ADRD in this region. Health, Aging and Dementia in South Africa: A Longitudinal Study (HAALSI) addresses core issues in dementia epidemiology in older South Africans. We implement measures harmonized with the global Health and Retirement Study (HRS) and Harmonized Cognitive Assessment Protocol (HCAP) networks to enable cross-national comparisons of dementia and its risk factors. Project 1 (Cognitive Function and Dementia) leverages our deeply phenotyped HAALSI Agincourt cohort to identify causal pathways underlying cognitive trajectories and applies well-validated neuropsychological assessments to a nationally representative sample. These data will provide the first national estimates of dementia prevalence in South Africa. We do this through tightly coordinated work across four overlapping cohorts. Our original HAALSI Agincourt cohort comprised 5059 respondents ≥40 years of age, for whom we collected three waves of data; this renewal will add two additional waves. HAALSI-HCAP Agincourt (n≈700) is an enriched subcohort that adds detailed neuropsychological testing, neuroimaging, and blood biomarkers of ADRD; this renewal adds one additional wave of HAALSI-HCAP Agincourt (wave 3). We propose to field a new, nationally representative study of 4500 men and women (plus partners) and a HAALSI-HCAP National survey (n≈624). Project 1 has 3 aims. Aim 1 focuses on characterizing the incidence and progression of mild cognitive impairment (MCI) and dementia in relation to neurodegeneration and ADRD neuropathology in the enriched Agincourt-HCAP cohort. We examine longitudinal change in magnetic resonance imaging (MRI) markers of brain aging and incorporate plasma markers of ADRD (i.e., Ab, p-tau, NfL, GFAP) to assess associations with dementia symptoms. In Aim 2, we refine and validate the HAALSI Global Cognitive Screen, HAALSI-HCAP, and HAALSI dementia algorithms for South African nationwide surveys of dementia. We collaborate with Project 4 to conduct a baseline National HAALSI-HCAP wave to generate national prevalence estimates for dementia and MCI. In Aim 3, we examine the impact of social factors, including novel indicators of educational quality and social connection on participants’ cognitive function and change trajectories. We explore informal educational experiences of special relevance in the context of rapid social changes in South Africa, including self-taught literacy and effects of children’s educational attainment on cognition in older parents. Optimizing all four cohorts (HAALSI Agincourt, HAALSI-HCAP Agincourt, HAALSI National, HAALSI-HCAP National) we identify distinct biological and social conditions that affect late-life cognitive function in South Africa. HAALSI provides rich, well-harmonized data to better understand modifiable factors in ADRD and inform global prevention strategies.

项目1：认知功能和痴呆 - 取消 阿尔茨海默氏病和相关痴呆症（ADRD）的最大影响可能是在低 - 和中等收入国家（LMIC）。特别是撒哈拉以南非洲，预计将遇到戏剧性的 痴呆症患病率的提高，并且需要对基于人群的严格研究的ADRD研究 这个区域。南非的健康，衰老和痴呆症：一项纵向研究（Haalsi）介绍了核心 南非老年人痴呆症流行病学问题。我们实施与全球协调的措施 健康与退休研究（HRS）和协调的认知评估方案（HCAP）网络 实现痴呆症及其危险因素的跨国比较。项目1（认知功能和 痴呆症）利用我们深层的表型Haalsi agincourt队列来识别因果关系 认知轨迹并将验证良好的神经心理学评估应用于全国代表 样本。这些数据将提供南非痴呆症患病率的首个全国性估计。我们这样做 通过在四个重叠的队列中紧密协调的工作。我们最初的Haalsi Agincourt队列 累积的5059名受访者≥40岁，我们为他们收集了三波数据。这个更新的意愿 添加两个额外的波。 Haalsi-Hcap Agincourt（N≈700）是一个丰富的子属菌，可添加详细信息 ADRD的神经心理学测试，神经影像学和血液生物标志物；此更新增加了一个 Haalsi-hcap agincourt的波（波3）。我们建议对4500的全国代表性研究进行实施 男性和女人（加上伴侣）和Haalsi-HCAP国家调查（N≈624）。项目1有3个目标。目标1 侧重于表征轻度认知障碍（MCI）和痴呆症的事件和进展 在富集的Agincourt-HCAP队列中，与神经变性和ADRD神经病理学有关。我们检查 磁共振成像（MRI）标记的纵向变化脑衰老并结合等离子体 ADRD的标记（即AB，P-TAU，NFL，GFAP）评估与痴呆症状的关联。在AIM 2中，我们 改进并验证Haalsi全球认知屏幕，Haalsi-Hcap和Haalsi痴呆算法 南非全国痴呆症调查。我们与项目4合作进行基线国家 Haalsi-Hcap波产生痴呆症和MCI的全国患病率估计。在AIM 3中，我们检查 社会因素的影响，包括新的教育质量和社会联系指标对 参与者的认知功能和变化轨迹。我们探索特殊的非正式教育经验 在南非快速社会变化的背景下的相关性，包括自学成才的扫盲和影响 儿童对年长父母认知的教育程度。优化所有四个队列（Haalsi Agincourt， Haalsi-Hcap Agincourt，Haalsi National，Haalsi-Hcap National）我们确定了独特的生物学和社会 影响南非晚期认知功能的条件。 Haalsi提供了丰富，饱受骚扰的数据 更好地了解ADRD中的可修改因素并为全球预防策略提供信息。