I3C DECADE: Disparities and Equity in Childhood Cardiovascular Exposures and Alzheimer's Dementia

I3C 十年：儿童心血管暴露和阿尔茨海默氏痴呆的差异和公平

基本信息

批准号：
10653088
负责人：
Lydia Bazzano
金额：
$ 305.12万
依托单位：
TULANE UNIVERSITY OF LOUISIANA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-01 至 2027-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10653088
关键词：
Acceleration Address Affect Age Alzheimer&apos s Disease Alzheimer&apos s disease pathology Alzheimer&apos s disease related dementia Alzheimer&apos s disease risk Biological Markers Black Populations Blood Blood Pressure Blood Vessels Cardiovascular system Child Childhood Clinical Clinical Practice Guideline Cognitive Cohort Studies Collaborations Data Data Set Development Disadvantaged Disparity Education Elderly Equity Ethnic Population Event Exposure to Factor Analysis Generations Geography Glucose Green space Growth Health Heart Impaired cognition Individual Indole-3-Carbinol International Investments Joints Knowledge Life Life Cycle Stages Lipids Longitudinal Studies Measures Metabolic National Heart, Lung, and Blood Institute National Institute on Aging Non-Insulin-Dependent Diabetes Mellitus Obesity Participant Population Postmenopause Premenopause Prevalence Prevention Process Recording of previous events Reproducibility Research Risk Factors Sampling Time United States National Institutes of Health Vascular System Weather Woman Work Youth blood-based biomarker boys brain health cardiovascular health cardiovascular risk factor clinical development cognitive performance cognitive testing cohort critical period data harmonization data resource dementia risk disease disparity effective therapy follow-up food security geographic disparity girls health data health disparity in utero indexing men middle age novel open data pollutant population based progression risk prospective public health relevance racial disparity racial population research study sex socioeconomic disadvantage socioeconomics

项目摘要

SUMMARY Risk for Alzheimer’s Disease and related dementias (ADRD) remains higher in black populations than in other race/ethnic groups.This may be due at least in part to accumulated disadvantage which accelerates the progression of cardiovascular (CV) risk factors, that in turn may contribute to the development of clinically silent Alzheimer’s pathology as early as middle age. Our team has demonstrated that exposure to CV risk factors such as obesity, elevated glucose, lipids and blood pressure can impact the vascular system by childhood and even in utero. Early vascular changes, in turn, may contribute to changes in brain health decades later. Despite documented socioeconomic and geographic disadvantages more often encountered by blacks (in, e.g., food security, green spaces, education quality, pollutants) that promote CV health disparities in childhood, there is little data examining such influences on Alzheimer’s related brain health in midlife or later. This is primarily due to limited prospectively collected, life-course data on blacks. Addressing this knowledge gap is increasingly urgent, as many more black and white children will develop adverse CV profiles now as compared to previous generations. We propose to leverage the significant NIH investment in prospectively collected data, from black and white men and women participating in the Bogalusa Heart Study (BHS), NHLBI Growth and Health Study (NGHS), and Princeton Lipid Research Study (PLRS). These unique life course studies have a strong history of collaboration and data harmonization formalized since 2009 through the international childhood CV cohort consortium (I3C), with joint follow-up of CV events since 2015. Shared exposure data include geographic, socioeconomic, and CV risk factors in childhood (from ages 3-19 years), with 40+ years of follow-up. Measuring brain health indicators in these cohorts will allow, for the first time, exploration of the impact of early life CV health disparities and antecedent disadvantages on midlife brain health in blacks and whites. In the proposed study, Disparities and Equity in Childhood CV Exposure and Alzheimer’s DEmentia (I3C DECADE), we will collect structural, functional, cognitive and blood-based indicators of ADRD-related brain health processes in mid-life (40-55 years), a period when the subtle impacts of subclinical vascular changes on brain health first begin to emerge, often several decades before ADRD become clinically evident. The PIs of these cohort studies will leverage their ongoing collaboration to build and share a novel data resource that advances open science in early life risk factors, and extends that effort to ADRD. The impact of this work will be to inform strategies that may reduce ADRD health disparities by identifying and intervening among black and white boys and girls whose CV burden places them at increased risk of ADRD decades later and has the potential to lead to changes in pediatric clinical practice guidelines. The proposed I3C DECADE Study represents a unique, and arguably the only opportunity to investigate the influence of childhood CV risk and disparities on ADRD-related brain health in the critical period of midlife.

概括黑人患阿尔茨海默病和相关痴呆症 (ADRD) 的风险仍然高于其他人群种族/族裔群体。这可能至少部分是由于累积的劣势加速了心血管（CV）危险因素的进展，反过来可能有助于临床疾病的发展我们的团队已经证明，接触心血管疾病的风险早在中年就已出现。肥胖、血糖升高、血脂和血压等因素会通过以下方式影响血管系统：童年甚至子宫内的早期血管变化反过来可能会导致大脑健康的变化。几十年后，尽管有记录的社会经济和地理劣势更经常遇到。黑人（在食品安全、绿地、教育质量、污染物等方面）加剧了CV健康差异在童年时期，几乎没有数据检验这种对中年或中年阿尔茨海默氏症相关大脑健康的影响。这主要是由于针对黑人的前瞻性收集的生命历程数据有限。知识差距日益紧迫，因为更多的黑人和白人儿童将发展出不良的简历与前几代相比，我们现在建议利用 NIH 的大量投资。前瞻性收集的数据来自参与 Bogalusa 心脏研究的黑人和白人男性和女性 (BHS)、NHLBI 生长与健康研究 (NGHS) 和普林斯顿脂质研究 (PLRS) 这些都是独一无二的。生命历程研究有着悠久的合作和数据协调历史，自 2009 年以来通过国际儿童 CV 队列联盟 (I3C)，自 2015 年以来对 CV 事件进行联合随访。共享暴露数据包括儿童时期（3-19 岁）的地理、社会经济和心血管风险因素年），通过对这些人群进行 40 多年的随访，测量大脑健康指标将首次实现这一目标。时间，探索早年CV健康差异和先行劣势对中年大脑的影响在拟议的研究中，黑人和白人的健康状况存在差异。阿尔茨海默氏痴呆（I3C DECADE），我们将收集结构、功能、认知和血液方面的信息中年（40-55岁）ADRD相关大脑健康过程的指标，这是一个微妙影响的时期亚临床血管变化对大脑健康的影响首先开始出现，通常早于 ADRD 几十年这些队列研究的 PI 将利用他们正在进行的合作来建立和实现。分享新颖的数据资源，推动早期生命风险因素的开放科学，并将这一努力扩展到这项工作的影响将是通过以下方式提供可能减少 ADRD 健康差异的策略：识别和干预那些简历负担增加的黑人和白人男孩和女孩几十年后 ADRD 的风险，并有可能导致儿科临床实践指南的变化。拟议的 I3C DECADE 研究代表了一个独特的、可以说是唯一的研究机会儿童心血管风险和中年关键时期 ADRD 相关大脑健康差异的影响。