Vascular Risk and Cognition in a Multi-ethnic Cohort

多种族人群的血管风险和认知

基本信息

批准号：
7923766
负责人：
CLINTON B WRIGHT
金额：
$ 18.02万
依托单位：
UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-01 至 2013-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7923766
关键词：
Address Affect Age Alcohol consumption Alzheimer&apos s Disease Area Biological Markers Biology Blood Blood Pressure Blood Vessels Brain Brain Diseases Brain Injuries Brain imaging C-reactive protein Chronic Kidney Failure Clinical Cognition Cognitive Communities Dementia Detection Diabetes Mellitus Disease Education Educational workshop Epidemiologist Equation Ethnic Origin Exposure to Functional disorder Heart Diseases Hispanics Homocysteine Homocystine Hypertension Image Impaired cognition Impairment Infarction Insulin Resistance Interleukin-6 Lead Linear Regressions Magnetic Resonance Imaging Measurement Measures Metabolic syndrome National Institute of Neurological Disorders and Stroke Neurologist Neuropsychological Tests Pattern Performance Peroxidases Phenotype Population Prevalence Progress Review Group Protocols documentation Public Health Publishing Race Reporting Research Research Methodology Risk Risk Factors Staging Stroke Testing Vascular Dementia Vascular Diseases White Matter Disease career cerebral atrophy cerebrovascular cohort fasting glucose inflammatory marker interest modifiable risk neuropsychological novel population based prospective receptor receptor for advanced glycation endproducts tumor white matter

项目摘要

DESCRIPTION (provided by applicant): Dr. Clinton Wright is a neurologist and epidemiologist with an interest in the effects of vascular risk factors on cognition. These relationships are poorly understood because past definitions of vascular dementia evolved from those for Alzheimer disease. The term vascular cognitive impairment has evolved to cover the wide range of effects of vascular disease on cognition, from pure forms ranging from mild dysfunction to vascular dementia, and including those mixed with degenerative causes such as Alzheimer disease. The candidate plans a career devoted to clarifying the phenotype of vascular cognitive impairment and identifying potentially modifiable risk factors. He has a special interest in multi-ethnic populations. The hypothesis of this proposal is that exposure to vascular risk factors causes distinct patterns of cognitive dysfunction depending on the type of brain injury. Clarification of the subtypes of vascular cognitive impairment as well as the identification of imaging and biological markers and potentially modifiable risk factors has been identified as a priority area by the NINDS Stroke Progress Review Group. The specific aims of the proposed research are: 1) To determine if exposure to particular vascular risk factors and inflammatory markers is related to specific cognitive domains using a sensitive battery of neuropsychological tests. Conventional and novel risk factors will include cardiac diseases, hypertension and blood pressure, diabetes, insulin resistance and the metabolic syndrome, reported alcohol consumption, total homocysteine and inflammatory markers; and 2) To determine if cerebrovascular brain damage as measured by quantitative MRI, including white matter hyperintensity volume, subclinical infarcts, subclinical microbleeds and brain atrophy are related to specific cognitive domains, adjusting for conventional and novel vascular risk factors. Linear regression using generalized estimating equations will be carried out to examine the effect of vascular risk factors and subclinical brain disease on multiple cognitive domains simultaneously to adjust for correlation among the neuropsychological tests. The detection of vascular cognitive impairment has public health implications as the number of people with early forms before frank dementia is estimated at three million in the U.S., a number equaling the prevalence of forms with dementia.

描述（由申请人提供）：克林顿·赖特（Clinton Wright）博士是一名神经科医生和流行病学家，对血管危险因素对认知的影响感兴趣。这些关系之所以很糟糕，是因为过去对血管性痴呆的定义是从阿尔茨海默氏病进化的。血管认知障碍一词已经演变为涵盖血管疾病对认知的广泛影响，从轻度功能障碍到血管性痴呆，包括与阿尔茨海默氏病等退行性原因混合的纯粹形式。候选人计划致力于阐明血管认知障碍的表型并确定潜在可修改的危险因素。他对多种族人口特别感兴趣。该提议的假设是，暴露于血管危险因素会导致不同的认知功能障碍模式，具体取决于脑损伤的类型。 NINDS Stroke Progress Review Group阐明了血管认知障碍的亚型以及对成像和生物标志物以及潜在可修改的危险因素的识别以及潜在的可修改风险因素的识别。拟议的研究的具体目的是：1）确定暴露于特定的血管危险因素和炎症标志物是否使用敏感的神经心理学测试与特定的认知领域有关。常规和新颖的危险因素将包括心脏病，高血压和血压，糖尿病，胰岛素抵抗和代谢综合征，报告的酒精消耗，总同型半胱氨酸和炎症标志物； 2）为了确定通过定量MRI测量的脑血管脑损伤（包括白质高强度量，亚临床梗塞，亚临床微生物和脑萎缩）是否与特定的认知结构域有关，并调整了常规和新的血管风险因素。将使用广义估计方程进行线性回归，以检查血管危险因素和亚临床脑疾病对多个认知领域的影响，以调整神经心理学测试之间的相关性。由于弗兰克痴呆症在美国估计有300万人的早期形式的人数，这一数字等于痴呆症的流行，因此对血管认知障碍的检测具有公共卫生的影响。