Risk Factors for Cognitive Decline in African-Americans

非裔美国人认知能力下降的危险因素

• 批准号: 8085735
• 负责人: Lisa L Barnes
• 金额: $ 71.99万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8085735
• 关键词: Address; African American; Aging; Alleles; Alzheimer' s Disease; Apolipoprotein E; Autopsy; Biological; Brain; Cerebral Infarction; Cerebrum; Cessation of life; Chronic; Chronic Kidney Failure; Clinical; Cognition; Cognitive; Cohort Studies; Data; Dementia; Diabetes Mellitus; Discrimination; Episodic memory; Genetic; Goals; Health; Hemoglobin; Impaired cognition; Infarction; Inflammatory; Lewy Bodies; Measurement; Measures; Memory; Microscopic; Minority; Minority Groups; Neurobiology; Non-Steroidal Anti-Inflammatory Agents; Participant; Pathology; Population; Prevalence; Prevention strategy; Public Health; Race; Reporting; Risk Factors; Semantic memory; Short-Term Memory; Speed; Testing; Therapeutic Intervention; Time; Visuospatial; age related; base; brain tissue; cognitive function; cohort; cytokine; disorder prevention; indexing; innovation; interest; mild neurocognitive impairment; neocortical; neuropathology; novel therapeutic intervention; performance tests; public health relevance; racial difference; research clinical testing; research study

DESCRIPTION (provided by applicant): Cognitive decline associated with aging and Alzheimer's disease (AD) is among the most common and debilitating conditions, and poses a large and increasing public health problem. Projections indicate that the prevalence of aging-related chronic conditions is expected to increase substantially in the next decade. This will be particularly true for minority populations, especially the older African American population, which is growing at an even more rapid pace than the older White population. The Minority Aging Research Study (MARS) is a longitudinal cohort study of more than 350 older African Americans without dementia who agreed to annual clinical evaluations. During the previous project period we identified several risk factors for cognitive decline in African Americans. The overall goal of the proposed continuation is to quantify three common neuropathologic indices including Alzheimer's disease pathology, cerebral infarctions, and Lewy bodies in MARS participants, and examine their associations to cognitive function and clinical risk factors. In addition, to increase power and examine racial differences in these associations, we propose to use existing longitudinal clinical and neuropathologic data on Whites from two other ongoing cohort studies at Rush. Our Specific Aims are to: 1) examine the association of the three post-mortem neuropathologic indices to 1a: level of global cognition and five cognitive abilities, 1b: change in global cognition and five cognitive abilities; 2) examine racial differences in the associations of neuropathology to level of and change in cognitive function; 3) test the hypothesis that the APOE e4 allele is associated with increased levels of AD pathology, and the 52 allele is associated with a lower level of AD pathology in African Americans; and 4) examine the relationship of BMI to neuropathology, and test the hypothesis that BMI is more strongly associated with AD pathology in Whites than in African Americans. There is limited data on the neuropathologic basis of cognitive impairment in African Americans. Integrating post-mortem indices into a study of risk factors for cognitive decline in one of the fastest growing minority groups is highly innovative and has the potential to greatly increase understanding of the ways in which risk factors interact with neuropathology to influence cognition and racial disparities in cognitive test performance. Further, the findings could have important implications for therapeutic intervention and disease prevention. PUBLIC HEALTH RELEVANCE: This project will examine the association of Alzheimer disease pathology and other common neuropathologic indices on risk factors and change in cognitive function over time in older African Americans. An important strength of the study is that it will take advantage of the availability of detailed information on cognitive function and biological and clinical risk factors of interest from the prior project period and supplement it with quantitative postmortem measurements on more than 100 African Americans. Findings from this study are expected to provide a better understanding of the extent to which neuropathologic indices contribute to cognitive impairment in African Americans, and how pathology may interact with important risk factors to effect racial differences in cognitive function.

描述（由申请人提供）：与衰老和阿尔茨海默氏病相关的认知下降是最常见和令人衰弱的疾病之一，并带来了一个较大且不断增加的公共卫生问题。预测表明，与衰老相关的慢性病的患病率预计在未来十年内将大大增加。对于少数族裔人口，尤其是年长的非裔美国人人口，这尤其如此，这比老年白人的速度更快。少数族裔老化研究（MARS）是一项纵向队列研究，对350多名没有痴呆症的非洲裔美国人，他们同意年度临床评估。在上一个项目期间，我们确定了非洲裔美国人认知能力下降的几个危险因素。拟议的延续的总体目标是量化三个常见的神经病理学指数，包括阿尔茨海默氏病病理学，大脑梗塞和火星参与者的路易体，并检查其与认知功能和临床风险因素的关联。此外，为了增加功率并检查这些关联中的种族差异，我们建议对Rush的其他两项正在进行的队列研究的白人使用现有的纵向临床和神经病理学数据。我们的具体目的是：1）检查三个后验尸神经病理学指数与1A的关联：全球认知水平和五种认知能力，1B：全球认知和五种认知能力的变化； 2）检查神经病理学与认知功能水平和变化的关联的种族差异； 3）检验以下假设：APOE E4等位基因与AD病理水平升高有关，而52等位基因与非洲裔美国人的AD病理水平较低有关； 4）检查BMI与神经病理学的关系，并检验了以下假设：BMI与白人的AD病理相比，与非裔美国人相比，BMI与AD病理学更密切相关。非裔美国人认知障碍的神经病理基础的数据有限。将验尸指数整合到对增长最快的少数群体之一认知下降的危险因素的研究中，这是高度创新的，并且有可能极大地增加对风险因素与神经病理相互作用的方式的理解，以影响认知测试绩效中的认知和种族差异。此外，这些发现可能对治疗干预和预防疾病具有重要意义。 公共卫生相关性：该项目将研究阿尔茨海默氏病病理学和其他常见的关于风险因素的神经病理学指数以及随着时间的流逝的认知功能的变化。该研究的一个重要优势在于，它将利用上一个项目时期的认知功能以及生物学和临床风险因素的详细信息，并对100多名非裔美国人进行定量验尸测量。预计这项研究的结果将更好地理解神经病理学指数在多大程度上导致非洲裔美国人认知障碍的程度，以及病理学如何与重要危险因素相互作用以影响认知功能的种族差异。