Leveraging Longitudinal Data and Informatics Technology to Understand the Role of Bilingualism in Cognitive Resilience, Aging and Dementia

利用纵向数据和信息学技术了解双语在认知弹性、衰老和痴呆中的作用

• 批准号: 10583170
• 负责人: HUA XU
• 金额: $ 141.18万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-15 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10583170
• 关键词: Address; Adult; Affect; Age; Age of Onset; Age-associated memory impairment; Aging; Algorithms; Alzheimer' s disease related dementia; American; Behavioral; Boston; California; Characteristics; Clinical; Cognition; Cognitive; Complex; Computing Methodologies; Confounding Factors (Epidemiology); Data; Dementia; Discipline; Education; Elderly; Electronic Health Record; Electronics; Environment; Face; Future; Generations; Geography; Health; Health Care Costs; Health Sciences; Health Services Research; Health system; Healthcare Systems; Immigrant; Impaired cognition; Individual; Informatics; Institution; Intervention; Investigation; Knowledge; Language; Life; Life Style; Longitudinal Surveys; Machine Learning; Maps; Measures; Methods; Morbidity - disease rate; Natural Language Processing; Nature; Needs Assessment; Neurologic; Neurology; Neuropsychology; Outcome; Pathway interactions; Patient Recruitments; Patients; Phenotype; Physical activity; Population; Population Heterogeneity; Prevention; Process; Prospective Studies; Prospective, cohort study; Psychiatry; Psychology; Quality of life; Registries; Reproducibility; Research; Research Support; Role; Sample Size; Site; Social support; Standardization; Stress; Surveys; Technology; Testing; Texas; Text; Time; Translating; US State; Universities; Work; age related; age related cognitive change; age related neurodegeneration; aging population; bilingualism; brain health; case finding; cognitive change; cognitive enhancement; cognitive function; cognitive process; cognitive reserve; cohort; comorbidity; coping; cost; design; disability; disorder prevention; electronic health record system; electronic structure; ethnic diversity; experience; health care delivery; improved; innovation; insight; instrument; interdisciplinary approach; machine learning algorithm; neural; novel; novel therapeutic intervention; observational cohort study; primary outcome; protective factors; psychologic; racial diversity; recruit; resilience; screening; social; social health determinants; statistics; theories; time use; tool

Project Summary Alzheimer’s Disease and Related Dementias (ADRD) along with other age-related neurodegenerative diseases contribute to significant morbidity and costs for the aging population worldwide. Advances in this field have uncovered that bilingualism is a protective factor that delays onset of ADRD and may enhance cognitive reserve. Still, little is clearly known about the direct impact of bilingualism on cognitive reserve and ADRD progression; multiple, entangled confounding variables, such as lifestyle and psychological resilience, complicate the relationship between bilingualism and cognition and warrant further investigation. Other major shortcomings in previous studies include small sample size, lack of population diversity and insufficient data on relevant covariates. We aim to address these critical gaps via the following specific aims. In Aim 1, we will leverage advanced informatics and longitudinal electronic health records (EHRs) from millions of patients across three geographically and demographically diverse sites (i.e., MGB [Boston, MA], UTHealth [Houston, TX], and UC Davis [Sacramento, CA]). We will develop robust algorithms to identify potential monolingual and bilingual cohorts and their phenotypes. We will disseminate reproducible informatics methods to support research cross-institutionally. In Aim 2, we will conduct a prospective cohort study to evaluate the dynamic cognitive changes in monolingual and bilingual older adults. We will explore potential pathways by which bilingualism impacts cognitive decline over time using comprehensive instruments and surveys to repeatedly measure cognitive resilience, cognitive reserve, and related factors, including social support, psychological resilience, and physical activity. In Aim 3, we will develop and validate machine learning algorithms to identify onset of age-related cognitive decline and dementia using EHR data. We will apply the validated language classifier for all participating EHR systems to examine the role of bilingualism in relation to the progression of cognitive decline and the effect of other factors recorded in EHR data. By integrating multiple disciplines to explore the influence of bilingualism on cognitive reserve, this proposed design will address major gaps and challenges in this field. Such research has the potential to transform the current understanding of neural and behavioral pathways in relation to language, culture, and environment. Furthermore, the knowledge gained may translate to improvements in existing interventions and novel therapeutic approaches for ADRD.

项目概要 阿尔茨海默病和相关痴呆症 (ADRD) 以及其他与年龄相关的疾病 神经退行性疾病导致人口老龄化的严重发病率和成本 世界范围内这一领域的进展表明，双语是一个保护因素。 延迟 ADRD 的发生并可能增强认知储备 尽管如此，人们对这种现象知之甚少。 双语对认知储备和 ADRD 进展的直接影响； 生活方式和心理弹性等混杂变量使关系变得复杂 双语和认知之间的关系以及其他重大缺陷值得进一步研究。 以往的研究存在样本量小、人口多样性缺乏以及数据不足等问题。 我们的目标是通过以下具体目标来解决这些关键差距。 在目标 1 中，我们将利用先进的信息学和纵向电子健康记录 (EHR) 来自三个地理和人口统计不同地点的数百万患者（即 MGB [波士顿，马萨诸塞州]、UTHealth [休斯顿，德克萨斯州] 和加州大学戴维斯分校 [萨克拉门托，加利福尼亚州]）我们将发展稳健。 我们将使用算法来识别潜在的单语和双语群体及其表型。 传播可重复的信息学方法以支持跨机构研究。 在目标 2 中，我们将进行前瞻性队列研究来评估动态认知变化 我们将探索双语的潜在途径。 随着时间的推移，使用综合工具和调查反复影响认知能力下降 衡量认知弹性、认知储备和相关因素，包括社会支持、 心理弹性和身体活动。 在目标 3 中，我们将开发并验证机器学习算法，以识别与年龄相关的疾病的发作 我们将使用经过验证的语言分类器来处理认知能力下降和痴呆症。 让所有参与的 EHR 系统检查双语在进展中的作用 认知能力下降以及 EHR 数据中记录的其他因素的影响。 通过整合多学科探讨双语对认知储备的影响， 这项拟议的设计将解决该领域的主要差距和挑战。 有可能改变目前对神经和行为途径的理解 此外，所获得的知识可以转化为语言、文化和环境。 ADRD 现有干预措施和新治疗方法的改进。