Neurological and digital correlates of cognition in Older Mandarin-speaking Adults

普通话老年人认知的神经和数字相关性

• 批准号: 10608780
• 负责人: William Tzu-lung Hu
• 金额: $ 223.61万
• 依托单位: RUTGERS BIOMEDICAL AND HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-15 至 2025-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10608780
• 关键词: Accounting; Acculturation; Adult; Aging; Alzheimer associated neurodegeneration; Alzheimer' s Disease; Americas; Animals; Anterior; Area; Articulation; Asian; Asian Americans; Behavioral; Biological Markers; Blood; California; Cerebrovascular Disorders; Chicago; China; Chinese; Chinese population; Clinical; Clinical Trials; Cognition; Cognitive; Communities; Data Set; Dementia; Detection; Diagnosis; Diagnostic; Digit structure; Disease; Disparate; Early Intervention; Elderly; Eligibility Determination; Enrollment; Equity; Europe; Exposure to; FDA approved; Familiarity; Frequencies; Generations; Goals; Health; High Prevalence; Home; Image; Impaired cognition; Incidence; Instruction; International; Knowledge; Language; Linguistics; Low Prevalence; Magnetic Resonance Imaging; Measures; Medial; Mediating; Memory; Minority; Nerve Degeneration; Neuroanatomy; Neurocognitive; Neurologic; Neurologist; Neuropsychological Tests; Neuropsychology; Participant; Performance; Persons; Plasma; Population Study; Prevalence; Research; Resolution; Resources; Rest; Retrospective Studies; Semantics; Severity of illness; Tablets; Temporal Lobe; Testing; Trail Making Test; Training; Translating; Translations; Validity and Reliability; White Matter Hyperintensity; bilingualism; cerebral atrophy; clinical diagnosis; clinical trial enrollment; cognitive function; cognitive reserve; cognitive testing; dementia risk; digital; digital measure; digital platform; disease phenotype; gray matter; health care availability; health disparity; health equity; healthy aging; improved; insight; instrument; literacy; mild cognitive impairment; neuroprotection; nonEnglish language; normal aging; novel; posters; recruit; social stigma; sound; tool; white matter

ABSTRACT Asian Americans are the fastest growing demographic group in the US, with Chinese now representing the third most common language spoken after English and Spanish. Diagnosis-based studies have shown reduced dementia risks among older Chinese adults in the US and China, but assessment-based studies have suggested significant under-diagnosis by 50% or more. A major problem in diagnosis is the lack of reliable tools to diagnose mild cognitive impairment (MCI) or dementia (including Alzheimer’s disease [AD]) among Chinese adults in the US: about half of Chinese neuropsychological tests were created through content- only translation without adjustment for cultural, linguistic, or neurological factors, while the remaining only have translated instructions. Because language-independent neuropsychological tests are limited in scope and resolution, detection of MCI/AD in older US Chinese adults is often delayed for early intervention, clinical trial enrollment, and initiation of disease-modifying therapies. Building on the unparalleled bilingual neurocognitive expertise at Rutgers and Stanford, we have developed new Mandarin-based neuropsychological tests accounting for cognition-related differences between Mandarin and English to mirror the National Alzheimer’s Coordinating Center assessments. These include: articulation-normalized forward digit span; articulation- and lexeme-adjusted Craft Story 21; lexeme- and frequency-adjusted word list recall; Mandarin-specific word generation tasks guided by character, phoneme/pinyin, and homonym (one character sound corresponding to multiple characters); and exposure-based Trail Making Test B. We leveraged our existing community relationships to demonstrate the feasibility and reliability of using these tools in older Mandarin speakers, and we will further expand their reliability and relationship to performance using English instruments by bilingual older adults (Aim 1); determine construct and diagnostic validity analysis accounting for imaging and plasma biomarkers of neurodegeneration (Aim 2); and determine if bilingualism mediates the effects of neurodegeneration (Aim 3). We will additionally transfer these tests onto a digital platform which can then be used by centers without Mandarin-speaking clinicians, and explore the feasibility of longitudinal neuropsychological, blood, and MRI analysis in a subset of the older Chinese adults. Through this effort, we will provide the first linguistically, culturally, and neuroanatomically appropriate cognitive tests for Mandarin speakers to enhance clinical detection of MCI/AD, enable equitable enrollment into clinical trials, reduce language-associated health disparities, and determine if bilingualism is neuroprotective among Mandarin speakers.

摘要 亚裔美国人是美国人口增长最快的群体， 汉语现在是继英语和西班牙语之后第三大最常用的语言。 基于诊断的研究表明，中国老年人患痴呆症的风险降低 美国和中国，但基于评估的研究表明严重的诊断不足 诊断中的一个主要问题是缺乏可靠的工具来诊断轻度症状。 中国人认知障碍（MCI）或痴呆（包括阿尔茨海默病 [AD]） 美国成年人：大约一半的中国神经心理学测试是通过内容创建的—— 仅翻译而未调整文化、语言或神经因素，而 剩下的只有翻译后的说明，因为与语言无关的神经心理学。 测试的范围和分辨率有限，在美国华裔老年人中检测 MCI/AD 的难度很大 经常因早期干预、临床试验入组和疾病修饰的启动而延迟 建立在罗格斯大学无与伦比的双语神经认知专业知识的基础上。 斯坦福大学，我们开发了新的基于普通话的神经心理学测试 普通话和英语之间与认知相关的差异反映了全国阿尔茨海默病 协调中心评估包括： 发音标准化的前向数字跨度； 发音和词位调整的 Craft Story 21；词位和频率调整的单词列表 回忆由汉字、音素/拼音引导的普通话特定单词生成任务，以及 同音异义（一个字符对应多个字符）和基于曝光的 路线制作测试 B. 我们利用现有的社区关系来展示 在年长的普通话使用者中使用这些工具的可行性和可靠性，我们将进一步 通过双语使用英语乐器扩展其可靠性以及与表演的关系 老年人（目标 1）；确定构建和诊断有效性分析 神经退行性变的影像和血浆生物标志物（目标 2）并确定是否双语； 介导神经退行性变的影响（目标 3）。 一个数字平台，可供没有普通话使用者的中心使用，以及 探索纵向神经心理学、血液和 MRI 分析在一个子集中的可行性 通过这一努力，我们将为中国老年人提供第一个语言上、文化上、 以及针对普通话使用者进行神经解剖学上适当的认知测试，以增强临床能力 检测 MCI/AD，实现临床试验的公平招募，减少与语言相关的 健康差异，并确定双语是否对讲普通话的人有神经保护作用。