Project 1 - Cognitive Function and Dementia

项目 1 - 认知功能和痴呆症

基本信息

批准号：
10627332
负责人：
LISA F BERKMAN
金额：
$ 64.43万
依托单位：
HARVARD SCHOOL OF PUBLIC HEALTH
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-15 至 2028-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10627332
关键词：
Address Affect Africa South of the Sahara African Age Years Aging Algorithms Alzheimer&apos s disease related dementia Alzheimer&apos s disease risk Alzheimer’s disease biomarker Biological Biological Markers Birth Blood Calibration Categories Characteristics Child Cognition Cognitive Collaborations Communities Consensus Country Credentialing Data Dementia Diagnosis Education Educational process of instructing Elderly Epidemiology Generations Glial Fibrillary Acidic Protein Goals Health Health and Retirement Study Health system Incidence Income International Linguistics Longitudinal Studies Magnetic Resonance Imaging Measurement Measures Nerve Degeneration Neurobehavioral Manifestations Neurobiology Neuropsychological Tests Neuropsychology Outcome Parents Participant Pathway interactions Pattern Performance Phenotype Plasma Population Population Study Prevalence Prevention strategy Protocols documentation Psychometrics Research Resources Respondent Risk Risk Factors Role Sampling Severities Shapes Sister Social Change Social Conditions Social Network Social support South Africa South African Surveys Symptoms Techniques Translating Validity and Reliability Variant Woman Work aging brain aging population blood-based biomarker cognitive change cognitive function cognitive reserve cognitive testing cohort data harmonization dementia risk diagnostic algorithm epidemiologic data experience global health informal learning innovation insight life history literacy low and middle-income countries magnetic resonance imaging biomarker men mild cognitive impairment neuroimaging neuropathology novel skills social social determinants social factors tau-1

项目摘要

Project 1: Cognitive Function and Dementia—Abstract The greatest impact of Alzheimer’s disease and related dementias (ADRD) is likely to be experienced in low- and middle-income countries (LMICs). Sub-Saharan Africa, in particular, is projected to encounter a dramatic increase in dementia prevalence and there is a growing need for rigorous population-based studies of ADRD in this region. Health, Aging and Dementia in South Africa: A Longitudinal Study (HAALSI) addresses core issues in dementia epidemiology in older South Africans. We implement measures harmonized with the global Health and Retirement Study (HRS) and Harmonized Cognitive Assessment Protocol (HCAP) networks to enable cross-national comparisons of dementia and its risk factors. Project 1 (Cognitive Function and Dementia) leverages our deeply phenotyped HAALSI Agincourt cohort to identify causal pathways underlying cognitive trajectories and applies well-validated neuropsychological assessments to a nationally representative sample. These data will provide the first national estimates of dementia prevalence in South Africa. We do this through tightly coordinated work across four overlapping cohorts. Our original HAALSI Agincourt cohort comprised 5059 respondents ≥40 years of age, for whom we collected three waves of data; this renewal will add two additional waves. HAALSI-HCAP Agincourt (n≈700) is an enriched subcohort that adds detailed neuropsychological testing, neuroimaging, and blood biomarkers of ADRD; this renewal adds one additional wave of HAALSI-HCAP Agincourt (wave 3). We propose to field a new, nationally representative study of 4500 men and women (plus partners) and a HAALSI-HCAP National survey (n≈624). Project 1 has 3 aims. Aim 1 focuses on characterizing the incidence and progression of mild cognitive impairment (MCI) and dementia in relation to neurodegeneration and ADRD neuropathology in the enriched Agincourt-HCAP cohort. We examine longitudinal change in magnetic resonance imaging (MRI) markers of brain aging and incorporate plasma markers of ADRD (i.e., Ab, p-tau, NfL, GFAP) to assess associations with dementia symptoms. In Aim 2, we refine and validate the HAALSI Global Cognitive Screen, HAALSI-HCAP, and HAALSI dementia algorithms for South African nationwide surveys of dementia. We collaborate with Project 4 to conduct a baseline National HAALSI-HCAP wave to generate national prevalence estimates for dementia and MCI. In Aim 3, we examine the impact of social factors, including novel indicators of educational quality and social connection on participants’ cognitive function and change trajectories. We explore informal educational experiences of special relevance in the context of rapid social changes in South Africa, including self-taught literacy and effects of children’s educational attainment on cognition in older parents. Optimizing all four cohorts (HAALSI Agincourt, HAALSI-HCAP Agincourt, HAALSI National, HAALSI-HCAP National) we identify distinct biological and social conditions that affect late-life cognitive function in South Africa. HAALSI provides rich, well-harmonized data to better understand modifiable factors in ADRD and inform global prevention strategies.

项目 1：认知功能与痴呆症——摘要阿尔茨海默氏病和相关痴呆症 (ADRD) 的最大影响可能会出现在低收入群体中。特别是撒哈拉以南非洲地区的中等收入国家预计将面临巨大的挑战。痴呆症患病率增加，并且越来越需要对 ADRD 进行严格的基于人群的研究该地区的健康、老龄化和痴呆症：一项纵向研究 (HAALSI) 解决了核心问题。我们实施与全球一致的措施。健康与退休研究 (HRS) 和协调认知评估协议 (HCAP) 网络实现痴呆症及其风险因素项目 1（认知功能和风险因素）的跨国比较。痴呆症）利用我们的深度表型 HAALSI Agincourt 队列来确定潜在的因果路径认知轨迹并将经过充分验证的神经心理学评估应用于全国代表这些数据将提供南非痴呆症患病率的首次全国估计。通过我们最初的 HAALSI Agincourt 队列中四个重叠队列的紧密协调工作。包括 5059 名 40 岁以上的受访者，我们为他们收集了三波数据；添加另外两个波 HAALSI-HCAP Agincourt (n≈700) 是一个丰富的子队列，添加了详细信息。此次更新增加了 ADRD 的神经心理学测试、神经影像学和血液生物标志物； HAALSI-HCAP Agincourt 浪潮（第 3 波）我们建议开展一项新的全国代表性研究，涉及 4500 人。男性和女性（加上合作伙伴）和 HAALSI-HCAP 全国调查 (n≈624) 项目 1 有 3 个目标。重点关注轻度认知障碍 (MCI) 和痴呆症的发病率和进展特征我们研究了丰富的 Agincourt-HCAP 队列中神经退行性变和 ADRD 神经病理学的关系。大脑衰老和血浆掺入的磁共振成像（MRI）标志物的纵向变化在目标 2 中，我们使用 ADRD 标记物（即 Ab、p-tau、NfL、GFAP）来评估与痴呆症状的关联。完善和验证 HAALSI 全球认知筛查、HAALSI-HCAP 和 HAALSI 痴呆算法我们与 Project 4 合作开展南非全国痴呆症调查。 HAALSI-HCAP 生成全国痴呆症和 MCI 患病率估计值在目标 3 中，我们进行了研究。社会因素的影响，包括教育质量和社会联系的新指标我们探索特殊的非正式教育经历。南非快速社会变革背景下的相关性，包括自学识字和自学识字的影响优化所有四个队列（HAALSI Agincourt， HAALSI-HCAP Agincourt、HAALSI National、HAALSI-HCAP National）我们确定了不同的生物学和社会学 HAALSI 提供了丰富且协调一致的数据。更好地了解 ADRD 中的可改变因素并为全球预防策略提供信息。