Early Life War Experiences and Alzheimer’s Disease and Related Dementias

早期生活的战争经历与阿尔茨海默病和相关痴呆症

基本信息

批准号：
10289646
负责人：
Kim Korinek
金额：
$ 31.67万
依托单位：
UNIVERSITY OF UTAH
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-06-01 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10289646
关键词：
Address Administrative Supplement Adult Adverse event Affect Age Aging Alzheimer&apos s disease related dementia Alzheimer&apos s disease risk Alzheimer’s disease biomarker American Atrocities Biological Biological Aging Biological Assay Biological Markers Blood specimen C-reactive protein Caring Chemicals Childhood Cognitive Collection Communities Conflict (Psychology)Data Data Analyses Data Collection Data Set Dementia Developing Countries Dioxins Elderly Environment Exposure to Family Family member Funding Gerontology Goals Health Healthcare Healthcare Systems Homocysteine Hydrocortisone Impaired cognition Income Institution Intake International Interview Investigation Knowledge Life Life Cycle Stages Link Long-Term Effects Longitudinal Studies Measurement Measures Methods Morbidity - disease rate Neurodegenerative Disorders Nutritional Outcome Parents Participant Pathway interactions Persons Physical Function Plasma Policies Policy Maker Population Post-Traumatic Stress Disorders Prevention Prevention education Process Property Psychological Stress Public Health Research Respondent Risk Risk Factors Sampling Schedule Series Serum Proteins Services Severities Stress Surveys Survivors Techniques Testing Time Trauma Validation Venous Vietnam Violence War Whole Blood Woman Work agent orange base biomarker panel blood-based biomarker caregiving cognitive function cognitive performance cognitive testing cohort combat dementia risk diagnostic panel directed attention early life exposure experience fighting food insecurity food shortage healthy aging human old age (65+)informant instrument low and middle-income countries member men mortality novel performance tests psychologic psychological stressor screening social stressor virtual young adult

项目摘要

PROJECT SUMMARY The primary goal of this administrative supplement is to collect necessary data and conduct data analysis in order to expand understanding of early life exposures to armed conflict as they influence risks for Alzheimer’s disease and related dementias (ADRD). The focus of the administrative supplement is the creation of data for measuring ADRD and analyzing ADRD risk factors among a subsample of the Vietnam Health and Aging Study (VHAS), an ongoing longitudinal study of 2,447 older adult survivors of the American War residing in four districts of northern Vietnam. The study team will assess ADRD through a cognitive performance test instrument, the Community Screening Instrument for Dementia (CSI-D), which has been validated widely in low-middle income contexts. The CSI-D, which involves both cognitive testing for the respondent and an informant interview with a close family member, will be subject to validation in the VHAS setting. In addition to the CSI-D, using whole blood samples slated for collection during the second wave of VHAS, the project supplement will collect and assay homocysteine and a blood-based biomarker diagnostic panel for ADRD adapted from O’Bryant et al. The parent study, which funds Wave I data collected in 2018 and Wave II collection scheduled for 2021, provides detailed, longitudinal data on myriad risk factors for ADRD that have been identified in other, largely western populations, namely severe psychological stressors of war; dioxin exposure due to widespread spraying of Agent Orange and other chemical defoliants across Vietnam; and experience of adverse conditions during childhood and young adulthood, including severe food shortage and community-level bombing exposure. The scope of work within the proposed supplement is to create additional data on nutritional intake, to obtain assays of the ADRD biomarker homocysteine and a 10-analyte ADRD biomarker panel, and to perform analyses which explore war-related stressors as they influence cognitive functioning and ADRD risk. Armed conflict has been most pervasive in developing countries like Vietnam, where the population both moving into old age and having directly experienced war is growing rapidly, but where we have virtually no knowledge of the long-term effects of war exposure on ADRD. This study directs attention toward war as it may contribute to or detract from healthy aging, especially neurodegenerative diseases like ADRD which impose heavy burdens upon healthcare and caregiving institutions in low-middle income countries. To meet our administrative supplement study goals, we will: a) create and implement a supplementary survey module which examines ADRD as assessed by the CSI-D within a subset of 450 members of the VHAS, selected according to a random quota sampling method that yields significant statistical power for assessing ADRD across levels of war stress exposure; b) perform assays of homocysteine and a ADRD biomarker panel using whole blood samples created in Wave II of VHAS; c) incorporate the CSI-D, ADRD biomarker panel, and homocysteine measures into the larger VHAS dataset; d) conduct analyses of wartime and post-conflict exposures, namely food insecurity/deficiency, extreme psychological stress and related PTSD, and agent orange exposure, and current experience of ADRD. The VHAS international project team will utilize the assembled data to examine dynamic linkages between war exposure, stress environments, social relations, and older adult experience of ADRD risk. We will employ longitudinal analytical techniques to address questions about war exposure’s enduring effects, including questions about the mechanisms through which war influences cognitive functioning. Results will be disseminated widely across communities of scholars, policy-makers, and practitioners in public health, gerontology and allied fields, to tailor prevention, care and support in war-affected populations.

项目摘要这种行政补充的主要目标是收集必要的数据并进行数据分析是为了扩大对武装冲突的早期生活暴露的理解影响阿尔茨海默氏病和相关痴呆症（ADRD）的风险。重点行政补充是创建用于测量ADRD的数据并分析ADRD风险越南健康与衰老研究的子样本（VHAS）的因素，这是一个正在进行的 2,447名居住在四个地区的美国战争老年人冲浪者的纵向研究越南北部。研究团队将通过认知绩效测试评估ADRD 仪器，痴呆症（CSI-D）的社区筛查工具，在低中间收入环境中广泛验证。 CSI-D涉及认知对受访者的测试和与亲密家庭成员进行的线人访谈，将受到主题在VHAS设置中验证。除了CSI-D之外，使用计划的全血样品在第二波VHA浪潮中收集，该项目补充剂将收集和分析同型半胱氨酸和基于血液的生物标志物诊断面板，适用于O'Bryant 等。家长研究，该研究资助了2018年收集的波浪I数据和Wave II收集计划于2021年，提供有关ADRD无数风险因素的详细纵向数据已经在其他西方人口中被发现，即严重的心理战争的压力；由于橙色和其他越南的化学脱叶剂；和童年时期不良状况的经验年轻的成年，包括严重的食物短缺和社区级轰炸。拟议的补充剂中的工作范围是创建有关营养的其他数据摄入量，以获取ADRD生物标志物同型半胱氨酸和10分析的ADRD的攻击生物标志物面板，并进行分析，以探索与战争相关的压力源的影响认知功能和ADRD风险。武装冲突在发展中最普遍像越南这样的国家，人口都进入老年并直接经验丰富的战争正在迅速增长，但是我们几乎不知道长期战争暴露对ADRD的影响。这项研究将注意力引向战争，因为它可能有助于或损害健康衰老，尤其是ADRD等神经退行性疾病在低中间收入国家的医疗保健和照料机构上，重型伯伦斯。为了满足我们的行政补充学习目标，我们将：a）创建和实施补充调查模块，该模块检查了CSI-D在A内评估的ADRD VHA的450个成员的子集，根据随机配额抽样方法选择在战争压力的范围内评估ADRD会产生重要的统计能力接触; b）使用全血进行同型半胱氨酸和ADRD生物标记面板的测定在VHA的Wave II中创建的样品； c）合并CSI-D，ADRD生物标志物面板和同型半胱氨酸将较大的VHA数据集测量； d）进行战时和冲突后暴露，即粮食不安全/缺乏，极端的心理压力和相关的PTSD和Agent Orange曝光以及ADRD的当前经验。 VHAS国际项目团队将利用组装数据来检查动态战争暴露，压力环境，社会关系与老年人之间的联系 ADRD风险的经验。我们将采用纵向分析技术来解决有关战争暴露的持久影响的问题，包括有关机制的问题战争影响认知功能。结果将被广泛传播公共卫生，老年医学和盟军领域，以量身定制受战争影响人群的预防，关心和支持。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The Impact of Early Life War Exposure on Mental Health among Older Adults in Northern and Central Vietnam.

DOI：
10.1177/00221465211039239
发表时间：
2021-12
期刊：
Journal of health and social behavior
影响因子：
5
作者：
Kovnick MO;Young Y;Tran N;Teerawichitchainan B;Tran TK;Korinek K
通讯作者：
Korinek K

A Life Course Perspective on the Wartime Migrations of Northern Vietnamese War Survivors.

DOI：
10.1080/17441730.2021.1956722
发表时间：
2021
期刊：
ASIAN POPULATION STUDIES
影响因子：
1.4
作者：
Young, Yvette;Korinek, Kim;Huu Minh, Nguyen
通讯作者：
Huu Minh, Nguyen

War across the life course: examining the impact of exposure to conflict on a comprehensive inventory of health measures in an aging Vietnamese population.

生命历程中的战争：研究冲突对老龄化越南人口健康措施综合清单的影响。

DOI：
10.1093/ije/dyaa247
发表时间：
2021
期刊：
International journal of epidemiology
影响因子：
7.7
作者：
Zimmer,Zachary;Fraser,Kathryn;Korinek,Kim;Akbulut-Yuksel,Mevlude;Young,YvetteMarie;Toan,TranKhanh
通讯作者：
Toan,TranKhanh

Is war hard on the heart? Gender, wartime stress and late life cardiovascular conditions in a population of Vietnamese older adults.