The role of depression in cognitive decline of oldest-old African Americans

项目摘要/摘要 老年人(85岁及以上)是人口增长最快的部分，患痴呆症的风险非常高。 与白人相比，一些少数群体，如非裔美国人，患痴呆症的风险更高。 然而，人们对导致他们高度易患痴呆症的风险因素知之甚少。 抑郁症，老年人最常见和最虚弱的精神疾病之一，一直是 一直与白人的认知能力下降有关。尽管非裔美国人中的抑郁症更多 与白人相比，只有少数几项研究调查了这种关系 在这个种族/民族群体中，抑郁症和认知能力下降之间的关系。据我们所知，这种关系已经 没有在年龄最大(≥80岁)的非裔美国人中进行检查。慢性炎症也与这两种疾病有关 抑郁和认知能力下降。因为抑郁症和炎症是可以治疗的，所以更好 了解它们在认知中的作用可能会降低这种非常高风险、不断增长和 未被充分研究的人群。 这项研究将考察抑郁症和炎症与认知变化之间的相互关系。 时间在192非痴呆症社区居住的最年长的非裔美国人中。我们将检查以下内容 三个具体目标：目标1：检查抑郁测量和认知能力下降之间的联系 随着时间的推移。我们假设：a)抑郁与认知衰退的速度更快有关。B)基于 令人信服的初步数据显示，冷漠是衡量抑郁症的指标，被认为与 认知功能下降的速度更快。目标2：检查基线炎症和 认知能力下降。我们假设，基线水平较高的炎性细胞因子与 认知功能下降的速度更快。目的3：研究抑郁、炎症和抑郁的相互关系 认知能力下降。A)我们假设炎症在两者之间的关系中起到调节作用 老年非裔美国人的抑郁和认知能力下降。如果产生了显著的结果，他们可以 提高公众对抑郁症的及时诊断和发展的重要性的认识 为最古老的非裔美国人社区提供基于机制的有效和有针对性的治疗， 他们患痴呆症的风险特别高。

PROJECT SUMMARY/ABSTRACT Older adults (85 and older), the fastest growing segment of the population, are at very high risk of dementia. Some minority groups, such as African Americans, are at higher risk of dementia compared to Whites. However, little is known about the risk factors that might be involved in their high susceptibility to dementia. Depression, one of the most frequent and debilitating psychiatric conditions in older adults, has been consistently associated with cognitive decline in Whites. Although depression in African Americans is more chronic and untreated, compared with Whites, only a handful of studies have investigated the relationship between depression and cognitive decline in this racial/ethnic group. To our knowledge, this relationship has not been examined in oldest-old (≥80) African Americans. Chronic inflammation is also associated with both depression and cognitive decline. Because depression and inflammation are treatable conditions, better understanding of their role in cognition may lead to reduced dementia risk in this very high risk, growing, and understudied population. This study will examine the inter-relationships of depression and inflammation with change in cognition over time in 192 non-demented community-dwelling oldest-old African Americans. We will examine the following three Specific Aims: Aim 1: To examine the association between depression measures and cognitive decline over time. We hypothesize that: a) Depression is related to a greater rate of cognitive decline. b) Based on compelling preliminary data, apathy is the depression measure hypothesized to be most strongly related to a greater rate of cognitive decline. Aim 2: To examine the association between baseline inflammation and cognitive decline. We hypothesize that higher levels of inflammatory cytokines at baseline are related to a greater rate of cognitive decline. Aim 3: To examine the inter-relationships of depression, inflammation and cognitive decline. a) We hypothesize that inflammation serves as a moderator in the relationship between depression and cognitive decline in oldest-old African Americans. If significant results are generated, they can lead to increasing public awareness about the importance of timely depression diagnosis and development of mechanism-based effective and well-targeted treatment for the oldest-old community of African Americans, who are at particularly high-risk for dementia.