Risk Factors for Alzheimer's Disease Among Latinos: Relationships Between Cardiovascular Disease Risk, Acculturation, Small Vessel Disease, and Alzheimer's Biomarkers

项目总结 拉丁美洲人/美国人在美国老年人口中占很大比例，而且还在不断增长，而且还在增加 与非拉丁裔/a白人相比，患阿尔茨海默病和相关痴呆(ADRD)的风险。证据 提示拉丁裔/AS在存在心血管疾病风险的情况下特别容易患ADRD 因子(CVDRF)。其他几个因素(例如，性别、文化适应、阿尔茨海默氏症生物标志物)可能会影响 CVDRF与ADRD风险的关联程度。例如，我们自己的初步数据表明，拉丁裔 CVDRF升高的女性更有可能患有轻度认知障碍(MCI)，这是一种中间阶段 在健康的认知和ADRD之间，比男性。有趣的是，文化适应较少(即保持拉丁裔/a 文化和较少采用英美文化)与更好的心血管健康有关， 尤其是在女性中，但试点数据将文化适应程度较低与认知能力较差联系在一起。最后，阿尔茨海默氏症 生物标志物正在变得更容易获得，但尚未在拉丁裔/世卫组织中进行彻底调查 更有可能患有阿尔茨海默氏症和脑血管病变(脑损伤与贫穷有关 心血管健康)，而不是纯粹的阿尔茨海默氏病的病理。拟议研究的总体目标 是制定一个关于中年人认知障碍和ADRD风险的综合特征 年长的拉丁裔/AS。为实现这一目标，拟议的项目将纳入心理社会(即文化适应)和 生物学[即CVDRF、小血管疾病(脑血管系统的标记物)和阿尔茨海默氏症生物标记物] 研究拉丁裔/50岁以上人群纵向认知变化的因素。更具体地说，拟议的 该项目将检查拉丁裔研究的详细认知数据-神经认知老化调查 (Sol-Inca)、Sol-Inca MRI(磁共振成像)和Sol-Inca AD(阿尔茨海默病)， 西班牙裔社区健康研究/拉丁裔研究的辅助研究(HCHS/SOL)。在目标1中，我们寻求 确定文化适应和MCI之间特定性别的联系，并测试CVDRF是否低于这种联系 在6,000多名拉丁裔/AS中，文化适应和MCI身份之间的差异。在目标2中，我们将使用针对性别的分析来 确定小血管疾病是否与CVDRF和MCI/痴呆状态之间的关系有关 (同时考虑到文化适应)；预计n=2400。在目标3中，我们将考察文化适应或 阿尔茨海默病生物标志物影响小血管疾病与MCI/痴呆状态之间的关系； 预计n=2400。拟议的K08项目将为候选人提供继续进行所需的工具 通过国家老年健康研究所调查拉丁裔/a认知老化和ADRD风险 作为一名独立的临床科学家，差异框架。

PROJECT SUMMARY Latinos/as are a large and growing segment of the United States older adult population and are at increased risk for Alzheimer’s disease and related dementias (ADRDs) compared to non-Latino/a Whites. Evidence suggests that Latinos/as are particularly susceptible to ADRD in the presence of cardiovascular disease risk factors (CVDRFs). Several other factors (e.g., sex, acculturation, Alzheimer’s biomarkers) may influence the degree to which CVDRFs are linked to ADRD risk. For example, our own preliminary data suggest that Latina women with elevated CVDRFs are more likely to have mild cognitive impairment (MCI), an intermediate stage between healthy cognition and ADRD, than men. Interestingly, less acculturation (i.e., maintaining Latino/a culture and less adoption of Anglo-American culture) has been associated with better cardiovascular health, particularly among women, but pilot data has linked lower acculturation to poorer cognition. Finally, Alzheimer’s biomarkers are becoming more accessible but have not been thoroughly investigated among Latinos/as who are more likely to have mixed Alzheimer’s and cerebrovascular pathology (brain damage linked to poor cardiovascular health) as opposed to pure Alzheimer’s pathology. The overarching goal of the proposed study is to develop a comprehensive characterization of cognitive impairment and ADRD risk among middle-age and older Latinos/as. To achieve this, the proposed project will incorporate psychosocial (i.e., acculturation) and biological [i.e., CVDRFs, small vessel disease (a marker of cerebrovasculature), and Alzheimer’s biomarkers] factors to study longitudinal cognitive change among Latinos/as 50+ years old. More specifically, the proposed project will examine detailed cognitive data from the Study of Latinos- Investigation of Neurocognitive Aging (SOL-INCA), SOL-INCA MRI (magnetic resonance imaging), and SOL-INCA AD (Alzheimer’s disease), ancillary studies to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). In aim 1 we seek to characterize gender-specific associations between acculturation and MCI, and test if CVDRFs underly the link between acculturation and MCI status in over 6,000 Latinos/as. In aim 2 we will use gender-specific analysis to determine if small vessel disease accounts for the relationship between CVDRFs and MCI/dementia status (while accounting for acculturation); projected n = 2,400. In aim 3, we will examine whether acculturation or Alzheimer’s biomarkers influence the relationships between small vessel disease and MCI/dementia status; projected n = 2,400. The proposed K08 project will provide the candidate the tools necessary to continue investigating Latino/a cognitive aging and ADRD risk through the National Institute on Aging’s Health Disparities Framework as an independent clinical scientist.