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

项目摘要 拉丁美洲人是美国老年人人口中一个很大且不断增长的部分， 与非拉丁美洲人相比，阿尔茨海默病和相关痴呆症（ADRD）的风险/a白人。证据 表明拉丁美洲人/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，阿尔茨海默氏症的生物标志物）可能会影响 CVDRF与ADRD风险相关的程度。例如，我们自己的初步数据表明， CVDRF升高的女性更有可能患有轻度认知障碍（MCI）， 健康认知和ADRD之间的关系有趣的是，较少的文化适应（即，保持拉丁美洲人/a 文化和较少采用英美文化）与更好的心血管健康有关， 特别是在妇女中，但试点数据表明，文化适应程度较低与认知能力较差有关。最后，老年痴呆症 生物标志物变得越来越容易获得，但在拉丁美洲人中尚未进行彻底调查， 更有可能混合阿尔茨海默氏症和脑血管病变（脑损伤与穷人有关）。 心血管健康），而不是纯粹的阿尔茨海默病的病理。拟议研究的总体目标 是发展一个全面的中年人认知障碍和ADRD风险的特征， 拉丁美洲人/as.为实现这一目标，拟议项目将纳入社会心理（即，文化适应）和 生物学[即，CVDRF、小血管疾病（脑血管系统的标志物）和阿尔茨海默病生物标志物] 研究拉丁美洲人/50岁以上人群纵向认知变化的因素。更具体地说，建议 该项目将检查来自拉丁美洲人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（HCHS/SOL）的辅助研究。在目标1中， 描述文化适应和MCI之间的性别特异性关联，并测试CVDRF是否是这种联系的基础 在6,000多名拉丁美洲人中，文化适应和MCI状态之间的关系。在目标2中，我们将使用针对性别的分析， 确定小血管疾病是否解释了CVDRF和MCI/痴呆状态之间的关系 （同时考虑文化适应）;预计n = 2，400。在目标3中，我们将研究文化适应或 阿尔茨海默氏症生物标志物影响小血管疾病和MCI/痴呆状态之间的关系; 预计n = 2，400。拟议的K 08项目将为候选人提供继续进行 通过国家老年健康研究所调查拉丁美洲人/a认知老化和ADRD风险 差异框架作为一个独立的临床科学家。

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.