Dementia Determinants in Caribbean and U.S. Hispanics

项目摘要/摘要“加勒比和美国拉美裔人口中的痴呆症决定因素”这项针对PAR-17-470的提案将极大地扩展关于加勒比裔人口痴呆症决定因素和后果的知识。我们建立在10/66痴呆症研究小组在波多黎各、多米尼加共和国和古巴首都大都市地区进行的国际协调调查的基础上；这三个岛屿/国家是绝大多数加勒比移民到美国的原产地。我们将把这些数据与美国健康和退休研究，特别是其健康认知老龄化项目(HCAP)子研究进行比较，该研究旨在对阿尔茨海默病和阿尔茨海默病相关痴呆(AD/ADRD)进行此类国际比较。10/66的数据显示，在这三个加勒比地区65岁以上的成年人中，痴呆症的患病率非常高，达到10%-12%，这三个地点的历史相似，但过去一个世纪社会结构的丰富变化为更好地了解加勒比裔移民人口中的AD/ADRD提供了巨大的希望。我们的国际合作团队将专注于三个具体目标：(1)在波多黎各和多米尼加共和国的非城市地区收集新的基线调查数据，这些数据与首都地区现有的10/66样本平行，以更好地捕捉这些发送岛屿/国家的生命周期暴露的变化。(2)分析AD/ADRD与假设的社会经济决定因素在不同背景下的关系，利用对非常不同的生活环境的比较，既理解AD/ADRD流行的驱动因素，又模拟在改变的社会环境下，AD/ADRD的流行如何可能看似不同。(3)分析AD/ADRD的比较社会成本(包括正式护理和非正式护理)，以模拟在社会安排改变的情况下，这些成本如何可能看似不同。

PROJECT SUMMARY/ABSTRACT “Dementia Determinants in Caribbean and U.S. Hispanic Populations” This proposal in response to PAR-17-470 will significantly expand knowledge regarding dementia determinants and consequences in Caribbean-origin populations. We build on the 10/66 Dementia Research Group’s internationally harmonized surveys in capital city metro areas of Puerto Rico, Dominican Republic, and Cuba; these three islands/countries are the origin of the vast majority of Caribbean immigrants to the U.S. We will compare these data with the U.S. Health and Retirement Study, and particularly its Healthy Cognitive Aging Project (HCAP) sub-study which was designed for such international comparisons of Alzheimer's Disease and Alzheimer's Disease Related Dementias (AD/ADRD). 10/66 data indicate a remarkably high dementia prevalence of 10-12% among adults ages 65+ in these three Caribbean sites, whose similar histories but richly varying societal structures over the past century offer great promise for better understanding AD/ADRD in Caribbean-origin immigrant populations. Our international collaborative team will focus on three specific aims: (1) Collect new baseline survey data in non-metro Puerto Rico and Dominican Republic that parallel existing 10/66 samples from capital city areas, to better capture the variation in lifecourse exposures in these sending islands/countries. (2) Analyze AD/ADRD relationships with hypothesized lifecourse socioeconomic determinants across contexts, exploiting comparisons across vastly heterogeneous life circumstances to both understand drivers of AD/ADRD prevalence and to simulate how prevalence could plausibly be different under altered social circumstances. (3) Analyze the comparative societal costs of AD/ADRD (including both formal and informal care) to simulate how these costs could plausibly be different under altered societal arrangements.