Predictors of Altered CNS Structure, Function, and Connectomics in the Elderly using a Health Disparities Framework

摘要 该项目的目标是利用我们的人类连接组项目（HCP）中的多样化样本 研究，大脑老化中的连接组学（COBRA），以调查结构和社会决定因素的作用 在阿尔茨海默病（AD）的自然史的健康利用健康公平的框架。我们提出 在AD背景下认知障碍发展中的种族不平等是由普遍存在的 结构性和制度化的不平等，在多个层面造成风险和不利处境，包括 生物，环境，行为，社会文化，如NIA健康差异研究所提出的 框架.我们的组织原则是，老年人认知功能障碍的表现是 影响连接体的两个独立过程-第一个是与AD相关的神经病理学。 第二个过程在历史上被称为“可改变的个体风险因素”，然而，这失败了。 认识到个人风险受到个人控制之外的因素的影响，这些因素将 使用健康公平框架进行衡量。 我们将增加现有样本（50%黑人，65%女性），增加150名参与者（总计 样本约400，最多4次研究访视）。每个参与者将贡献HCP指定的 人口统计、行为和实验室数据。所有参与者都将接受广泛的大脑成像 包括MRI和PET（淀粉样蛋白和tau示踪剂）。所有MRI数据将上传至 Connectome Coordinating Facility和行为/认知PET数据将上传至NIMH Data 存档。在本地，我们将使用这些数据来解决与结构，功能，AD，老化相关的特定问题 和血管疾病的多模态研究，利用MRI，fMRI的差异优势， Aβ和tau成像。

Abstract The goal of this project is to leverage the diverse sample in our Human Connectome Project (HCP) Study, Connectomics in Brain Aging (COBRA) , to investigate the role(s) of structural and social determinants of health in the natural history of Alzheimer’s Disease (AD) utilizing a health equity framework. We propose that racial inequities in the development of cognitive impairments in the context of AD are driven by pervasive structural and institutionalized inequities that shape risk and disadvantage at multiple levels, including biological, environmental, behavioral, sociocultural, as proposed in the NIA Health Disparities Research Framework. Our organizing principle is that the expression of cognitive dysfunction in the elderly is the result of two independent processes affecting the connectome — the first is the neuropathology associated with AD. The second process historically has been referred to as “modifiable individual risk factors”, however, this fails to recognize that individual risk is influenced by factors that are outside of an individual’s control, and which will be measured using a health equity framework. We will augment our existing sample (50% Black, 65% Female) with an additional 150 participant (total sample ~400 with up to four study visits). Each of the participants will contribute the HCP-specified demographic, behavioral and laboratory data. All of the participants will undergo extensive brain imaging biannually including MRI and PET (amyloid and tau tracers). All of the MRI data will be uploaded to the Connectome Coordinating Facility, and the behavioral/cognitive, PET data will be uploaded to the NIMH Data Archive. Locally, we will use these data to address specific questions related to structure, function, AD, aging and vascular disease in multi-modality studies leveraging the differential advantages of MRI, fMRI, and in vivo Aβ and tau imaging.