Cognitive Function, Alzheimer's Disease and Related Disorders in the HAALSI Cohort

摘要：HAALSI患者的认知功能与阿尔茨海默病及相关疾病(ADRD) 这项研究的首要目标是确定阿尔茨海默病的发病率和流行率，并重新 迟发性痴呆症(ADRD)及其相关的生物学和社会危险因素 居住在南非阿金库尔的南非男女，年龄在40岁及以上(n=5059)。《健康与健康》 非洲的老龄化：对南非INDEPTH社区的纵向研究(HAALSI)已经完成 第一波，并持续到2021年的另外两波，提供超过6年的后续行动。哈尔西 是作为美国健康和退休研究(HRS)和其他全球 学习。2016年，我们启动了HAALSI痴呆症研究，包括 HAALSI，以及认知正常和轻度认知障碍(MCI)的HAALSI参与者的一个子样本 更详细的认知、临床和功能评估(n=607)。目前支持的方法是 HAALSI痴呆症研究的可能扩展是部署两个额外的丰富评估浪潮- 实施核磁共振成像，以获得更详细的关于ADRD的社会和生物风险因素的信息 HAALSI队列。我们将在未来的HAALSI中增加基于认知筛查的可能痴呆的新病例 电波纵向收集6年内准确的发病率和患病率。 目标1：评估ADRD的发生率和患病率，并描述认知功能和变化 在HAALSI的队列中。有了6年的纵向信息，我们有3波敏感的神经心理学- 临床测量、临床和信息者评估以及功能结果。我们估计流行和包括 减少痴呆病例，描述认知老化的轨迹，并描述脑老化的结构标志物。 ING通过核磁共振亚研究。目的2：评估偶发痴呆的生物学预测因素、认知功能 和衰退，以及大脑老化。我们使用MRI来测量区域体积、皮质厚度和 大小血管脑血管病。我们评估神经成像生物标记物之间的关联， 痴呆症、认知障碍以及与艾滋病毒和血管疾病的关系。静脉采血 使我们能够评估ADRD的已知遗传风险，如载脂蛋白E(APOE)-E4等位基因、ATP- 在这个新的人群中，结合盒亚家族A成员7(ABCA7)和AD多基因风险评分。目标 3：评估突发痴呆、认知障碍和认知功能衰退的社会风险因素。我们会 实施心理社会措施，检查痴呆症、认知能力下降和脑功能的程度。 情感受到教育经历、社会参与和网络以及童年逆境的影响。我们会 探索生物和社会风险因素对结果的中介关系。 我们的研究为了解撒哈拉以南地区的ADRD、认知和脑老化做出了重要贡献 在非洲，许多国家正在经历人口和流行病的快速转变。

ABSTRACT: Cognitive Function, Alzheimer's Disease and Related Disorders (ADRD) in HAALSI The overarching goal of this study is to identify the incidence and prevalence of Alzheimer's Disease and Re- lated Dementias (ADRD) and associated biological and social risk factors in a population-based cohort of South African men and women aged 40 and over (n=5059) living in Agincourt, South Africa. The Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) has completed its first wave and continues for two additional waves through 2021, providing over 6 years of follow-up. HAALSI was developed as a harmonized sister study to the US Health and Retirement Study (HRS) and other global studies. In 2016, we launched the HAALSI Dementia Study, including all probable cases of dementia within HAALSI, and a subsample of HAALSI participants with normal cognition and mild cognitive impairment (MCI) for more detailed cognitive, clinical, and functional assessments (n= 607). The approach of the currently pro- posed extension of the HAALSI Dementia Study is to field two additional waves of enriched assessments sup- plemented with MRIs to obtain more detailed information on social and biological risk factors for ADRD in the HAALSI cohort. We will add new cases of probable dementia based on cognitive screening in future HAALSI waves to gather longitudinally accurate incidence and prevalence rates over 6 years. AIM 1: Estimate the incidence and prevalence of ADRD and characterize cognitive function and change in the HAALSI cohort. With 6 years of longitudinal information, we have 3 waves of sensitive neuropsycholog- ical measures, clinical and informant assessments, and functional outcomes. We estimate prevalent and inci- dent dementia cases and describe trajectories of cognitive aging, and describe structural markers of brain ag- ing via an MRI substudy. AIM 2: Evaluate biological predictors of incident dementia, cognitive function and decline, and brain aging. We use MRI to measure regional volume, cortical thickness, and markers of small and large vessel cerebrovascular disease. We assess associations between neuroimaging biomarkers, dementia, and cognitive impairment and associations with HIV and vascular disease. Venous blood collection enables us to evaluate known genetic risks for ADRD, such as Apolipoprotein E (APOE)-E4 allele, ATP- binding cassette sub-family A member 7 (ABCA7) and AD polygenic risk scores in this novel population. AIM 3: Evaluate social risks factors for incident dementia and cognitive impairment and decline. We will administer psychosocial measures to examine the extent to which dementia, cognitive decline, and brain func- tion are affected by educational experience, social engagement and networks, and childhood adversity. We will explore mediating relationships between biological and social risk factors on outcomes. Our study makes an important contribution to understanding ADRD, cognition, and brain aging in sub-Saharan Africa where many countries are experiencing rapid demographic and epidemiologic transitions.