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

HAALSI 队列中的认知功能、阿尔茨海默病和相关疾病

• 批准号: 10465039
• 负责人: LISA F BERKMAN
• 金额: $ 74.25万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10465039
• 关键词: Affect; Africa; Africa South of the Sahara; Aging; Alleles; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Apolipoprotein E; Binding; Biological; Blood; Blood Glucose; Blood Vessels; Brain; Cerebrovascular Disorders; Cerebrovascular system; China; Clinical; Cognition; Cognitive; Cognitive aging; Collection; Communities; Country; Data Collection; Dementia; Diagnosis; Disease; Elderly; Epidemiology; Etiology; Europe; Event; Family; Frequencies; Future; Genetic; Genetic Risk; Goals; HIV; HIV Infections; Health; Health and Retirement Study; Hypertension; Impaired cognition; Incidence; India; Interview; Longitudinal Studies; Longitudinal cohort; Magnetic Resonance Imaging; Measures; Mediating; Medical; Methods; Mexico; Neurologist; Neuropsychology; Normal Range; Outcome; Participant; Physicians; Population; Population Research; Prevalence; Protocols documentation; Risk; Risk Factors; Schools; Sex Differences; Sister; Site; Social Network; South Africa; South African; Standardization; Testing; Thick; Vascular Diseases; Venous; Woman; adjudicate; age difference; aged; aging brain; base; childhood adversity; cognitive change; cognitive function; cognitive testing; cohort; dementia risk; experience; falls; follow-up; functional decline; functional outcomes; high risk; hypercholesterolemia; imaging biomarker; informant; literacy; member; men; mild cognitive impairment; neuroimaging marker; novel; polygenic risk score; population based; programs; psychosocial; rural South Africa; screening; social; social engagement; vascular risk factor

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.

摘要：HAALSI患者的认知功能、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患病率， 迟发性痴呆（ADRD）和相关的生物和社会风险因素在一个基于人群的队列， 年龄在40岁及以上的南非男性和女性（n=5059），居住在南非阿金库尔。健康和 非洲老龄化：南非INDEPTH社区的纵向研究（HAALSI）已经完成了其 第一波，并将继续到2021年的另外两波，提供超过6年的随访。哈尔斯 作为美国健康与退休研究（HRS）和其他全球研究的协调姐妹研究， 问题研究2016年，我们启动了HAALSI痴呆症研究，包括所有可能的痴呆症病例， HAALSI，以及认知正常和轻度认知障碍（MCI）的HAALSI参与者的子样本 进行更详细的认知、临床和功能评估（n= 607）。目前，亲- HAALSI痴呆症研究的延伸是进行两波额外的丰富评估， 进行MRI检查，以获得关于ADRD的社会和生物风险因素的更详细信息， 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 波收集纵向准确的发病率和患病率超过6年。 目的1：评估ADRD的发病率和患病率，并描述认知功能和变化 在HAALSI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、临床和知情人评估以及功能结局。我们估计流行和增加- dent痴呆症的情况下，并描述认知老化的轨迹，并描述大脑的结构标记， 通过MRI子研究。目的2：评估痴呆事件的生物学预测因子，认知功能 以及大脑老化。我们使用MRI来测量区域体积、皮质厚度和 小血管和大血管脑血管病。我们评估神经影像学生物标志物之间的关联， 痴呆、认知障碍以及与艾滋病毒和血管疾病的相关性。静脉采血 使我们能够评估已知的ADRD遗传风险，如载脂蛋白E（APOE）-E4等位基因，ATP- 结合盒亚家族A成员7（ABCA 7）和AD多基因风险评分。目的 3：评估痴呆和认知障碍和衰退的社会风险因素。我们将 管理心理社会措施，以检查痴呆，认知能力下降和大脑功能的程度， 教育经历、社会参与和网络以及童年逆境都会影响到儿童的行为。我们将 探索生物和社会风险因素对结果之间的中介关系。 我们的研究为了解撒哈拉以南非洲的ADRD，认知和大脑老化做出了重要贡献。 非洲许多国家正在经历人口和流行病的快速转变。