Impact of COVID-19 on AD Occurrence: A Biracial Intergenerational Population Study

芝加哥健康与老龄化项目（Health and Aging Project，简称HAD）对阿尔茨海默氏症做出了几项重大贡献 疾病和相关痴呆（ADRD）流行病学。这些领域包括种族差异、患病率和 痴呆症的发病率趋势，社会，生活方式，血管，遗传风险因素，神经影像学和血液 在一项针对非裔美国人（AAs）和欧洲裔美国人的大型基于人群的社区研究中， （EA）。使用年长的单亲和正在进行的中年后代队列，我们将测试几种新的和 关于COVID-19对ADRD、MCI、认知下降和结构MRI大脑影响的创新假设 损伤通过延长授予的NIA NOSI行政补助金，代际研究提供了 研究的显著优势：（1）SARS-CoV-2感染对高血压患者的直接影响 炎症细胞因子，特别是在COVID-19传播风险高的家庭中，这导致了不利的 认知结果;以及（2）COVID-19爆发造成的身体和认知变化的间接影响 活动，社会参与和血管危险因素在不同社区的共享家庭环境。 为了解决这一科学研究领域，我们建议进行一项以双胞胎人口为基础的社区研究 对4,000名老年父母进行了两次人群认知评估和详细的临床评估， ADRD在1，200名参与者中进行，具体目标如下：（1）估计2020年美国人口普查人口 ADRD的校正总体和人口统计学特异性（年龄、人种/种族和性别）患病率和发生率， MCI和痴呆的可能性，并检验患病率和发病率在前后是否有变化 新冠肺炎。此外，检测高危AA父母中ADRD的5年风险是否有高危后代 与EA相比;（2）检查身体和认知活动，社会参与，BMI和 从COVID前到后的高血压以及这些变化对ADRD，MCI，认知障碍 衰退和核磁共振脑损伤此外，测试这些关联是否随年龄、性别（男性与女性）、 AA父母和后代与EA父母和后代相比;（3）测试参与者是否具有 SARS-CoV-2 RNA感染与血清学抗体和炎性细胞因子浓度升高 在具有较高血管危险因素的人群中，ADRD、MCI、认知功能下降和结构性疾病的风险较高。 核磁共振脑损伤此外，测试这些关联是否在AA父母和后代中更高， EA。该提案在制定预防战略和治疗方案方面具有巨大的公共卫生影响。 研究COVID-19对不同年龄段人群从中年到晚年健康的影响， 在社会上处于不利地位的AA少数群体。

The Chicago Health and Aging Project (CHAP) has made several significant contributions to Alzheimer's disease and related dementias (ADRD) epidemiology. These areas include racial disparities, prevalence, and incidence of dementia trends, social, lifestyle, vascular, genetic risk factors, and neuroimaging and blood biomarkers in a large population-based community study of African Americans (AAs) and European Americans (EAs). Using the older CHAP parent and the ongoing midlife offspring cohorts, we will test several novel and innovative hypotheses on the impact of COVID-19 on ADRD, MCI, cognitive decline, and structural MRI brain injury. By extending the awarded NIA NOSI Administrative Supplement, the intergenerational study provides significant advantages by investigating: (1) the direct effect of SARS-CoV-2 infections amongst those with higher inflammatory cytokines, especially in families with a high risk of COVID-19 transmission, which leads to adverse cognitive outcomes; and (2) an indirect effect of COVID-19 outbreak-imposed changes in physical and cognitive activities, social engagement, and vascular risk factors in a shared family environment in diverse communities. To address this scientific area of research, we propose to conduct a biracial population-based community study of 4,000 older CHAP parents with two population cognitive assessments and detailed clinical evaluations for ADRD in 1,200 participants with the following specific aims: (1) Estimate the 2020 US census demographic adjusted overall and demographic-specific (age, race/ethnicity, and gender) prevalence and incidence of ADRD, MCI, and dementia likelihood and test whether the prevalence and incidence have changed before and after COVID-19. Also, test whether the 5-year risk of ADRD among high-risk AA parents has high-risk offspring compared to EAs; (2) Examine the change in physical and cognitive activities, social engagement, BMI, and hypertension from pre- to post-COVID and the impact of these changes on the risk of ADRD, MCI, cognitive decline, and MRI brain injury. Also, test whether these associations are higher by age, sex (males vs. females), and among AA parents and offspring compared to EA parents and offspring; (3) Test whether participants with SARS-CoV-2 RNA infections and serology antibodies and elevated concentrations of inflammatory cytokines among those with higher vascular risk factors have a higher risk of ADRD, MCI, cognitive decline, and structural MRI brain injury. Also, test whether these associations are higher among AA parents and offspring compared to EAs. This proposal has an enormous public health impact in developing preventive strategies and therapeutic studies on the impact of COVID-19 on population health across generations from midlife to late-life in a diverse population with socially disadvantaged AA minorities.