The Health & Aging Brain Study - Health Disparities (HABS-HD)

HABS-HD总体摘要 2018年的AT（N）框架为该领域提供了阿尔茨海默病的第一个生物学概念 (AD)是为了推进临床试验事实上，第一种降淀粉样蛋白药物（aducanumab） 现在已经获得了食品药品管理局的许可然而，几乎所有支持框架本身的数据，以及临床数据， 来自非西班牙裔白色（NHW）个体的研究。到2060年，美国将成为 大部分是“非白人”，15%的人口是非洲裔美国人（AA），27.5%是西班牙裔（65%的人口是白人）。 是墨西哥裔美国人[MA]）。因此，迫切需要了解 AT（N）框架和相关的基于生物标志物的治疗，占美国人口的43%。目前， AD和AD相关痴呆（ADRD）的负担最高，而西班牙裔将经历最大的 到2060年AD/ADRD增加。此外，NIA AD+ADRD实施里程碑的里程碑1 明确要求检查“多种病因的早期机制途径”（1.I）、社会文化（1.I）和 基于社区的队列中的麻烦（1.B）因素，包括尖端成像、流体、遗传和 其他生物标志物，以了解AD的健康差异。大脑健康与衰老 研究-健康差异（HABS-HD）是第一个大规模的，基于社区的项目，同时研究 AT（N）定义的每一种生物标志物，与NIA健康差异研究框架保持一致， 在美国三个最普遍的种族/民族群体中，AA、MA和NHW。HABS-HD的目标 U19的目标如下：目标1：收集成像、临床、生物学和遗传学数据， 最大的不同人群的纵向队列，检查整个成年期的AT（N）生物标志物。目标2： 收集生命历程的麻烦（通过地区数据索引），以及社会文化数据，并研究如何 这些因素影响不同人群中AT（N）生物标志物的时间、顺序和轨迹。目的 3：向全球科学界传播HABS-HD数据和样本。将制作HABS-HD数据 通过LONI提供，而生物流体样品将通过HABS-HD组学核心提供。Genomics 将根据NIH/NIA指南提供数据。HABS-HD的长期目标是建立人口- 为AD的新型治疗和预防策略提供特定的信息精准医学。推进这一 为了实现这一目标，我们将开展以下项目：项目1）研究AT（N）的时间、序列和轨迹 不同人群的生物标志物;项目2）检查血管，代谢和炎症的影响 不同人群中AT（N）生物标志物的时间、序列和轨迹的因素; 3)检查麻烦的影响（通过邻里劣势）和社会文化因素对 不同人群中AT（N）生物标志物的时间、序列和轨迹。

HABS-HD OVERALL ABSTRACT The 2018 AT(N) framework provided the field with the first biological conceptualization of Alzheimer’s disease (AD) for the explicit purpose of advancing clinical trials. In fact, the first amyloid-lowering drug (aducanumab) has now received FDA clearance. However, nearly all data supporting the framework itself, as well as clinical trials, comes from research among non-Hispanic white (NHW) individuals. By 2060 the U.S. will become largely “non-white” with 15% of the population being African American (AA) and 27.5% being Hispanic (65% of which are Mexican American [MA]). Therefore, there is an urgent need to understand the relevance of the AT(N) framework, and associated biomarker-based therapeutics, for 43% of the U.S. population. AAs currently have the highest burden of AD and AD related dementias (ADRD) while Hispanics will experience the greatest increase in AD/ADRDs by 2060. Moreover, Milestone 1 of the NIA AD+ADRD Implementation Milestones explicitly call for examination of “early mechanistic pathways of multiple etiologies” (1.I), sociocultural (1.I) and exposome (1.B) factors among community-based cohorts that include cutting edge imaging, fluid, genetic and other biomarkers in diverse populations to understand health disparities in AD. The Health & Aging Brain Study – Health Disparities (HABS-HD) is the first large-scale, community-based project to simultaneously study each of the AT(N) defined biomarkers, in alignment with the NIA Health Disparities Research Framework, across the three most prevalent racial/ethnic groups in the U.S., AA, MA, and NHW. The Aims of the HABS-HD U19 are as follows: Aim 1: To collect imaging, clinical, biological and genetic data which will result in the largest longitudinal cohort of diverse populations that examines AT(N) biomarkers across adulthood. Aim 2: To collect life-course exposome (via the Area Deprivation Index), as well as sociocultural data and examine how these factors affect the timing, sequence and trajectories of AT(N) biomarkers among diverse populations. Aim 3: To disseminate HABS-HD data and samples to the global scientific community. HABS-HD data will be made available via LONI while biofluid samples will be made available through the HABS-HD Omics Core. Genomics data will be made available per NIH/NIA guidelines. The long-term goal of HABS-HD is to establish population- specific informed precision medicine for novel treatment and prevention strategies for AD. To advance this goal, we will conduct the following Projects: Project 1) Examine the timing, sequence and trajectories of AT(N) biomarkers across diverse populations; Project 2) Examine the impact of vascular, metabolic and inflammatory factors on the timing, sequence and trajectories of AT(N) biomarkers across diverse populations; and Project 3) Examine the impact of the exposome (via neighborhood disadvantage) and sociocultural factors on the timing, sequence and trajectories of AT(N) biomarkers across diverse populations.