Subjective Cognitive Decline and Objective Cognitive Trajectories in Older Hispanics/Latinos

老年西班牙裔/拉丁裔的主观认知衰退和客观认知轨迹

• 批准号: 10552574
• 负责人: Zvinka Zoe Zlatar
• 金额: $ 76.36万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10552574
• 关键词: Acculturation; Activities of Daily Living; Age; Alleles; Alzheimer' s Disease; Alzheimer' s disease pathology; Alzheimer' s disease related dementia; Alzheimer’s disease biomarker; Amyloid beta-Protein; Anxiety; Apolipoprotein E; Biological Markers; California; Clinical; Cognition; Cognitive; Cognitive deficits; Country; Data; Dementia; Disease; Early Diagnosis; Early identification; Education; Educational Status; Elderly; Enrollment; Ethnic Origin; Ethnic Population; Future; Goals; Growth; Hispanic; Hispanic Populations; Impaired cognition; Individual; Individual Differences; Language Tests; Latino; Latino Population; Learning; Measurement; Measures; Mediating; Memory; Mental Depression; Moods; Not Hispanic or Latino; Participant; Patient Recruitments; Patient Self-Report; Perception; Persons; Population; Population Heterogeneity; Predictive Value; Prevention; Questionnaires; Recommendation; Reporting; Research; Risk; Risk Marker; Sampling; Site; Spain; Symptoms; Time; United States; Universities; Vision; Work; age related; blood-based biomarker; cognitive ability; cognitive change; cognitive function; cognitive performance; cognitive testing; cohort; disability; ethnic minority; experience; health literacy; healthy aging; improved; improved outcome; informant; mild cognitive impairment; novel; pre-clinical; predictive marker; preventive intervention; prospective; racial population; sex; β-amyloid burden

Project Summary/Abstract This project is directly aligned with the NIA’s strategic goals of 1) developing improved approaches for the early detection and diagnosis of disabling illnesses and age-related debilitating conditions and 2) identifying appropriate strategies for disease, illness, and disability prevention and healthy aging among the underserved. As the older adult population continues to grow, it is expected that an increasing number of seniors will be living with Alzheimer’s disease and related dementias. As such, it is imperative to identify early risk markers of cognitive decline prior to symptom manifestation. Although Hispanics/Latinos (henceforth referred to as Hispanics) are at increased risk for mild cognitive impairment compared to non-Hispanic Whites, research investigating early risk markers in this growing and underserved segment of the United States (U.S.) population is lacking. One potential early risk marker of Alzheimer’s disease is subjective cognitive decline (SCD), which is used to describe self- reported perceived changes in cognitive function compared to a previous state. Although the expression, reporting, and predictive value of SCD may vary due to factors such as cultural/ethnic background, acculturation, and education level, little research has been conducted outside of non-Hispanic White cohorts. In fact, most existing SCD research with Hispanics has been conducted in Spain, whose population is very culturally different than Hispanics living in the U.S. The proposed study will help advance SCD research by characterizing the cognitive and biomarker correlates of SCD in U.S. Hispanics cross-sectionally, and by establishing its predictive value for cognitive change over three years. To achieve this, we will prospectively administer a validated SCD questionnaire, a culturally sensitive cognitive test battery, mood questionnaires (i.e., depression), and culturally- relevant measures that may influence SCD to older Hispanics with normal cognition (N=100) or mild cognitive impairment (N=100). We will also obtain SCD reports from participant’s informants to determine its differential ability to predict cognitive decline. Participant recruitment will leverage on existing cohorts at two sites: The University of California San Diego Shiley-Marcos Alzheimer’s Disease Research Center (ADRC) and the 1Florida ADRC. We will investigate if self and informant SCD reports are associated with concurrent, objective cognitive function (adjusting for relevant covariates) and examine if baseline SCD reports predict change in cognition over 3 years. Moreover, we will use existing biomarkers collected by the ADRCs, as well as novel blood-based biomarkers, to investigate if SCD is associated with amyloid-β and apolipoprotein E ε4 allelic status. Furthermore, we will investigate if acculturation, health literacy, country of origin, and language of testing, as well as demographic variables (age, sex, years of education) influence SCD reporting. Findings will characterize the cognitive and biomarker profile and predictive value of SCD in U.S. Hispanics, help refine SCD measurement, and identify individual differences in SCD reporting that may confer greater risk for decline.

项目总结/摘要 该项目直接与NIA的战略目标保持一致，即：1）为早期 检测和诊断致残性疾病和与年龄相关的衰弱性疾病; 2）识别 在得不到充分服务的人群中采取适当的疾病、疾病和残疾预防战略以及健康老龄化战略。 随着老年人口的持续增长，预计将有越来越多的老年人生活在 阿尔茨海默氏症和相关痴呆症患者。因此，必须确定认知障碍的早期风险标志物。 在症状出现之前下降。虽然西班牙裔/拉丁裔（以下简称西班牙裔）在 与非西班牙裔白人相比，轻度认知障碍的风险增加，研究调查早期风险 在美国这个不断增长和服务不足的市场中，人口缺乏。一个潜在 阿尔茨海默病的早期风险标志物是主观认知下降（SCD），它被用来描述自我， 报告了与之前状态相比认知功能的感知变化。虽然表达， SCD的报告和预测值可能因文化/种族背景，文化适应， 和教育水平，很少有研究已经进行了非西班牙裔白色队列以外。其实大部分 现有的SCD研究是在西班牙进行的，西班牙人的文化差异很大 这项拟议的研究将有助于推进SCD研究， 认知和生物标志物相关的SCD在美国西班牙裔横截面，并通过建立其预测 三年内认知变化的价值。为了实现这一目标，我们将前瞻性地使用经验证的SCD 问卷，文化敏感的认知测试组合，情绪问卷（即，抑郁症），以及文化- 可能影响认知正常的老年西班牙裔（N=100）或轻度认知障碍的SCD的相关指标 损伤（N=100）。我们亦会从参与者的举报人取得SCD报告，以确定其差异 预测认知能力下降的能力。参与者招募将利用两个研究中心的现有队列： 加州大学圣地亚哥分校Shiley-Marcos阿尔茨海默病研究中心（ADRC）和 1佛罗里达州ADRC。我们将调查自我和告密者SCD报告是否与并发、客观 认知功能（调整相关协变量），并检查基线SCD报告是否预测 3年以上的认知。此外，我们将使用ADRC收集的现有生物标志物，以及新的生物标志物。 基于血液的生物标志物，以研究SCD是否与淀粉样蛋白-β和载脂蛋白E ε4等位基因状态相关。 此外，我们还将调查文化适应、健康素养、原籍国和测试语言， 人口统计学变量（年龄、性别、受教育年限）影响SCD报告。调查结果将描述 认知和生物标志物特征以及美国西班牙裔SCD的预测价值，有助于完善SCD测量， 并确定SCD报告中可能导致更大下降风险的个体差异。