Identification of early cognitive change in diverse African populations. A harmonisation consortium to inform future dementia prevention studies.

识别不同非洲人群的早期认知变化。

• 批准号: MR/X03092X/1
• 负责人: Stella-Maria Paddick
• 金额: $ 49.53万
• 依托单位: Newcastle University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FX03092X%2F1
• 关键词: Identification; early; cognitive; change; diverse

This study will benefit older people living in Africa who are at risk of getting dementia, specifically Alzheimer's disease, the most common type of dementia worldwide. Over two thirds of people with dementia worldwide live in countries classified as 'low and middle income'. These 'low and middle income' countries have lower resources per person to cope with the challenges of dementia. This includes most African countries, where numbers of people with dementia are growing rapidly, because people are living longer due to better healthcare. We know that up to four in ten dementias could be prevented. Despite this, almost all research on how to prevent dementia has been done in and for, 'high income' countries like the UK. The earliest changes of Alzheimer's disease happen years prior to diagnosis. By the time there is obvious memory difficulty, the underlying brain damage is widespread and may be irreversible. Researchers have started to create ways of measuring these earliest changes through tests of brain functions which may be affected earlier than memory. These include tests of language, and one's ability to find one's way (navigation). Currently, we do not have tests to identify these early Alzheimer's disease changes in older people in Africa. It is well-known that culture and education affect performance on cognitive tests, and that measures designed in high income countries are unlikely to work well. We need African tests of the brain functions we know to be affected in early Alzheimer's disease, that are comparable to high-income country tests so that joint studies can be conducted. This study will create a formal partnership of community groups, people with dementia, Ministry of Health representatives, and academic researchers with experience of designing tests for early Alzheimer's disease in other countries to address these issues. In Tanzania, we will collaborate with local communities and dementia groups to evaluate existing tests of the brain functions affected earliest in Alzheimer's disease, adapt these tests to be acceptable to them and agree on how best to explain tests to older people so that they feel comfortable trying them. We will conduct a series of validation studies in hospital clinics and in a rural community, comparing performance on our adapted early tests to existing dementia tests used in Africa and with clinical diagnosis of Alzheimer's disease by a specialist doctor. Working with volunteers, communities, and the Tanzanian Ministry of Health, we will investigate what the normal test scores should be for an older person in Tanzania. We will ask over 700 people aged 60 and over to volunteer at Government health promotion events, and produce data on test performance by age, educational level, sex, and geographical location. We will work with another population study in Kilimanjaro, to use census data to help us establish a community baseline study and pilot follow-up to find out if our tests are likely to be feasible and useful in studies of change over time. Once we have properly evaluated the tests in Tanzania, the African Dementia Consortium network will repeat our work on normal test scores in their individual countries by training early career researchers. This additional work is planned for Benin, Ethiopia, Kenya, Uganda, Nigeria, Ghana, and Mozambique. This work will help our partnership of researchers to develop a future African dementia prevention study. This work may later also benefit researchers who work with minority populations in the UK. Our goal is to publish a set of effective tests, which other researchers can easily use. We want African older people to be able to take part in global dementia prevention studies wherever they live so that they have sound information on how to reduce their risk. Having firm evidence that African early Alzheimer's disease tests exist and are useful is the first step in making this happen.

这项研究将使居住在非洲的老年人受益于患有痴呆症的风险，特别是阿尔茨海默氏病，这是全球最常见的痴呆症类型。全球痴呆症患者中有三分之二生活在被归类为“低收入和中等收入”的国家。这些“低收入和中等收入”国家的人均资源较低，以应对痴呆症的挑战。这包括大多数非洲国家，那里的痴呆症患者数量正在迅速增长，因为由于医疗保健的状态更好，人们的寿命更长。我们知道，可以防止多达十分之一的痴呆症。尽管如此，几乎所有关于如何预防痴呆症的研究已经在像英国这样的“高收入”国家 /地区进行。阿尔茨海默氏病的最早变化发生在诊断前几年。到明显的记忆难度时，潜在的脑损伤已广泛，可能是不可逆转的。研究人员已经开始创建通过测试可能比记忆早期影响的大脑功能测试来衡量这些最早变化的方法。这些包括语言的测试以及一个人找到自己的方式的能力（导航）。目前，我们没有测试来确定非洲老年人的这些早期阿尔茨海默氏病的变化。众所周知，文化和教育会影响认知测试的表现，而在高收入国家中设计的措施不太可能效果很好。我们需要对我们知道在阿尔茨海默氏病中受到影响的大脑功能的非洲测试，这些功能与高收入国家测试相当，以便可以进行联合研究。这项研究将建立一个正式的伙伴关系，包括社区群体，痴呆症患者，卫生部代表和学术研究人员，在其他国家 /地区为早期阿尔茨海默氏病设计测试经验，以解决这些问题。在坦桑尼亚，我们将与当地社区和痴呆症小组合作，评估对阿尔茨海默氏病最早影响的大脑功能的现有测试，适应这些测试可以接受，并同意如何最好地向老年人解释测试，从而使他们感到舒适地尝试。我们将在医院诊所和农村社区中进行一系列验证研究，将我们改编的早期测试的表现与非洲现有的痴呆症测试以及专家医生的临床诊断对阿尔茨海默氏病进行了比较。与志愿者，社区和坦桑尼亚卫生部合作，我们将调查坦桑尼亚老年人的正常考试成绩。我们将要求700多名60岁及60岁以上的人参加政府健康促进活动的志愿者，并按年龄，教育水平，性别和地理位置划分测试绩效的数据。我们将与乞力马扎罗岛的另一项人口研究合作，使用人口普查数据来帮助我们建立社区基线研究和试点后续行动，以了解我们的测试是否可能是可行的，并且在随着时间的变化研究中有用。一旦我们正确评估了坦桑尼亚的测试，非洲痴呆症联盟网络将通过培训早期职业研究人员来重复我们在其各个国家的正常考试成绩的工作。计划为贝宁，埃塞俄比亚，肯尼亚，乌干达，尼日利亚，加纳和莫桑比克开展这项额外工作。这项工作将帮助我们与研究人员的合作伙伴关系，以开发未来的非洲痴呆预防研究。这项工作后来也可能使与英国少数群体合作的研究人员受益。我们的目标是发布一系列有效的测试，其他研究人员可以轻松使用它们。我们希望非洲老年人能够在他们居住的任何地方参加全球预防研究，以便拥有有关如何降低风险的合理信息。拥有坚定的证据表明非洲早期的阿尔茨海默氏病测试存在，并且很有用，这是实现这一目标的第一步。