EPIDEMIOLOGY OF DEMENTIA IN THE FRAMINGHAM STUDY

描述(改编自申请者摘要)：我们计划确定 9至11岁人群中痴呆症的发病率和类型 生命中最古老的。在这一增长最快的部分 人群，对其流行病学和临床表现知之甚少 痴呆症。弗雷明翰的研究队列，现在包括667名男性和女性，年龄 78至104岁(平均85.1岁)无痴呆症记录。的研究。 弗雷明翰的痴呆症自1976年以来一直在进行，当时全面的 进行了神经心理测试，并进行了无痴呆症的队列研究 已确认身份。自那以后，我们发现了新的痴呆症病例，方法是 迷你精神状态检查(MMSE)筛查，每两年进行一次，随后是 全面的神经学和神经心理学评估。 我们将重新对667人中的大多数人进行神经心理学治疗 无痴呆症幸存者，估计约182名受试者将同意 对大脑进行核磁共振扫描。认知表现和认知衰退的衡量标准，因为 1976-78年的神经心理学电池将与：半定量的 测量总的和局部的脑体积，脑白质高强度 MR扫描的WMHI体积、无症状性脑梗塞(SCI)和卒中体积。 利用现有的脑捐赠计划，系统性半定量 这些受试者大脑的神经病理学研究将与磁共振相关， 认知能力的表现和下降，以及以前测量的风险因素。 使用在以下过程中收集的前瞻性和系统性数据 弗雷明翰研究，最早2年，最远50年 之前，我们计划将生活方式变量、医疗信息、实验室 测量、记录在案的内科疾病和认知功能的发病率 可能是阿尔茨海默病和血管性痴呆。我们将确定所有新的病例 在这一总体人群样本中，这些老年幸存者中的痴呆症 接下来的五年。痴呆症更可能是由血管疾病引起的，而不是 高龄人群中的AD。根据核磁共振，神经学和 神经心理评估(少数基于神经病理学) 研究)我们将能够确认诊断并确定机制 这些受试者患痴呆症的潜在原因。我们也将处于一个独特的位置 与痴呆症有关的先兆和既往心血管疾病包括 血管性痴呆和确定血管因素对 阿尔茨海默病。

DESCRIPTION (Adapted from the Applicant's Abstract): We plan to determine the incidence and type of dementia in persons in the 9th through the 11th decades of life, the oldest-old. In this most rapidly growing portion of the population, little is known about the epidemiology and clinical manifestations of dementia. The Framingham Study cohort, now includes 667 men and women, ages 78 to 104 years (mean age 85.1) documented to be free of dementia. The study of dementia in Framingham has been underway since 1976 when a comprehensive neuropsychological battery was administered and a dementia-free cohort was identified. We have since identified new cases of dementia by means of Mini-Mental State Exam (MMSE) screening, administered biennially, followed by a comprehensive neurological and neuropsychological evaluation. We will re-administer the neuropsychology battery to most of the 667 dementia-free survivors and estimate approximately 182 subjects will consent to an MRI scan of the brain. Measures of cognitive performance and decline, since the neuropsychology battery in 1976-78, will be related to: semiquantitative measures of total and regional brain volumes, white matter hyperintensity (WMHI) volume, silent cerebral infarcts (SCI) and stroke volume on MR scans. Utilizing the existing brain donation program, systematic semiquantitative neuropathological study of the brains of these subjects will be related to MRI, cognitive performance and decline, and, previously measured risk factors. Using data collected prospectively and systematically over the course of the Framingham Study, as recently as 2 years before and as remotely as 50 years ago, we plan to relate lifestyle variables, medical information, laboratory measures, documented medical illness and cognitive functioning to the incidence of probable AD and vascular dementia. We will identify all new cases of dementia in these elderly survivors of this general population sample during the next five years. Dementia may result more often from vascular disease than from AD in persons of advanced age. Based on MRI, neurological and neuropsychological evaluations, (and in a small number based on neuropathologic study) we will be able to confirm the diagnosis and determine the mechanism underlying the dementia in these subjects. We will also be in a unique position to relate precursors of, and prior cardiovascular disease to dementia including vascular dementia and to determine the contribution of vascular factors to the dementia of AD.