IDENTIFYING CASES AND COSTS OF DEMENTIA IN THE U.S.

描述（申请人摘要）：Kenneth朗加博士是一名普通内科医师 内科系和研究所的教员 社会研究的研究员他在获得研究经验的同时， 博士在加州大学公共政策和完成罗伯特伍德约翰逊 临床学者计划在UM。在培训期间，他 启动了关于痴呆症的直接和非正式治疗费用的试点研究 同时作为一个合作者在美国国立卫生研究院资助的健康和退休研究 他的近期职业目标是获得新的临床和研究技能 在两个临床认知障碍的纵向研究所需的 他的长期目标是领导多学科的 研究工作，以更好地了解社会和经济影响， 对患者、家庭和社会的影响。 UM提供了一个独特而丰富的环境来支持研究中的培训 衰老和认知障碍。朗加博士将由资深的 密歇根州医学院社会研究所教师 阿尔茨海默病研究中心和公共卫生学院。他将 受益于他与主要研究者的合作 （罗伯特·威利斯博士）和HRS的合作研究者。 该研究计划将利用6波HRS数据（1993年至1999年间收集） 2004）研究认知的直接和非正式的成本 以人口为基础的全国代表性样本的损害。的 纵向设计（长达11年的随访）和广泛的数据， 社会经济地位、合并症和非正式照顾者将被用来 确定认知障碍的严重程度（从轻度 或临床前至严重疾病）以及直接和家庭负担费用。 纵向模型将确定发病率的决定因素， 认知障碍的进展，以及入住疗养院， 死亡将开发马尔可夫模型来估计寿命成本 与认知障碍相关，并决定成本的分布 年龄，性别，种族，社会经济地位和公共（医疗保险和 医疗补助）和私人付款人。该项目将更好地定义经济 美国痴呆症日益流行的影响，以及 新的治疗方法的潜在好处，以防止或减缓进展， 这种昂贵且日益普遍的疾病。

DESCRIPTION (applicant s abstract): Dr. Kenneth Langa is a General Internist and faculty member in the Department of Internal Medicine and the Institute for Social Research at the UM. He gained research experience while earning a Ph.D. in Public Policy at the UC and completing the Robert Wood Johnson Clinical Scholars Program at the UM. During his fellowship training he initiated pilot studies on direct and informal caregiving costs of dementia while working as a Collaborator on the NIA-funded Health and Retirement Study (HRS).His immediate career goal is to obtain new clinical and research skills required for the longitudinal study of cognitive impairment in both clinical and population-based settings; his long-term goal is to lead multidisciplinary research efforts to better understand the social and economic impact of dementia on patients, families, and society. The UM provides a uniquely rich environment to support training in the study of aging and cognitive impairment. Dr. Langa will be mentored by senior faculty in the Institute for Social Research, Medical School, Michigan Alzheimer's Disease Research Center, and School of Public Health. He will benefit from his established collaborations with the principal investigator (Robert J. Willis, Ph.D.) and Co-Investigators of the HRS. The research plan will utilize 6 waves of HRS data (collected between 1993 and 2004) to study the direct and informal caregiving costs of cognitive impairment in a population-based nationally representative sample. The longitudinal design (with up to 11 years of follow-up) and extensive data on socioeconomic status, co-morbidities, and informal caregivers will be used to determine the relationship between severity of cognitive impairment (from mild or pre-clinical to severe disease) and direct and family caregiving costs. Longitudinal models will identify determinants of the incidence and progression of cognitive impairment, as well as nursing home admission and death. Markov models will be developed to estimate the lifetime costs associated with cognitive impairment, and determine the distribution of costs across age, gender, race, socioeconomic status, and public (Medicare and Medicaid) and private payers. This project will better define the economic impact of the growing prevalence of dementia in the United States, as well as the potential benefits of new treatments to prevent or slow the progression of this costly and increasingly common condition.