SOCIAL FACTORS AND EPIDEMIOLOGY OF COGNITIVE DECLINE

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DESCRIPTION (provided by applicant): Dr Shadlen aims to become a leading contributor to the body of literature on dementia epidemiology. Her research interests include examining the influence of ethnicity and social engagement on cognitive decline and dementia. During the period of this K08 award, she will enhance her research and training skills at the University of Washington. The proposed program includes: 1) coursework in linear modeling and survival analysis, 2) experience in design of longitudinal studies, 3) experience in grant management. Dr. Eric B. Larson will oversee her research and training. Dr. Itamar B. Abrass will provide geriatric expertise and academic career guidance. Consultants include Drs. Annette Fitzpatrick, and David Siscovick. The incidence of AD may be two-fold higher among Blacks compared to Whites. Reasons for this discrepancy are not well explained. Recent studies suggest that there is an association between lifestyle engagement and clinical expression of dementia. Lifestyle engagement is the manifestation of purposeful activities that maintains a current state of well being or promotes a desirable future. If low lifestyle engagement is more common among Blacks, then, this may contribute to increased risk of developing dementia. The proposed work will capitalize on six years of prospective observation in an epidemiological cohort of 3602 Cardiovascular Health Study (CHS) Memory Project participants. Questions addressed in this study may suggest interventions to reduce cognitive decline, hence delaying the progression to dementia. The specific aims are: 1) To examine the associations and determine the utility of measures of Lifestyle Engagement in predicting the trajectory of cognitive decline; 2) To examine various operationally defined domains of lifestyle engagement and compare their abilities to predict subsequent incident dementia; 3) To determine whether there are ethnic differences in the pattern of distribution of lifestyle engagement and their associations with cognitive decline and incident dementia; and 4) To evaluate the association of Lifestyle Engagement and survival. The Mentored Clinical Scientist Development Award will enable Dr Shadlen to 1) obtain formal training in advanced epidemiological techniques, 2) analyze a national, multi-center, multiethnic database, and 3) test a model that social factors have direct effects on the epidemiology of neurodegenerative disease. Hence, these projects will allow Dr Shadlen to achieve her 5-year goal of synthesis of her interests in racial differences, dementia, and epidemiology into an independent, thought-provoking research program.