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

描述(申请人S摘要)：肯尼斯·兰加博士是一名普通内科医生 他是内科和研究所的教员 密歇根大学社会研究中心。他在获得研究经验的同时获得了一份 加州大学公共政策博士和完成罗伯特·伍德·约翰逊 密歇根大学临床学者计划。在他的团契训练期间，他 关于痴呆症的直接和非正式护理费用的启动试点研究 作为NIA资助的健康和退休研究的合作者 他的直接职业目标是获得新的临床和研究技能 认知障碍的纵向研究需要在两个临床上 和以人口为基础的环境；他的长期目标是领导多学科 研究工作，以更好地了解艾滋病的社会和经济影响 痴呆症对患者、家庭和社会的影响。 UM提供了一个独特的丰富环境来支持研究中的培训 衰老和认知障碍。兰加医生将由高年级学生指导 密歇根州医学院社会研究所教员 阿尔茨海默病研究中心和公共卫生学院。他会的 从他与首席调查员建立的合作中受益 罗伯特·J·威利斯博士以及HRS的联合调查员。 该研究计划将利用6波HRS数据(从1993年至 2004)研究了认知能力的直接和非正式照料成本 以人口为基础的具有全国代表性的样本中的损害。这个 纵向设计(有长达11年的跟踪调查)和大量数据 社会经济地位、合并症和非正式照顾者将习惯于 确定认知损害的严重程度之间的关系(从轻度 或临床前到严重疾病)以及直接和家庭护理费用。 纵向模型将确定发病的决定因素和 认知障碍的进展，以及疗养院的入院和 死亡。将开发马尔可夫模型来估计生命周期成本 与认知障碍相关，并决定成本的分布 跨年龄、性别、种族、社会经济地位和公共部门(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 美国痴呆症发病率不断上升的影响，以及 预防或延缓癌症进展的新疗法的潜在益处 这种代价高昂且越来越常见的疾病。

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.