AGE OF DEMENTIA ONSET AND CARDIOVASCULAR RISK FACTORS

痴呆症发病年龄和心血管风险因素

• 批准号: 6808103
• 负责人: Jeremy M. Silverman
• 金额: $ 36.01万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-15 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6808103
• 关键词: Alzheimer' s disease; age difference; apolipoprotein E; biomarker; body physical activity; body weight; cardiovascular disorder; case history; cholesterol; clinical research; cognition disorders; disease /disorder onset; disease /disorder proneness /risk; homocysteine; human genetic material tag; human old age (65+); human subject; human very old age (85+); hypertension; longitudinal human study; magnetic resonance imaging; male; neuropsychological tests; noninsulin dependent diabetes mellitus; smoking

Several ongoing longitudinal studies have found evidence that many cardiovascular disease risk factors (CvRFs) are also risk factors for Alzheimer disease (AD). Most study cohorts, however, do not include many of the oldest old, and when present, they are predominantly female. Data from our center suggest CvRFs may be especially potent for AD in the very old. We selected diabetes, total cholesterol, hypertension, and plasma homocysteine concentration, based on prior research, for primary hypothesis testing. We will investigate whether there is a relationship between each one of these four CvRFs with cognitive decline and AD in an elderly male veteran population and explore whether this effect is strengthened with increased age. An "Aging Research Clinic" will be established at the Bronx VA specifically dedicated to this project. Eligible subjects must be older than 75 (with special emphasis on recruiting the very old) and be free of dementia. In addition to the four primary CvRFs, subjects will receive a comprehensive CvRF examination in conjunction with the cardiovascular research program at the Bronx VA. The four primary risk factors will be directly assessed at baseline in each subject. In addition, the baseline risk factor assessment will include: age, smoking, family history, weight and waistline, prior medical history for cardiovascular events, apolipoprotein E (and other relevant genotyping), C reactive protein, physical activity and other risk factors. Subjects will also be evaluated at baseline for left ventricular hypertrophy, carotid artery intima media thickness and proximal capacitative or large artery compliance, and distal oscillatory small artery compliance by radial artery pulse wave analysis. MRIs will be conducted at baseline in all subjects and at follow up in those who show evidence of cognitive decline (CDR30.5) to assess the role of cerebrovascular disease. The subjects will be followed longitudinally on an annual basis to determine who among them show evidence of cognitive decline (CDR > or = 0.5) and AD, as well as other possible forms of dementias (e.g. vascular dementia). As many of these CvRFs are modifiable, implicating them as risk factors for very late onset cognitive decline and AD holds the potential for making major public health gains for the very old--the fastest growing segment of the U.S. population.

一些正在进行的纵向研究发现，许多心血管疾病风险因素（CvRF）也是阿尔茨海默病（AD）的风险因素。然而，大多数研究组群并不包括许多最年长的老人，即使有，也主要是女性。来自我们中心的数据表明，CvRFs可能对老年人的AD特别有效。我们根据先前的研究选择糖尿病、总胆固醇、高血压和血浆同型半胱氨酸浓度作为主要假设检验。我们将研究这四种CvRFs中的每一种与老年男性退伍军人群体中认知能力下降和AD之间是否存在关系，并探讨这种影响是否随着年龄的增长而加强。一个“老龄化研究诊所”将建立在布朗克斯弗吉尼亚州专门致力于这一项目。资格 受试者年龄必须超过75岁（特别强调招募高龄者），且无痴呆症。除了四项主要CvRF外，受试者还将接受全面的CvRF检查，并与布朗克斯VA的心血管研究项目联合进行。将在基线时直接评估每例受试者的四个主要风险因素。此外，基线风险因素评估将包括：年龄、吸烟、家族史、体重和腰围、既往心血管事件病史、载脂蛋白E（和其他相关基因分型）、C反应蛋白、体力活动和其他风险因素。还将在基线时通过桡动脉脉搏波分析评价受试者的左心室肥大、颈动脉内膜中层厚度和近端容量性或大动脉顺应性以及远端振荡性小动脉顺应性。所有受试者将在基线时进行MRI，显示认知下降证据的受试者将在随访时进行MRI（CDR 30.5），以评估脑血管疾病的作用。 疾病将每年对受试者进行纵向随访，以确定其中谁显示出认知下降（CDR >或= 0.5）和AD以及其他可能形式的痴呆（例如血管性痴呆）的证据。由于这些CvRF中的许多是可修改的，这意味着它们是极晚发性认知衰退的风险因素，而AD有可能为美国人口中增长最快的老年人带来重大的公共卫生收益。