Epidemiology of Brain Aging in the Very Old

老年人脑老化的流行病学

• 批准号: 7198421
• 负责人: LON Ray WHITE
• 金额: $ 154.91万
• 依托单位: KUAKINI MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-01 至 2012-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7198421
• 关键词: Adopted; Age; Aging; Alanine; Alzheimer' s Disease; Amino Acids; Ankle; Anti-Inflammatory Agents; Anti-inflammatory; Antibodies; Apnea; Appendix; Architecture; Archives; Area; Arginine; Arousal; Ascorbic Acid; Asia; Aspartic Acid; Attention; Autopsy; Basal Ganglia; Beds; Blood Pressure; Blood Vessels; Blood specimen; Body mass index; Brain; Brain Pathology; C-reactive protein; CETP gene; Cardiovascular system; Categories; Central Sleep Apnea; Cessation of life; Characteristics; Clinical; Clinical Data; Coffee; Cognitive; Collaborations; Condition; DNA; Data; Data Set; Dementia; Depth; Diabetes Mellitus; Diagnostic; Dietary Fats; Disease; Early treatment; Elderly; Electrocardiogram; End Point; Endocrine; Energy Intake; Epidemiology; Equilibrium; Estradiol; Etiology; Evaluation; Exons; Factor Analysis; Family; Family member; Fasting; Fibrinogen; Freezing; Frequencies; Functional disorder; Funding; Future; Gait; Genotype; Glucose; Glutamic Acid; Glycine; Gonadal Steroid Hormones; Grant; Heart; Heart Rate; Herpes Labialis; Herpes zoster disease; High Density Lipoproteins; High Prevalence; Hippocampus (Brain); Hour; Impaired cognition; Incidence; Individual; Infarction; Infection; Inflammation; Insulin; Intake; Interleukin-6; Interview; Japanese American; Knowledge; Laboratories; Laboratory Infection; Lead; Lesion; Leukocytes; Lewy Body Disease; Life; Link; Living Wills; Longitudinal Studies; Low-Density Lipoproteins; Lymphocyte Count; MRI Scans; Magnetic Resonance Imaging; Measurement; Measures; Memory impairment; Metabolic; Methods; Motor; Muscle Rigidity; Nerve Degeneration; Neurodegenerative Disorders; Neurologic; Neurologic Examination; Nonagenarian; Numbers; Nutritional; Operative Surgical Procedures; Orthostatic Hypotension; Outcome; Parietal; Parkinson Disease; Parkinson' s Dementia; Parkinsonian Disorders; Participant; Pathologic; Pathology; Pattern; Perfusion; Peripheral Vascular Diseases; Pharmaceutical Preparations; Phase; Physical Function; Plasma; Polysomnography; Population; Positioning Attribute; Posture; Prevention strategy; Principal Investigator; Probability; Proline; Protocols documentation; Psychotic Disorders; Public Health; Publishing; Pulse Rates; Range; Rate; Recording of previous events; Relative (related person); Reporting; Research; Research Personnel; Resources; Respiration; Risk; Risk Factors; Sampling; Score; Segmented Neutrophil; Serine; Serum; Serum Albumin; Severities; Skinfold Thickness; Sleep; Slide; Staging; Subgroup; Surface; Telephone; Telephone Interviews; Testing; Time; Tissue Sample; Tissue Stains; Total Sugar; Tremor; Triceps Brachii Muscle; Upper arm; Uric Acid; Variant; Vascular Dementia; Vitamin D; Walking; Work; aged; aging brain; base; blood lipid; cardiovascular risk factor; cognitive function; cohort; cysteine rich protein; depressive symptoms; design; executive function; fitness; functional decline; human CETP protein; human very old age (85+); impaired glucose tolerance; improved; interest; member; men; middle age; mild neurocognitive impairment; neocortical; neuropathology; neuropsychological; prevent; programs; putamen; research clinical testing; research study; saturated fat; sleep abnormalities; time interval; tissue fixing

DESCRIPTION (provided by applicant): This application is for the continuation of the project, "Epidemiology of Brain Aging in the Very Old", a population-based longitudinal study of Alzheimer's disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), mild cognitive impairment (MCI), and Parkinson's disease (PD). The cohort consists of Japanese-American men who have been followed in the Honolulu Heart Program (HHP) since 1965 and in the Honolulu-Asia Aging Study (HAAS) since 1991. Accrued resources include standardized measurements and observations from multiple prior examination cycles. Since 1991 these have included assessments of cognitive and motor function. Frozen blood samples and DNA are available for nearly all participants. Polysomnography studies and MRI scans are available on sub-samples, and extensive neuropathologic data are collected from ongoing, separately funded brain pathology projects. Two examination cycles were completed during the 2001-06 funding period. Identification of incident cases of AD, VaD, DLB, and PD, and extensive risk factor analyses resulted in several published reports. Neuropathologically confirmed mixed dementia was found to occur with high frequency. Unexpectedly, incidence of PD declined in the oldest subjects while dementia showed a steady rise. The central aims of the continuation will be: 1) estimation of incidence and clinical trajectories of decline for dementia, AD, VaD, DLB, PD, and MCI, between ages 87 and 105 years, 2) identification of additional risk factors and determinants for these conditions, with a special focus or relationships of cardiovascular factors to neurodegenerative conditions, and 3) correlation of clinical features and endpoints with neuropathological findings for participants who die and receive post-mortem examinations (supported by other grants). The target sample will be comprised of approximately 1,100 surviving participants when the initial examination begins. We expect to examine 767 (75%). Three examination cycles will be conducted at 1.5 year intervals, plus standardized telephone interviews with family informants at 6 month intervals. The youngest participant will be 87 years at the initial examination. The oldest at the final continuation cycle is expected be 112 years. These more frequent contacts are expected to enhance rapport with family members, improve our assessments of functional decline in the final months of life, and increase autopsy rates. The National Alzheimers Coordinating Center Uniform Data Set will be used for diagnostic criteria and methods and an expert neuropsychologist will join the team of core investigators. The unique design and resources of the HAAS will lead to improvements in our understanding of disease mechanisms for these conditions, and in turn, to strategies to prevent or delay their progression in the very old.

描述（由申请人提供）：本申请是为了继续开展“老年人脑老化的流行病学”项目，该项目是一项基于人群的阿尔茨海默病（AD）、血管性痴呆（VaD）、路易体痴呆（DLB）、轻度认知障碍（MCI）和帕金森病（PD）的纵向研究。该队列由自1965年以来在檀香山心脏计划（HHP）和自1991年以来在檀香山-亚洲老龄化研究（哈斯）中接受随访的日裔美国男性组成。应计资源包括标准化测量和多个先前检查周期的观察结果。自1991年以来，这些评估包括认知和运动功能的评估。几乎所有参与者都可以获得冷冻血液样本和DNA。多导睡眠图研究和MRI扫描可用于子样本，广泛的神经病理学数据收集正在进行的，单独资助的脑病理学项目。在2001- 2006年资助期间，完成了两个考试周期。识别AD、VaD、DLB和PD的事件病例，并进行广泛的风险因素分析，产生了几份已发表的报告。神经病理学证实的混合性痴呆发生率高。出乎意料的是，PD的发病率在年龄最大的受试者中下降，而痴呆症的发病率则稳步上升。继续开展工作的中心目标是：1）估计年龄在87至105岁之间的痴呆、AD、VaD、DLB、PD和MCI的发病率和下降的临床轨迹，2）识别这些病症的额外风险因素和决定因素，特别关注心血管因素与神经退行性病症的关系，及3）研究参加者在去世后接受尸体剖检时，其临床特征及终点与神经病理学结果的相关性（由其他赠款资助）。在初步检查开始时，目标样本将由大约1 100名幸存的参与者组成。我们预计将检查767（75%）。每隔一年半将进行三次检查，并每隔6个月对家庭举报人进行标准化电话访谈。最年轻的参与者在初次考试时将是87岁。最后一个延续周期的最大年龄预计为112岁。这些更频繁的接触有望增强与家庭成员的关系，改善我们对生命最后几个月功能下降的评估，并提高尸检率。国家老年痴呆症协调中心统一数据集将用于诊断标准和方法，一名神经心理学家专家将加入核心研究小组。哈斯的独特设计和资源将使我们对这些疾病的疾病机制的理解得到改善，从而制定预防或延缓老年人疾病进展的策略。