Patterns and Predictors of Cognitive Decline

认知能力下降的模式和预测因素

• 批准号: 7222763
• 负责人: KENNETH M LANGA
• 金额: $ 29.41万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-15 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7222763
• 关键词: Accounting; Acute; Acute Disease; Address; Adult; Affect; African American; Age; Aging; Alzheimer' s Disease; American; Apolipoprotein E; Area; Attention; Behavioral; Cardiovascular Diseases; Caring; Cerebrovascular Disorders; Cessation of life; Childhood; Chronic Disease; Clinical; Clinical assessments; Cognition; Cognitive; Communities; Complex; Country; Daily; Data; Data Analyses; Databases; Dementia; Demographic Aging; Development; Diabetes Mellitus; Diagnosis; Diagnostic; Doctor of Philosophy; Economics; Elderly; Event; Family; Family Sizes; Family health status; Floor; Funding; Future; Gender; General Anesthesia; Genotype; Government Programs; Growth; HGS gene; Health; Healthcare; Healthcare Systems; Home environment; Hypertension; Impaired cognition; Incidence; Individual; Injury; Intervention; Knowledge; Life; Link; Longevity; Magnetic Resonance Spectroscopy; Measures; Medical; Medicare; Medicare/Medicaid; Memory; Methods; Modeling; Nested Case-Control Study; Non-linear Models; Numbers; Obesity; Operative Surgical Procedures; Outcome; Pathway interactions; Patient Self-Report; Pattern; Personal Satisfaction; Policy Maker; Policy Making; Population; Poverty; Prevalence; Principal Investigator; Probability; Protocols documentation; Quality of life; Range; Recording of previous events; Relative (related person); Research; Retirement; Risk; Risk Factors; Sampling; Shapes; Social Network; Social Security; Socioeconomic Factors; Spouses; Structure; Study Subject; Techniques; Testing; Time; United States; Vascular Dementia; Work; base; cardiovascular risk factor; care systems; cognitive change; cognitive function; cost; cost effectiveness; design; disability; expectation; experience; follow-up; geographic difference; hypercholesterolemia; member; middle age; mild neurocognitive impairment; neuropsychological; prevent; programs; social; treatment duration

DESCRIPTION (provided by applicant): Patterns and Predictors of Cognitive Decline Cognitive decline leading to mild cognitive impairments and dementia is an increasingly common and important cause of disability and decreased quality of life for older Americans. The expected growth in the number of older adults with cognitive impairment and dementia will also place an increasing burden on families, the health care system, and social programs, such as Medicare. Given this wide-ranging impact, it is important to understand the patterns and predictors of cognitive decline in older Americans. The proposed studies will: 1) provide new information on the longitudinal trajectories of cognitive decline over a 12-year period in a nationally representative sample of older Americans; and 2) identify risk factors from across the life span (childhood, middle-age, and older-age) that increase the likelihood for developing cognitive impairment and dementia as one ages. To perform these studies we will use unique linked population-based data from the NIA-funded Health and Retirement Study (MRS) (N~22,000; 1992 - 2004), the MRS supplemental Aging, Demographics, and Memory Study (ADAMS) (N=856, 2001 - 2005), as well as linked Medicare administrative data for ADAMS subjects (1986-2002). Latent growth curve modeling techniques using biennial MRS cognitive tests from 1992 - 2004 will allow the identification of the longitudinal trajectory of cognitive decline among those diagnosed in the ADAMS with normal cognitive function, cognitive impairment, or dementia. Detailed data on: cardiovascular risk factors; acute medical events and surgical interventions; childhood and adult poverty, and the extent of social networks and social engagement will be used in nested case-control studies to test hypotheses regarding life-long risks for cognitive decline. These studies will provide a better understanding of the patterns and predictors of cognitive decline in a nationally representative sample of older adults and, therefore, allow more informed health care planning and policy-making. In addition, a better understanding of the relative importance of medical, behavioral, and socioeconomic factors that are risks for cognitive decline and dementia will help clinicians and policy-makers target high-risk groups, implement interventions to prevent or slow cognitive decline, and better assess the cost-effectiveness of current and future interventions.

描述（由申请人提供）：认知衰退的模式和预测因素认知衰退导致轻度认知障碍和痴呆是美国老年人残疾和生活质量下降的一个越来越常见和重要的原因。患有认知障碍和痴呆症的老年人数量的预期增长也将给家庭、医疗保健系统和医疗保险等社会项目带来越来越大的负担。鉴于这种广泛的影响，重要的是要了解美国老年人认知能力下降的模式和预测因素。拟议的研究将：1）提供关于美国老年人全国代表性样本中12年内认知能力下降纵向轨迹的新信息; 2）确定整个生命周期（童年，中年和老年）的风险因素，这些风险因素会增加随着年龄增长发展认知障碍和痴呆的可能性。为了进行这些研究，我们将使用来自NIA资助的健康与退休研究（MRS）（N = 22，000; 1992 - 2004），MRS补充老化，人口统计学和记忆研究（亚当斯）（N=856，2001 - 2005）的独特的基于人群的相关数据，以及亚当斯受试者的相关医疗保险管理数据（1986-2002）。使用两年一次的MRS认知测试从1992年至2004年的潜在增长曲线建模技术将允许识别的纵向轨迹的认知功能下降的诊断在亚当斯中与正常的认知功能，认知障碍，或痴呆症。详细数据：心血管危险因素;急性医疗事件和手术干预;儿童和成人贫困，以及社交网络和社会参与的程度将用于嵌套病例对照研究，以检验关于认知能力下降的终身风险的假设。这些研究将提供一个更好的了解模式和预测因素的认知能力下降，在全国代表性样本的老年人，因此，允许更明智的医疗保健规划和决策。此外，更好地了解认知能力下降和痴呆症风险的医疗，行为和社会经济因素的相对重要性将有助于临床医生和政策制定者瞄准高危人群，实施干预措施以预防或减缓认知能力下降，并更好地评估当前和未来干预措施的成本效益。