Patterns and Predictors of Cognitive Decline

描述（由申请人提供）：认知能力下降的模式和预测因素导致轻度认知障碍和痴呆的认知能力下降是美国老年人残疾和生活质量下降的一个日益普遍和重要的原因。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，了解美国老年人认知能力下降的模式和预测因素是很重要的。提出的研究将：1)在具有全国代表性的美国老年人样本中，提供关于12年期间认知能力下降的纵向轨迹的新信息；2)确定在整个生命周期（童年、中年和老年）中，随着年龄的增长，增加患认知障碍和痴呆可能性的风险因素。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补充老龄化，人口统计和记忆研究（ADAMS） （N=856, 2001 - 2005）以及ADAMS受试者的医疗保险管理数据（1986-2002）的独特关联人口数据。使用1992 - 2004年两年一次的MRS认知测试的潜在增长曲线建模技术，将允许在ADAMS中诊断为正常认知功能、认知障碍或痴呆的患者中识别认知衰退的纵向轨迹。详细数据：心血管危险因素；急性医疗事件和手术干预；儿童和成人的贫困，以及社会网络和社会参与的程度将被用于嵌套病例对照研究，以检验有关认知能力下降终身风险的假设。这些研究将更好地了解具有全国代表性的老年人样本中认知能力下降的模式和预测因素，从而使卫生保健规划和决策更加知情。此外，更好地了解认知能力下降和痴呆风险的医学、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，实施预防或减缓认知能力下降的干预措施，并更好地评估当前和未来干预措施的成本效益。

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.