Vascular Risk and Cognition in a Multi-ethnic Cohort

多种族人群的血管风险和认知

• 批准号: 7470772
• 负责人: CLINTON B WRIGHT
• 金额: $ 18.02万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7470772
• 关键词: Address; Affect; Age; Alcohol consumption; Alzheimer' s Disease; Area; Biological Markers; Biology; Blood; Blood Pressure; Blood Vessels; Brain; Brain Diseases; Brain Injuries; Brain imaging; C-reactive protein; Chronic Kidney Failure; Clinical; Cognition; Cognitive; Communities; Dementia; Detection; Diabetes Mellitus; Disease; Education; Educational workshop; Epidemiologist; Equation; Ethnic Origin; Exposure to; Fasting; Functional disorder; Glucose; Heart Diseases; Hispanics; Homocysteine; Homocystine; Hypertension; Image; Impaired cognition; Impairment; Infarction; Inflammation; Inflammatory; Insulin Resistance; Interleukin-6; Lead; Linear Regressions; Magnetic Resonance Imaging; Measurement; Measures; Metabolic syndrome; Neurologist; Neuropsychological Tests; Numbers; Pattern; Performance; Peroxidase; Phenotype; Population; Prevalence; Progress Review Group; Protocols documentation; Public Health; Publishing; Purpose; Race; Range; Reporting; Research; Research Methodology; Risk; Risk Factors; Staging; Standards of Weights and Measures; Stroke; Testing; Vascular Dementia; Vascular Diseases; White Matter Disease; base; career; cerebral atrophy; cerebrovascular; cohort; interest; modifiable risk; neuropsychological; novel; prospective; receptor; receptor for advanced glycation endproducts; tumor; white matter

DESCRIPTION (provided by applicant): Dr. Clinton Wright is a neurologist and epidemiologist with an interest in the effects of vascular risk factors on cognition. These relationships are poorly understood because past definitions of vascular dementia evolved from those for Alzheimer disease. The term vascular cognitive impairment has evolved to cover the wide range of effects of vascular disease on cognition, from pure forms ranging from mild dysfunction to vascular dementia, and including those mixed with degenerative causes such as Alzheimer disease. The candidate plans a career devoted to clarifying the phenotype of vascular cognitive impairment and identifying potentially modifiable risk factors. He has a special interest in multi-ethnic populations. The hypothesis of this proposal is that exposure to vascular risk factors causes distinct patterns of cognitive dysfunction depending on the type of brain injury. Clarification of the subtypes of vascular cognitive impairment as well as the identification of imaging and biological markers and potentially modifiable risk factors has been identified as a priority area by the NINDS Stroke Progress Review Group. The specific aims of the proposed research are: 1) To determine if exposure to particular vascular risk factors and inflammatory markers is related to specific cognitive domains using a sensitive battery of neuropsychological tests. Conventional and novel risk factors will include cardiac diseases, hypertension and blood pressure, diabetes, insulin resistance and the metabolic syndrome, reported alcohol consumption, total homocysteine and inflammatory markers; and 2) To determine if cerebrovascular brain damage as measured by quantitative MRI, including white matter hyperintensity volume, subclinical infarcts, subclinical microbleeds and brain atrophy are related to specific cognitive domains, adjusting for conventional and novel vascular risk factors. Linear regression using generalized estimating equations will be carried out to examine the effect of vascular risk factors and subclinical brain disease on multiple cognitive domains simultaneously to adjust for correlation among the neuropsychological tests. The detection of vascular cognitive impairment has public health implications as the number of people with early forms before frank dementia is estimated at three million in the U.S., a number equaling the prevalence of forms with dementia.

描述（由申请人提供）：Clinton Wright 博士是一位神经学家和流行病学家，对血管危险因素对认知的影响感兴趣。人们对这些关系知之甚少，因为过去对血管性痴呆的定义是从阿尔茨海默病的定义演变而来的。血管性认知障碍一词已经发展到涵盖了血管疾病对认知的广泛影响，从单纯的轻度功能障碍到血管性痴呆，还包括与阿尔茨海默病等退行性原因混合的疾病。该候选人计划致力于阐明血管性认知障碍的表型并识别潜在的可改变的风险因素。他对多种族人口特别感兴趣。该提议的假设是，根据脑损伤的类型，暴露于血管危险因素会导致不同的认知功能障碍模式。 NINDS 中风进展审查小组已将澄清血管性认知障碍亚型以及识别影像和生物标志物以及潜在可改变的危险因素确定为优先领域。拟议研究的具体目标是：1）使用一系列敏感的神经心理学测试来确定暴露于特定血管危险因素和炎症标志物是否与特定认知领域相关。传统和新的危险因素包括心脏病、高血压、糖尿病、胰岛素抵抗和代谢综合征、报告的饮酒量、总同型半胱氨酸和炎症标志物； 2) 确定定量 MRI 测量的脑血管损伤，包括白质高信号体积、亚临床梗塞、亚临床微出血和脑萎缩是否与特定认知领域相关，并调整传统和新型血管危险因素。将使用广义估计方程进行线性回归，以同时检查血管危险因素和亚临床脑疾病对多个认知领域的影响，以调整神经心理学测试之间的相关性。血管性认知障碍的检测具有公共健康意义，因为在美国，患有明显痴呆症之前患有早期形式痴呆症的人数估计为 300 万人，这个数字相当于痴呆症形式的患病率。