Patterns and Predictors of Cognitive Decline

认知衰退的模式和预测因素 认知功能减退导致轻度认知障碍和痴呆症是一种日益普遍和 导致美国老年人残疾和生活质量下降的重要原因。中国经济的预期增长 患有认知障碍和痴呆症的老年人的数量也将给 家庭、医疗保健系统和社会计划，如医疗保险。鉴于这种广泛的影响，它 对于了解美国老年人认知能力下降的模式和预测因素很重要。 拟议的研究将：1)为认知衰退的纵向轨迹提供新的信息 在全国具有代表性的老年美国人样本中进行为期12年的调查；以及2)确定风险因素 从整个生命周期(童年、中年和老年)来看，都会增加罹患 认知障碍和痴呆症作为一个年龄。 为了进行这些研究，我们将使用来自NIA资助的健康项目的独特的基于人口的相关数据 和退休研究(MRS)(N~22,000；1992-2004)，MRS补充年龄、人口统计和 记忆研究(ADAMS)(N=856,2001-2005)，以及亚当斯的相关医疗保险管理数据 科目(1986-2002)。使用两年一次的磁共振认知测试的潜在增长曲线建模技术 1992-2004年将能够确定这些人中认知能力下降的纵向轨迹 在亚当斯被诊断为认知功能正常、认知障碍或痴呆。详细数据 关于：心血管危险因素；急性医疗事件和外科干预；儿童和成人贫困， 社交网络和社会参与的程度将在嵌套病例对照研究中用于测试 关于认知能力下降的终生风险的假设。 这些研究将提供更好的理解认知能力下降的模式和预测因素。 具有全国代表性的老年人样本，因此允许更多知情的卫生保健规划 和政策制定。此外，更好地了解医疗、行为和医疗保健的相对重要性 社会经济因素是认知衰退和痴呆症的风险，这将有助于临床医生和政策制定者 针对高危人群，实施干预措施以防止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。

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 MRScognitive 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.