Patterns and Predictors of Cognitive Decline

认知能力下降的模式和预测因素 认知能力下降导致轻度认知障碍和痴呆症是一种越来越常见的疾病， 这是美国老年人残疾和生活质量下降的重要原因。预期增长率 患有认知障碍和痴呆症的老年人人数也将增加对老年人的负担。 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， 对于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。 拟议的研究将：1）提供关于认知下降纵向轨迹的新信息 在12年的时间里，在一个全国性的老年美国人样本中; 2）确定风险因素 在整个生命周期（童年、中年和老年）中，增加了患上糖尿病的可能性 认知障碍和老年痴呆。 为了进行这些研究，我们将使用来自NIA资助的健康研究中心的基于人口的独特关联数据。 和退休研究（MRS）（N~ 22，000; 1992 - 2004），MRS补充老化，人口统计学， 记忆研究（亚当斯）（N=856，2001 - 2005），以及亚当斯的相关医疗保险管理数据 主题（1986-2002）。潜伏生长曲线建模技术，使用两年一次的MRScoglycan测试， 1992年至2004年将允许确定这些人中认知能力下降的纵向轨迹 在亚当斯中诊断为认知功能正常、认知障碍或痴呆。详细数据 关于：心血管风险因素;急性医疗事件和外科手术;儿童和成人贫困， 社交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 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理解模式和预测的认知下降， 具有全国代表性的老年人样本，因此可以进行更明智的医疗保健规划 和政策制定。此外，更好地理解医疗、行为和 社会经济因素是认知能力下降和痴呆症的风险，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。

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.