DEMENTIA AND DISABILITY IN THAI ELDERLY

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目及 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 痴呆症在不发达社会中越来越普遍。检测，诊断和治疗痴呆症的方法适用于发展中经济体是至关重要的，以避免出现的健康差异，在照顾痴呆症患者。泰国老年痴呆症和残疾项目（DDP）联合了加州大学洛杉矶分校阿尔茨海默病中心和玛希隆大学神经病学分部神经退行性疾病和行为神经病学部门的专业知识，以应对新制定的公共卫生任务（《康复和残疾人法》，BE 2534）要求每个大学或医疗中心负责照顾曼谷指定集水区的病人。这项研究将主要在泰国玛希隆大学与Vorapun Senanarong博士合作进行。作为NIH资助#P50 AG 16570的扩展。DDP中提出的方法已被Mahidol集水区负责人Udom Kachitorn教授接受，作为检测和描述泰国老年痴呆症和残疾的手段。2650名泰国老年人居住在集水区，将在寺庙、学校和老年人俱乐部接受为期6个月的筛查。我们预计将识别130名痴呆症患者和450名无痴呆症的认知障碍患者（CIND）。将对这些患者进行评估，以确定痴呆和认知障碍的原因。这些患者加上100名非痴呆、非残疾对照将在1年后重新评估。我们假设，泰国日常生活活动量表将在40%的泰国老年人中检测到残疾;痴呆将在5%的泰国老年人中存在;阿尔茨海默病将占在泰国老年人中检测到的痴呆的60%; CIND将在17%的泰国老年人中存在，痴呆的1年发病率将在基线CIND患者中存在;在基线时患有痴呆的患者将表现出每年4个泰国精神状态检查点的认知下降;并且残疾将与认知恶化高度相关。研究阶段（培训、筛选、评估和随访）将在3年内完成。我们的计划是雄心勃勃的，玛希隆大学将承担大量的费用分摊。这项研究的结果是至关重要的残疾人和认知障碍的泰国城市老年人的需求的公共卫生规划。残疾诊断方案将作为在曼谷其他集水区进行残疾和痴呆症筛查的模式。主要的外国合作者和加州大学洛杉矶分校阿尔茨海默病中心的首席研究员在过去的几个项目中成功合作，并共同发表了几篇手稿。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Dementia is becoming increasingly common in underdeveloped societies. Methods for detecting, diagnosing, and treating dementia appropriate for application in developing economies is critically important to avoid the emergence of health disparities in care of dementia patients. The Dementia and Disability in Thai Elderly Project (DDP) unites the expertise of the UCLA Alzheimer's Disease Center and the Neurodegenerative Disease and Behavioral Neurology Section of the Division of Neurology of Mahidol University to respond to a newly instituted public health mandate (the Rehabilitation and Disabled Persons Act, BE2534) requiring that each university or medical center take responsibility for the care of patients in their assigned catchment areas in Bangkok. This research will be done primarily in Thailand at Mahidol University in collaboration with Vorapun Senanarong, M.D. as an extension of NIH grant #P50 AG16570. The methodology proposed in the DDP has been accepted by the individual responsible for the Mahidol catchment area, Professor Udom Kachitorn, as the means of detecting and characterizing dementia and disability in Thai elderly. Two thousand-six hundred fifty Thai elderly live in the catchment area and will be screened over a 6-month period in temples, schools, and elderly clubs. We anticipate the identification of 130 individuals with dementia and 450 individuals with cognitive impairment with no dementia (CIND). These patients will be assessed to determine the cause of the dementia and cognitive impairment. These patients plus 100 non-demented, non-disabled controls will be reassessed 1 year later. We hypothesize that the Thai Activities of Daily Living scale will detect disability in 40% of Thai elderly; dementia will be present in 5% of Thai elderly; Alzheimer's disease will account for 60% of the dementia detected in Thai elderly; CIND will be present in 17% of Thai elderly, the 1-year incidence of dementia will be present in those with CIND at baseline; patients with dementia at baseline will exhibit a cognitive decline of 4 Thai Mental Status Examination points per year; and disability will be highly correlated with cognitive deterioration. The phases of the study (training, screening, assessment, and follow-up) will be completed over a 3-year period. Our program is ambitious and substantial cost sharing will be undertaken by Mahidol University. The outcomes of this study are critically important for public health planning of the needs of disabled and cognitively impaired urban Thai elderly. The DDP will serve as a model for the implementation for disability and dementia screening in other catchment areas of Bangkok. The major foreign collaborators and the principal investigator of the UCLA Alzheimer's Disease Center have successfully collaborated on several past projects and have published several manuscripts together.