Risk Factors for Cognitive Decline in African-Americans

描述（由申请人提供）：与衰老和阿尔茨海默病（AD）相关的认知衰退是最常见和最令人衰弱的疾病之一，并构成了一个巨大且日益严重的公共卫生问题。预测表明，与老龄化有关的慢性病的发病率预计在今后十年将大幅增加。对于少数民族人口，尤其是年龄较大的非裔美国人人口来说，情况尤其如此，他们的增长速度甚至比年龄较大的白色人口还要快。少数民族老龄化研究（MARS）是一项纵向队列研究，研究对象是350多名无痴呆症的老年非裔美国人，他们同意接受年度临床评估。在上一个项目期间，我们确定了非裔美国人认知能力下降的几个风险因素。建议继续的总体目标是量化三个常见的神经病理学指标，包括阿尔茨海默病病理学，脑梗死，和路易体在MARS参与者，并检查其与认知功能和临床风险因素的关联。此外，为了增加功率和检查这些协会的种族差异，我们建议使用现有的纵向临床和神经病理学数据的白人从其他两个正在进行的队列研究拉什。我们的具体目标是：1）检查三种死后神经病理学指标与1a：总体认知水平和五种认知能力，1b：总体认知水平和五种认知能力的变化之间的关系：2）检查神经病理学与认知功能水平和变化之间的关系的种族差异; 3）检验APOE e4等位基因与非裔美国人中AD病理学水平升高相关，而52等位基因与AD病理学水平较低相关的假设;和4）检查BMI与神经病理学的关系，并检验BMI与白人中AD病理学的相关性比与非裔美国人中AD病理学的相关性更强的假设。关于非裔美国人认知障碍的神经病理学基础的数据有限。将死后指数纳入增长最快的少数群体之一的认知能力下降风险因素的研究是非常创新的，并有可能大大增加对风险因素与神经病理学相互作用影响认知能力和认知测试表现种族差异的方式的理解。此外，这些发现可能对治疗干预和疾病预防具有重要意义。

DESCRIPTION (provided by applicant): Cognitive decline associated with aging and Alzheimer's disease (AD) is among the most common and debilitating conditions, and poses a large and increasing public health problem. Projections indicate that the prevalence of aging-related chronic conditions is expected to increase substantially in the next decade. This will be particularly true for minority populations, especially the older African American population, which is growing at an even more rapid pace than the older White population. The Minority Aging Research Study (MARS) is a longitudinal cohort study of more than 350 older African Americans without dementia who agreed to annual clinical evaluations. During the previous project period we identified several risk factors for cognitive decline in African Americans. The overall goal of the proposed continuation is to quantify three common neuropathologic indices including Alzheimer's disease pathology, cerebral infarctions, and Lewy bodies in MARS participants, and examine their associations to cognitive function and clinical risk factors. In addition, to increase power and examine racial differences in these associations, we propose to use existing longitudinal clinical and neuropathologic data on Whites from two other ongoing cohort studies at Rush. Our Specific Aims are to: 1) examine the association of the three post-mortem neuropathologic indices to 1a: level of global cognition and five cognitive abilities, 1b: change in global cognition and five cognitive abilities; 2) examine racial differences in the associations of neuropathology to level of and change in cognitive function; 3) test the hypothesis that the APOE e4 allele is associated with increased levels of AD pathology, and the 52 allele is associated with a lower level of AD pathology in African Americans; and 4) examine the relationship of BMI to neuropathology, and test the hypothesis that BMI is more strongly associated with AD pathology in Whites than in African Americans. There is limited data on the neuropathologic basis of cognitive impairment in African Americans. Integrating post-mortem indices into a study of risk factors for cognitive decline in one of the fastest growing minority groups is highly innovative and has the potential to greatly increase understanding of the ways in which risk factors interact with neuropathology to influence cognition and racial disparities in cognitive test performance. Further, the findings could have important implications for therapeutic intervention and disease prevention.