Community-Based Early Identification of MCI in at Risk African Americans

基于社区的非裔美国人 MCI 早期识别

• 批准号: 8929117
• 负责人: VOYKO KAVCIC
• 金额: $ 21.27万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-30 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8929117
• 关键词: African American; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease risk; Area; Behavioral; Brain; Caring; Clinical; Clinical Trials; Clinical assessments; Cognitive; Communities; Comorbidity; Computers; Consensus; Cross-Sectional Studies; Data; Data Set; Dementia; Development; Diagnosis; Diagnostic Services; Disease; Early Diagnosis; Early identification; Economics; Elderly; Electroencephalography; Emergency medical service; Ensure; Familiarity; Family; Feasibility Studies; Frequencies; Funding; Future; General Population; Gerontology; Health; Impaired cognition; Individual; Institutes; Intervention; Life; Longevity; Longitudinal Studies; Measurement; Measures; Medical; Memory; Memory impairment; Methodology; Methods; Michigan; Mind; Minority; Modality; Neurologic; Neuropsychological Tests; Participant; Patients; Pharmaceutical Preparations; Play; Population; Population Heterogeneity; Prevention trial; Recruitment Activity; Research; Risk; Role; Sampling; Savings; Signal Transduction; Staging; Structure; Testing; Time; United States National Institutes of Health; Universities; Variant; base; caucasian American; cognitive change; cognitive performance; cognitive rehabilitation; cognitive testing; cohort; community setting; computerized; demographics; diagnostic accuracy; experience; functional disability; health disparity; high risk; inpatient service; metropolitan; mild cognitive impairment; neuropathology; neurophysiology; neuropsychological; novel; novel strategies; outreach; research clinical testing; social; socioeconomics; symposium; treatment response

DESCRIPTION (provided by applicant): Community-dwelling, African-American elders show faster rates of cognitive decline than elderly white Americans and are almost twice as likely to develop mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, in the early stages of these disorders, African-American elders are less likely to be diagnosed or receive treatment. Such health disparities represent a critical roadblock to early identification and care for MCI and dementia, which not only diminishes the medical and social benefits to the individual patient and family, but also fiscal savings at the state and federal levels. Development of economically viable and culturally acceptable methods of early detection of cognitive change is critical in minority populations. With the increase in longevity and the rapid increase in the proportion of elderly in the population, it is important to evaluate the earliest risk for dementia more accurately in order to guide environmental and clinical interventions for older adults. MCI, characterized by cognitive difficulties without clear functional impairment, is a daily-life-limitig condition that in most cases is a precursor to AD. Access to well characterized elderly who are at risk for MCI (e.g., memory complaint, but otherwise healthy) provides a unique opportunity to study the earliest signs of accelerated cognitive decline in individuals at highest risk for developing dementia. The proposed cross-sectional study will test to what extent computerized cognitive tests and portable electroencephalography (EEG/ERP) methodology can be used to easily, accurately and efficiently identify early cognitive decline and MCI in elderly African-Americans within their community setting. Additionally, we will also evaluate feasibility and acceptability of these computer-based and electrophysiological methods. We propose to accomplish the above aims by recruiting a total of 200 at risk African Americans (age e 65 years) from among the 1,100 participants in the Healthier Black Elders Center (HBEC) in their communities within the Detroit metro area. We will use an MCI-enriched sampling by recruiting only those older African Americans who in the recent past expressed subjective memory complaints. These 200 at risk elder African Americans will be extensively evaluated with two computerized tests (i.e., CogState and NIH Toolbox), EEG/ERP recordings, and a structured medical/neuropsychological exam and consensus. Our community based proposal, combining behavioral and EEG/ERP methods, will be used to establish the utility and acceptability of these measures and to potentially generate profiles of at risk healthy, elderly African-Americans, who may, within a short period of time, develop MCI (participants will be longitudinally followed after this project). We predict that a combination of behavioral and EEG/ERP methods will allow development of objective markers that will reliably identify early signs of cognitive decline. Such markers, in addition to identification of significant cognitive decline, may also play a significan role in the recruitment of larger, more diverse populations in order to evaluate the efficiency of new pharmacological approaches.

描述（由申请人提供）：居住在社区的非裔美国老年人的认知能力下降速度比美国白人老年人快，发生轻度认知障碍（MCI）和阿尔茨海默病（AD）的可能性几乎是白人老年人的两倍。然而，在这些疾病的早期阶段，非裔美国老年人被诊断或接受治疗的可能性较小。这种健康差异是早期识别和护理轻度认知障碍和痴呆症的一个重大障碍，这不仅减少了对患者个人和家庭的医疗和社会福利，而且还减少了州和联邦一级的财政节省。发展

项目成果

Cortical configuration by stimulus onset visual evoked potentials (SO-VEPs) predicts performance on a motion direction discrimination task.

• DOI: 10.1016/j.ijpsycho.2015.04.004
• 发表时间: 2015-06
• 期刊: International journal of psychophysiology : official journal of the International Organization of Psychophysiology
• 作者: B. Zalar;T. Martin;V. Kavcic