Epidemiology of Alzheimer's Disease and Cognition: Innovative Approaches to Global Harmonization

开发阿尔茨海默病（AD）、痴呆和认知功能的敏感和有效指标， 低识字率和低收入国家具有挑战性，需要创造性的方法来补充 标准的神经心理电池在这项建议中，我们的目标是采用一种创新的方法， 评估认知，并根据标准认知电池、医疗和线人来验证它。 评估，根据MRI评估脑功能，并对3名HRS姐妹进行APOE遗传分析 国家：南非（HAALSI）、美国（HRS/COG）和爱尔兰（TILDA）。南非低 老年人的识字率，书面语言的使用程度不同，文化线索不同 与西方工业化国家相比。为了评估在这种情况下的认知，我们评估 认知功能利用非语言和最低限度的数字评估， 域.通过片剂给药，立即记录反应并评分。石碑- 将根据统一认知评估方案（HCAP）对基于评估的评估进行验证 由HRS跨HAALSI、TILDA和HRS/COG开发（目标1）。来自MRI的其他信息， 基因分析增加了有效性。增加了临床和线人访谈，以制定广告， 痴呆风险评分（Aim 2）。我们在年龄和教育分层中进行验证和协调 在三个队列中的每一个中，300名50 - 79岁的男性和女性的样本（n=900）。 新的“下一代”仪器正在开发中，我们现在需要有关它们的信息。 与标准认知评估相比。协作中的额外心理测量评估 与沥青（R 01 AG 051170，琼斯PI）将有助于完善这些措施。开发人行横道 这些措施和其他常用的指数之间的关系是特别重要的一套姐妹 与健康和退休研究相关的研究，其中明确的目标是允许比较 尤其是在AD和痴呆症方面。TILDA和HAALSI具有特定优势 因为他们从早期的波中获得了丰富的额外神经心理学和健康数据 在教育程度不同的老年人口中。我们的建议有两个目的： 目标1.为了评估基于牛津的语言控制认知测量的有效性， 与使用HRS/COG、TILDA和HAALSI相同平台的HCAP测量相关 1.a.评价牛津评估的内容、标准和结构效度， 1.b.根据心理测量学分析， 1.c.开发一套具有良好心理测量特性的较短且协调的项目 目标二。根据额外的信息，在每个国家制定一个共同的痴呆症风险评分 从代理人/线人和临床评价中收集。该风险评分将得到协调和验证。

Developing sensitive and valid indicators of Alzheimer's Disease (AD), dementia and cognitive function in low literacy and low income countries is challenging and requires creative approaches to complement standard neuropsychological batteries. In this proposal, we aim to incorporate an innovative approach to assessing cognition and to validate it against standard cognitive batteries, medical and informant assessments, brain function assessed from MRI's and genetic analyses of APOE in 3 HRS sister countries: South Africa (HAALSI), United States (HRS/COG), and Ireland (TILDA). South Africa has a low literacy rate in older people, varying degrees of use of written language and different cultural cues compared to Western industrialized countries. In order to assess cognition in this setting, we assess cognitive function leveraging non-verbal and minimally numeric assessments for a range of cognitive domains. Through administration via tablets, responses are recorded and scored immediately. The tablet- based assessments will be validated in relation to the Harmonized Cognitive Assessment Protocol (HCAP) developed by HRS across HAALSI, TILDA and HRS/COG (Aim 1). Additional information from MRI's and genetic analyses increase validity. Clinical and informant interviews are added to develop an AD and dementia risk score (Aim 2). We conduct the validations and harmonization in age and education stratified samples of 300 men and women 50 -79 years old in each of the three cohorts (n=900). Novel `next generation' instruments are being developed and we now need information regarding their validity compared to standard cognitive assessments. Additional psychometric evaluation in collaboration with PITCH (R01AG051170, Jones PI) will aid in refining these measures. Developing cross-walks between these measures and other commonly used indices is of special importance in the set of sister studies related to the Health and Retirement Study where the explicit goals are to permit comparisons across countries, especially with regard to AD and dementia. TILDA and HAALSI offer specific advantages in calibration because they have had rich additional neuropsychological and health data from earlier waves across an educationally diverse older population. We have two aims in our proposal: Aim 1. To assess the validity of the Oxford based language controlled cognitive measures in relation to the HCAP measures using identical platforms for HRS/COG, TILDA and HAALSI 1.a. to evaluate content, criterion and construct validity of Oxford assessments against 1.b. to develop a refined battery of items based on the psychometric analyses 1.c. to develop a shorter and harmonized set of items that have good psychometric properties Aim 2. To develop a common dementia risk score in each country based on the additional information gathered from proxy/informants and a clinical evaluation. This risk score will be harmonized and validated.