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

阿尔茨海默病的流行病学和认知：全球协调的创新方法

• 批准号: 9344783
• 负责人: LISA F BERKMAN
• 金额: $ 70.62万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9344783
• 关键词: Adult; Africa; Age; Aging; Alleles; Alzheimer disease screening; Alzheimer' s Disease; Apolipoprotein E; Assessment tool; Brain; Calibration; Cereals; Clinical; Clinical Data; Clinical assessments; Cognition; Cognitive; Cognitive aging; Collaborations; Communities; Community Health; Complement; Country; Cues; Data; Dementia; Developed Countries; Disease; Education; Educational Background; Epidemiologic Studies; Epidemiology; Evaluation; Floor; Genetic; Goals; Health; International; Interview; Interviewer; Ireland; Knowledge; Language; Lead; Longitudinal Studies; Low Income Population; Magnetic Resonance Imaging; Measurement; Measures; Medical; Medical Genetics; Methods; Modeling; Older Population; Pathway interactions; Population Heterogeneity; Prevalence; Process; Property; Protocols documentation; Proxy; Psychometrics; Research Personnel; Retirement; Risk; Sampling; Sensitivity and Specificity; Sister; South Africa; South African; Tablet Computer; Tablets; Testing; Training; United States; Universities; Validation; Variant; Walking; Woman; Writing; age related cognitive disorder; base; brain health; clinical Diagnosis; cognitive control; cognitive function; cognitive testing; cohort; conditioning; genetic analysis; health data; indexing; informant; information gathering; innovation; instrument; literacy; low and middle-income countries; low income country; men; neuroimaging; neuropsychological; next generation; novel; novel strategies; research clinical testing; response; socioeconomics

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.

在阿尔茨海默氏病（AD），痴呆和认知功能中开发敏感且有效的指标 低识字和低收入国家具有挑战性，需要创造性的方法来补充 标准神经心理电池。在此提案中，我们旨在纳入一种创新的方法 评估认知并对标准认知电池，医疗和线人进行验证 评估，从MRI的MRI和APOE遗传分析评估的大脑功能3小时姐妹 国家：南非（Haalsi），美国（HRS/COG）和爱尔兰（Tilda）。南非的低 老年人的识字率，不同程度的书面语言和不同的文化提示 与西方工业化国家相比。为了在这种情况下评估认知，我们评估 认知功能利用非语言和最小数字评估的认知功能 域。通过通过平板电脑给药，记录响应并立即评分。平板电脑 - 基于统一的认知评估协议（HCAP）将验证基于的评估。 由HRS开发在Haalsi，Tilda和HRS/COG（AIM 1）。 MRI的其他信息， 遗传分析提高了有效性。添加了临床和线人访谈以开发广告和 痴呆症风险评分（AIM 2）。我们进行年龄和教育的验证和协调 在三个队列中的每一个中，每个人中的每一个（n = 900），有300名男性和女性的样本。 新颖的“下一代”乐器正在开发中，我们现在需要有关它们的信息 与标准认知评估相比，有效性。协作中的其他心理测量评估 随着音高（R01AG051170，Jones Pi）将有助于完善这些措施。开发跨步行 在这些措施和其他常用索引之间，在姐妹的一组中特别重要 与健康和退休研究有关的研究，该研究明确的目标是允许比较 在整个国家，尤其是关于广告和痴呆症。 Tilda和Haalsi提供特定的优势 校准之所以进行校准，是因为他们从早期的波浪中获得了丰富的额外神经心理学和健康数据 在教育多样化的老年人中。我们的建议有两个目标： 目的1。评估基于牛津语言的有效性控制的认知措施 使用HRS/COG，TILDA和HAALSI的相同平台与HCAP测量有关 1.A.评估牛津评估的内容，标准和构建有效性 1.B.根据心理测量分析开发精致的项目 1.C.开发具有良好心理测量特性的较短且协调的项目集 目标2。根据其他信息在每个国家 /地区建立共同的痴呆症风险评分 从代理/线人和临床评估中收集。此风险评分将得到协调和验证。