Factors Influencing Decline in AD Trends in a Biracial Population Study

几项研究表明AD趋势长期下降。然而，影响消极长期性的因素 AD趋势未知。此外，这些世俗趋势中的种族差异也需要建立， 非裔美国少数民族。为了解决这些问题，我们建议使用一项基于大型人群的研究， 执行功能、情景记忆和整体整体认知和定向的认知测试， 10，801名参与者，2，839名非裔美国人和欧洲人参与者临床诊断为AD 研究1993年至2012年间AD趋势的年龄、种族和性别特异性下降的美国种族，以及 AD长期呈负趋势的原因。具体而言，本建议的五个目标是：（1） AD趋势的人口统计学差异目的：使用以下指标评价AD的年龄、性别和种族特异性趋势： 阿尔茨海默病流行和偶发的认知、ADLS和临床诊断的复合和个体测试 （2）危险因素目的：了解人口统计学特征， AD患者的高血压、中风、糖尿病、体重指数（BMI）、感知压力和抑郁症状 使用认知、ADLS和流行和偶发疾病的临床诊断的复合和个体测试的趋势 从1993年到2012年。(3)保护性因素目的：考察受教育程度， 收入，社会参与，神经质，外向性，体力活动和认知丰富的活动， AD趋势使用认知、ADLS和临床诊断的复合和个体测试， 1993年至2012年发生的AD事件。(4)药物使用目的：检查如何抗高血压，他汀类药物， 糖尿病药物和多种维生素补充剂的使用可能与AD事件相关，以及如何改变 在高血压、他汀类药物和糖尿病中，使用复合和 1993年至2012年期间的认知，ADLS和AD临床诊断的个体测试。在本提案中，我们 使用新开发的AD似然评分（ADLS）来翻译临床样本中的AD临床诊断， 使用19个神经心理学测试，在我们的人群样本中，使用4个短电池， 神经心理学测试这种方法将大大提高我们发现潜在原因的能力， AD趋势的长期下降。此外，我们的提案还研究了AD趋势中的人口统计学差异， 可能影响AD趋势的假定危险因素和预防因素。该提案有可能 在潜在确定可能影响AD趋势的因素方面产生巨大的公共卫生影响， 干预研究，可用于改善一般人群中已确定的因素。

Several research studies suggest a secular decline in AD trends. However factors influencing negative secular trend in AD are unknown. Besides, racial differences in these secular trends also need to be established for African American minorities. To address these issues, we propose to use a large population-based study with cognitive tests of executive functioning, episodic memory, and overall global cognition and orientation in 10,801 participants, and clinical diagnosis of AD in 2,839 participants of African American and European American ethnicity to study age, race, and sex-specific decline in AD trends between 1993 and 2012, and reasons for a negative secular trend in AD. More specifically, the five objectives of this proposal are: (1) Demographic differences in AD trends aim: evaluate age-, sex-, and race-specific trends in AD using composite and individual tests of cognition, ADLS, and clinical diagnosis in prevalent and incident Alzheimer’s AD from 1993 to 2012; (2) Risk factors aim: understand the association of demographic characteristics, hypertension, stroke, diabetes, Body Mass Index (BMI), perceived stress, and depressive symptoms on AD trends using composite and individual tests of cognition, ADLS, and clinical diagnosis of prevalent and incident AD between 1993 and 2012. (3) Protective factors aim: examine the association of educational attainment, income, social engagement, neuroticism, extraversion, physical activity, and cognition enriching activities on AD trends using composite and individual tests of cognition, ADLS, and clinical diagnosis of prevalent and incident AD between 1993 and 2012. (4) Medications use aim: Examine how anti-hypertensive, statin, and diabetes medication, and multi-vitamin supplement use may be associated with incident AD, and how change in hypertension, statin, and diabetes medication use may be associated with AD trends using composite and individual tests of cognition, ADLS, and clinical diagnosis of AD between 1993 and 2012. In this proposal, we use a newly developed AD likelihood score (ADLS) to translate clinical diagnosis of AD in clinical sample that uses 19 neuropsychological tests to likelihood of AD in our population sample that uses 4 short-battery neuropsychological tests. Such an approach will drastically improve our power to detect potential reasons for secular decline in AD trends. In addition, our proposal examines demographic differences in AD trends, and putative risk factors and preventive factors that might influence AD trends. This proposal has the potential to make a large public health impact in potentially identifying factors that could be influencing AD trends leading to intervention studies that could be geared towards improving the identified factors in the general population.