Lifecourse cardiovascular risk, depression and cognition in black & white adults

黑人生命全程心血管风险、抑郁和认知

• 批准号: 9250052
• 负责人: Adina Zeki Al Hazzouri
• 金额: $ 12.24万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9250052
• 关键词: Address; Adult; Age; Aging; Attention; Body Composition; Brain; Brain imaging; Cardiovascular system; Child; Clinical; Clinical assessments; Cognition; Coronary Artery Risk Development in Young Adults Study; Data; Development; Elderly; Epidemiology; Etiology; Event; Exposure to; Funding; Goals; Health; Hypertension; Impaired cognition; Knowledge; Lesion; Life; Life Cycle Stages; Measures; Mental Depression; Mentored Research Scientist Development Award; Mentors; Methodology; Modeling; Nature; Obesity; Outcome; Pathway interactions; Prevalence; Public Health; Reading; Research; Research Activity; Research Personnel; Risk; Risk Factors; Role; Statistical Methods; Time; Training; Training Activity; Woman; Work; biracial; cardiovascular risk factor; career; cerebrovascular; cognitive function; cognitive performance; cohort; common symptom; data structure; depressive symptoms; emerging adult; epidemiological model; feeding; hippocampal atrophy; imaging study; improved; indexing; men; middle age; neuroimaging; neuroimaging marker; neuropathology; neuropsychiatric disorder; neuropsychiatry; programs; public health relevance; racial disparity; white matter; young adult

DESCRIPTION (provided by applicant): Cognitive function and depressive symptoms share many cardiovascular origins and their prevalence increases dramatically with age. Emerging evidence suggests that the influence of cardiovascular risk factors on cognition and depressive symptoms outcomes progresses over the life course and may be different in older adults compared to middle-aged and younger adults. Racial disparities in cardiovascular risk factors and the age at which they develop may further exacerbate these associations. This 5-year K01 award application seeks to improve our knowledge of the influence of cardiovascular risk factors on cognitive function and depressive symptoms over the life course in black and white adults. Additionally, this proposal will elucidate the role of cardiovascular risk factors with underlying structural brain changes over the life course. This proposal involves analyses of two large biracial epidemiologic cohorts: including 1) the ongoing CARDIA (Coronary Artery Risk Development in Young Adults) study of 5,115 young adult to middle-aged men and women (52% blacks and 48% whites), and 2) the ongoing Health ABC (Health, Aging and Body Composition) study of 3,075 older adult men and women (42% blacks and 58% whites). We hypothesize that greater exposure to non-optimal cardiovascular measures will be associated with worse cognitive function, greater number of depressive symptoms, and worse structural brain indices such as greater white matter lesions and hippocampal atrophy across the life course in blacks and whites. The data structure of the cohorts will enable us to evaluate several life course epidemiologic models such as early vs. late life cardiovascular exposure, with the possibility of evaluating sensitive periods. This life course approach is mirrored in the scientifi aims of this proposal. In Aim 1, we will determine how young adulthood and midlife cardiovascular exposure (CARDIA) and late life cardiovascular exposure (Health ABC) influence trajectories of depressive symptoms. In Aims 2 and 3, we will determine how young adulthood cardiovascular exposure influences cognitive performance and structural brain integrity at midlife (CARDIA) and how late life cardiovascular exposure influences cognitive decline and structural brain integrity in late life (Health ABC). The proposed analyses are embedded in a training and mentoring plan that will (1) advance my conceptual training in the clinical aspect of cognition and depressive symptoms outcomes, cardiovascular and cerebrovascular aspects in particular; (2) train me in neuroimaging and markers of structural brain integrity; and (3) advance my methodologic training in longitudinal and neuroimaging related statistical methods and my knowledge of life course models. My training plan will include formal courses, clinical assessment and grand rounds, attendance at scholarly seminars, directed readings and professional development activities specifically tailored to my training goals. Having the K01 support will result in preliminary data and the mentoring necessary to establish myself more strongly as an independent investigator and promote the development of a successful R01 application.

描述（由申请人提供）：认知功能和抑郁症状有许多共同的心血管起源，其患病率随着年龄的增长而急剧增加。新出现的证据表明，心血管危险因素对认知和抑郁症状结局的影响在整个生命过程中不断发展，并且在老年人中与中年人和年轻人相比可能有所不同。心血管危险因素的种族差异及其发生的年龄可能进一步加剧这些关联。这项为期5年的K01奖申请旨在提高我们对黑人和白人成人生命过程中心血管危险因素对认知功能和抑郁症状影响的认识。此外，这一建议将阐明心血管危险因素在生命过程中潜在的大脑结构变化中的作用。该建议涉及对两个大型双种族流行病学队列的分析：包括1)正在进行的CARDIA（年轻人冠状动脉风险发展）研究，涉及5115名青年至中年男性和女性（52%黑人和48%白人），以及2)正在进行的健康ABC（健康、衰老和身体成分）研究，涉及3075名老年男性和女性（42%黑人和58%白人）。我们假设，在黑人和白人的整个生命过程中，更多地暴露于非最佳心血管措施将与更差的认知功能、更多的抑郁症状和更差的脑结构指数（如更大的白质病变和海马萎缩）相关。队列的数据结构将使我们能够评估几个生命过程流行病学模型，如早期与晚期心血管暴露，并有可能评估敏感期。这种生命历程方法反映在这项提案的科学目标中。在目的1中，我们将确定青年和中年心血管暴露（CARDIA）和晚年心血管暴露（Health ABC）如何影响抑郁症状的轨迹。在目标2和3中，我们将确定年轻成年期心血管暴露如何影响中年认知表现和脑结构完整性（CARDIA），以及晚年心血管暴露如何影响晚年认知能力下降和脑结构完整性（Health ABC）。建议的分析嵌入在培训和指导计划中，该计划将(1)推进我在认知和抑郁症状结果的临床方面的概念培训，特别是心脑血管方面；(2)训练我神经影像学和脑结构完整性标记；(3)提高我在纵向和神经影像学相关统计方法方面的方法学训练以及我对生命历程模型的了解。我的培训计划将包括正式课程、临床评估和大型查房、参加学术研讨会、指导阅读和专门为我的培训目标量身定制的专业发展活动。拥有K01的支持将产生初步数据和必要的指导，以建立自己更强大的独立研究者地位，并促进成功的R01应用程序的开发。