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Healthy Heart, Healthy Brain? A Pooled Life-course Cohort for Dementia Risk Assessment

心脏健康，大脑健康？

基本信息

批准号：
9217270
负责人：
Kristine Yaffe
金额：
$ 194.85万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-05-01 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9217270
关键词：
Address Adult Adverse effects Age Aging Alzheimer&apos s Disease Alzheimer&apos s disease risk American Heart Association Blood Pressure Body Composition Body Weight Brain Cardiovascular system Clinical Cognition Cognitive Cognitive aging Consensus Coronary artery Data Dementia Development Diet Elderly Exposure to Gender Health Heart Hypertension Impaired cognition Incidence Intervention Investigation Life Life Cycle Stages Lipids Modification Multi-Ethnic Study of Atherosclerosis Nerve Degeneration Obesity Outcome Participant Pattern Phase Physical activity Positioning Attribute Prevalence Process Prospective cohort Public Health Publishing Race Research Risk Risk Assessment Risk Factors Sex Characteristics Smoking Statistical Methods Symptoms Time Woman Work adverse outcome biracial cardiovascular health cardiovascular risk factor cognitive function cohort ethnic difference fasting glucose follow-up gender disparity improved insight men middle age novel pre-clinical protective effect racial and ethnic racial and ethnic disparities racial difference racial disparity sex sex disparity stem therapy design young adult

项目摘要

ABSTRACT Neurodegenerative processes leading to dementia, especially Alzheimer disease, begin long before clinical features become apparent, and several lines of evidence suggest that cardiovascular risk factor reduction may be one of the most viable strategies to modify the course of the preclinical phase. Exposure to cardiovascular risk factors begins early in life and continues throughout adulthood with pronounced gender and racial/ethnic differences in the age at which cardiovascular exposures develop. For example, Blacks may show earlier, longer and more severe exposure to cardiovascular risk than whites. However, current evidence about the timing and influence of these exposures on cognitive aging and Alzheimer disease is controversial, supporting the need for a life-course approach. For example, the effects of hypertension may be more adverse in mid-life than late-life. Furthermore, there is growing consensus that racial/ethnic and gender disparities in risk of Alzheimer disease and cognitive function may exist. These disparities may partly stem from differences in prevalence and cumulative cardiovascular risks, as well as differences in their association with Alzheimer disease and cognition. Yet, there is a paucity of longitudinal research addressing these associations within a life-course framework. This study will use published statistical methods in a novel way to pool multiple data and to create a pooled cohort in order to provide improved estimates of age-specific exposures to cardiovascular risk factors over the life-course on Alzheimer disease and cognitive outcomes associated with aging. We will work with four biracial prospective cohorts which together span the adult life-course, and with compatible data on major cardiovascular risk factors, mid and late life cognition and dementia outcomes: the Coronary Artery Risk Development in Young Adults (CARDIA), Multi Ethnic Study of Atherosclerosis (MESA), Cardiovascular Health Study (CHS), and Health, Aging and Body Composition Study (Health ABC). This poled cohort will enable us to 1) estimate life-course exposures to cardiovascular risk factors, in particular for participants with follow-up starting later in life, then 2) determine the type and timing of exposures that influence cognitive decline and risk of Alzheimer disease and other dementia, and 3) how modifications of these exposures may reduce the burden of cognitive decline and Alzheimer disease, as well as racial and gender disparities. Understanding how modifications of these exposures may reduce the burden of cognitive decline and Alzheimer disease is critical for public health.

摘要导致痴呆，特别是阿尔茨海默病的神经退行性过程，早在临床前开始就开始了。特征变得明显，并且一些证据表明，心血管危险因素的减少可能是改变临床前阶段进程的最可行策略之一。暴露于心血管风险因素始于生命早期，并在整个成年期持续存在，心血管暴露发生的年龄差异。例如，黑人可能会更早出现，比白人更长更严重地暴露于心血管风险。然而，目前的证据表明，这些暴露对认知老化和阿尔茨海默病的时间和影响是有争议的，支持需要一个生命过程的方法。例如，高血压的影响在中年可能更不利而不是晚年此外，越来越多的人一致认为，种族/族裔和性别差异的风险，可能存在阿尔茨海默病和认知功能。这些差异可能部分源于患病率和累积心血管风险，以及它们与阿尔茨海默病相关性的差异疾病和认知。然而，缺乏纵向研究解决这些协会在一个生命历程框架。这项研究将以一种新颖的方式使用已发表的统计方法来汇集多个数据，创建一个汇总队列，以提供年龄特异性心血管暴露的更好估计值阿尔茨海默病的生命过程中的风险因素和与衰老相关的认知结果。我们将与四个birthday前瞻性队列一起工作，这些队列共同跨越成年人的生命历程，并具有兼容的数据主要心血管危险因素、中晚期认知和痴呆结局：冠状动脉年轻人的风险发展（CARDIA），多种族动脉粥样硬化研究（梅萨），心血管健康研究（CHS）和健康，衰老和身体成分研究（健康ABC）。这支波兰军队将使我们能够1）估计心血管风险因素的生命过程暴露，特别是对于有以下情况的参与者在以后的生活中开始随访，然后2）确定影响认知能力的暴露类型和时间阿尔茨海默病和其他痴呆症的下降和风险，以及3）如何修改这些暴露可能减少认知能力下降和阿尔茨海默病的负担，以及种族和性别差异。了解这些暴露的改变如何减轻认知能力下降的负担，阿尔茨海默病对公共卫生至关重要。