Factors Influencing Decline in AD Trends in a Biracial Population Study

混血人口研究中影响 AD 趋势下降的因素

• 批准号: 9422107
• 负责人: Kumar B. Rajan
• 金额: $ 9.28万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2018-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9422107
• 关键词: Address; African American; Age; Aging; Algorithms; Alzheimer' s Disease; American; Antihypertensive Agents; Attention; Body mass index; Cardiovascular Diseases; Characteristics; Chicago; Chronic; Clinical; Cognition; Cognitive; Complex; Data Sources; Development; Diabetes Mellitus; Diagnosis; Elderly; Employee Strikes; Episodic memory; Ethnic Origin; European; General Population; Health; Hypertension; Incidence; Income; Individual; Intervention Studies; Interview; Longitudinal cohort; Measures; Mental Health; Methodology; Minority; Multivitamin; Neighborhoods; Neuropsychological Tests; Neurotic Disorders; Neurotics; Outcome; Participant; Pattern; Pharmaceutical Preparations; Physical activity; Population; Population Study; Prevalence; Prevention strategy; Preventive; Probability; Public Health; Race; Recurrence; Risk; Risk Factors; Sampling; Sampling Studies; Stress; Stroke; Testing; Time; Time trend; Translating; base; biracial; clinical Diagnosis; cognitive function; cognitive testing; depressive symptoms; epidemiology study; executive function; falls; improved; interest; neurocognitive test; pre-clinical; racial difference; research clinical testing; research study; sex; social engagement; stress symptom; trend

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.

几项研究表明，AD的趋势会长期下降。然而，影响负面世俗的因素 AD的趋势是未知的。此外，这些世俗趋势中的种族差异也需要为 非洲裔美国少数民族。为了解决这些问题，我们建议使用一项大规模的基于人群的研究 执行功能、情景记忆以及整体认知和定向的认知测试 10,801名参与者和2,839名非裔美国人和欧洲人的AD临床诊断 美国种族研究1993至2012年间AD的年龄、种族和特定性别的下降趋势，以及 AD出现长期负面趋势的原因。更具体地说，这项建议的五个目标是：(1) AD趋势中的人口统计学差异目的：评估特定年龄、性别和种族的AD趋势 阿尔茨海默病的认知、日常生活能力和临床诊断的综合和个体测试 AD(1993-2012)；(2)危险因素目的：了解人口统计特征之间的关联， 高血压、中风、糖尿病、体重指数(BMI)、感受到的压力和AD的抑郁症状 使用认知、ADLS和流行和事件的临床诊断的综合和个体测试的趋势 公元1993至2012年间。(3)保护因素目的：考察受教育程度的关联性， 收入、社会参与度、神经质、外向性、体力活动和认知丰富活动 使用认知、ADLS和临床诊断的认知、ADLS和临床诊断的综合和单独测试的AD趋势 1993至2012年间的AD事件。(4)药物使用目的：检查抗高血压、他汀类药物和 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药物的使用可能与AD趋势有关，使用复合和 1993至2012年间AD的认知、ADLS和临床诊断的个别测试。在这项提案中，我们 使用新开发的AD似然评分(ADLS)来转换临床样本中的AD临床诊断 使用19项神经心理测试来评估我们人群样本中使用4个短路电池的AD的可能性 神经心理测试。这种方法将极大地提高我们发现潜在原因的能力 AD趋势的长期下降。此外，我们的提案还考察了AD趋势中的人口统计学差异，以及 可能影响AD趋势的假定危险因素和预防因素。这项提议有可能 在潜在地确定可能影响AD趋势的因素方面对公共卫生产生重大影响 旨在改善普通人群中已确定的因素的干预研究。