Hypertensive Disorders of Pregnancy and Subsequent Risk of Vascular Dementia, Alzheimer's Disease, or Related Dementia: A Retrospective Cohort Study Taking into Account Mid-Life Mediating Factors.

项目摘要/摘要 这是对Karen Schliep博士的K01奖项的申请，Karen Schliep博士是公共卫生终身助理教授 在犹他大学。施利普博士正在确立自己作为女性生命历程中一名年轻研究员的地位 流行病学，特别是在老龄化研究的一个新领域--提高我们对女性 增加阿尔茨海默病(AD)和相关痴呆症(RD)的风险，并创造女性特有的 旨在降低风险和改善结果的干预措施。这一奖项将使施利普博士实现她的目标 通过支持研究独立完成以下培训目标：1)发展 在生物医学信息学和以人口为基础的研究方法方面的专业知识；2)在 进行临床认知健康评估；3)加强对影响 女性中老年认知健康；以及4)扩展技能，独立领导和管理 成功的研究项目。施利普博士组建了一个由一名主要导师组成的指导团队。 迈克尔·瓦尔纳，产科医生，全国知名的母胎医学研究员，在 妊娠并发症，包括妊娠期高血压疾病(HDP)和两名共同导师：Dr。 诺曼·福斯特是认知神经学家和老年神经学家，也是痴呆症研究的公认领导者， 和肯·史密斯博士，国际知名的人口分析和遗传/家庭专家 流行病学。施利普博士有五名顾问，他们在分类建模、ADRD神经心理学、 中年妇女的健康、纵向和生存数据分析，以及慢性病流行病学。 人们对HDP与HDP之间的关系知之甚少，据估计，HDP会使2%-8%的妊娠复杂化， 和类似炎性血管病因的长期不良母体神经结局，包括 阿德勒。据估计，目前有540万美国人患有ADRD，其中三分之二是女性。作为 美国老龄化人口增加，痴呆症患病率预计到2019年接近1320万至1600万 2050年。为什么ADRD对女性的影响不成比例尚不清楚。施利普博士的研究目标是开发 痴呆各亚型(包括AD、血管性痴呆、路易体)的分类模型 痴呆症和额颞部痴呆症)来分析纵向的、个人级别的数据，以更好地了解 HDP可能会增加女性患ADRD的风险。施利普博士将通过以下研究实现这一目标 目的：1)提高卫生管理数据库中ADRD诊断的准确性；以及2)调查 HDP与ADRD的相关性及中年中介因素。该提案的预期结果 包括1)一种在大型相关健康管理机构内准确捕获痴呆症病例新方法 数据库；2)HDP如何与特定痴呆亚型联系的清晰度；3)技能、经验、 并为Schliep博士提供初步数据，以支持未来确定其他性别特定风险因素的研究 痴呆和可干预的中介因素。

PROJECT SUMMARY/ABSTRACT This is an application for a K01 award for Dr. Karen Schliep, a tenure-line Assistant Professor of Public Health at the University of Utah. Dr. Schliep is establishing herself as a young investigator in women’s life-course epidemiology, specifically in a novel area of aging research—to improve our understanding of women’s increased risk of Alzheimer’s disease (AD) and related dementias (RD) and create women-specific interventions to mitigate risk and improve outcomes. This award will allow Dr. Schliep to achieve her goal of research independence by providing her support to accomplish the following training aims: 1) develop expertise in biomedical informatics and population-based research methods; 2) gain experience in the conduction of clinical cognitive health assessments; 3) enhance knowledge of modifiable factors affecting women’s mid- and late-life cognitive health; and 4) expand skills to independently lead and manage a successful research program. Dr. Schliep has assembled a mentoring team comprising a primary mentor, Dr. Michael Varner, an obstetrician and nationally renowned maternal-fetal medicine investigator with expertise in pregnancy complications including hypertensive disorders of pregnancy (HDP), and two co-mentors: Dr. Norman Foster, a cognitive neurologist and geriatric neurologist and recognized leader in dementia research, and Dr. Ken Smith, an internationally known expert in population-based analyses and genetic/family epidemiology. Dr. Schliep has five advisors with expertise in classification modeling, ADRD neuropsychology, mid-life women’s health, longitudinal and survival data analysis, and chronic disease epidemiology. Little is known regarding the association between HDP, estimated to complicate 2–8% of all pregnancies, and long-term adverse maternal neurological outcomes with similar inflammatory vascular etiologies, including ADRD. An estimated 5.4 million Americans currently suffer from ADRD, two-thirds of whom are women. As the US aging population increases, prevalence of dementia is expected to approach 13.2 to 16.0 million cases by 2050. Why ADRD disproportionately affects women is not known. Dr. Schliep’s research objective is to develop classification models for the various dementia subtypes (including AD, vascular dementia, Lewy body dementia, and frontotemporal dementia) to analyze longitudinal, individual-level data to better understand how HDP may increase a woman’s risk for ADRD. Dr. Schliep will accomplish this through the following research aims: 1) increase accuracy of ADRD diagnoses within health administrative databases; and 2) investigate the association between HDP and ADRD, and mid-life mediating factors. The proposal’s expected outcomes include 1) a novel method to accurately capture dementia cases within large linked health administrative databases; 2) clarity on how HDP may be linked with specific dementia subtypes; and 3) skills, experience, and preliminary data for Dr. Schliep to support future studies identifying other sex-specific risk factors for dementia and mediating factors amenable to interventions.