Incident Vascular Brain Injury, Probable Alzheimer's Disease, and Cognitive Change in Elderly American Indians

老年印第安人的血管性脑损伤、可能的阿尔茨海默病和认知变化

• 批准号: 9894705
• 负责人: Astrid M Suchy-Dicey
• 金额: $ 12.56万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9894705
• 关键词: Address; African American; Alzheimer' s Disease; American Indians; Brain; Brain Pathology; Cephalic; Cerebrovascular Disorders; Cerebrovascular Trauma; Cessation of life; Clinical; Cluster Analysis; Cognitive; Cohort Studies; Data; Data Collection; Data Set; Dementia; Development Plans; Diagnostic; Disease; Disease Progression; Educational workshop; Elderly; Elements; Environment; Ethnic Origin; Ethnic group; Etiology; Evaluation; Event; Evidence based intervention; Exclusion; Frequencies; Functional Magnetic Resonance Imaging; Funding; Future; General Population; Geography; Grant; Health; Healthcare Systems; Image; Impaired cognition; Incidence; Individual; Knowledge; Longitudinal cohort study; Magnetic Resonance Imaging; Measures; Medical Genetics; Memory; Mental Depression; Mentors; Methods; Minority; Minority Groups; Monitor; National Institute of Neurological Disorders and Stroke; National Institute on Aging; Nerve Degeneration; Neuroepidemiology; Neurological observations; Neuropsychological Tests; Neuropsychology; Not Hispanic or Latino; Outcome; Participant; Pathology; Patient risk; Pattern; Population; Positioning Attribute; Prevalence; Prevention; Protocols documentation; Quality of life; Race; Recording of previous events; Research; Research Personnel; Resources; Risk; Risk Factors; Sampling; Severities; Social Environment; Standardization; Stroke; Subgroup; Targeted Research; Thinking; Time; Tribes; Ursidae Family; aged; aging brain; analytical method; burden of illness; cardiovascular health; cardiovascular risk factor; career development; caucasian American; cerebral atrophy; clinical examination; clinical risk; cognitive change; cognitive testing; cohort; disability; disorder prevention; environmental stressor; experience; follow-up; health disparity; high risk; innovation; mild cognitive impairment; neuroimaging; neuropathology; novel; population based; pre-clinical; preservation; prevent; psychosocial; recruit; rural residence; skills; social stressor; socioeconomics; success; vascular contributions

PROJECT SUMMARY / ABSTRACT A workshop convened in 2013 by National Institute of Aging and the National Institute of Neurological Diseases and Stroke prioritized research on cognitive impairment of multiple etiologies, contributions of vascular brain injury (VBI) to neurodegeneration and Alzheimer's Disease (AD), and disparities involving race, ethnicity, socioeconomics, and rural residence. VBI is a leading cause of accelerated brain aging and a major risk factor for stroke, cognitive decline, depression, and probable Alzheimer's disease (AD). However, few studies have evaluated VBI, cognitive impairment, and AD in American Indians (AIs), who bear a heavy burden of risk factors for these conditions. This exclusion is unfortunate, since the distinctive history, risk profiles, environmental stressors, social environments, and healthcare systems of AIs likely result in patterns of disease that differ substantially from other populations. Our research team has conducted the only cohort study to date of covert VBI in AIs. In 2010-2013, Cerebrovascular Disease and its Consequences in American Indians study completed standardized clinical examinations, neuropsychological testing, and cranial MRI on more than 1,000 AIs aged 64-95 years from 10 tribes in 3 states. In 2016, we began re-examination of surviving participants using the same protocols, augmented by assessment for probable AD. However, the particular grant mechanism from the National Institute on Aging that provides funding for this follow-up examination is limited to data collection, with no resources allocated for analysis. In this proposal, we will capitalize on the accumulated longitudinal data to apply sophisticated imaging and analysis methods to quantify and evaluate associations for incident VBI, neurodegeneration, and changes in cognitive status in this elderly minority population. Our Specific Aims are to: (1) establish normative and diagnostic standards for mild cognitive impairment and dementia in elderly AIs, and evaluate associations and determinants for incident VBI, cerebral atrophy, cognitive decline, and probable AD; (2) conduct cluster analyses to identify novel neuroimaging profiles that predict subgroups of elderly AIs at highest risk for cerebral atrophy, cognitive decline, and probable AD; and (3) complete a rigorous career development plan that will position the applicant as an independent investigator and leader in innovative neuroepidemiology research with minority populations. This proposal leverages a timely opportunity to generate the first population-based estimates of and address novel scientific questions on VBI and cognitive impairment in AIs, a minority population with pervasive health disparities.

项目总结/摘要 2013年由国家老龄化研究所和国家神经疾病研究所举办的研讨会 和中风优先研究多种病因的认知障碍，血管脑的贡献 损伤（VBI）对神经变性和阿尔茨海默病（AD）的影响，以及涉及种族，民族， 社会经济和农村居住。VBI是大脑加速老化的主要原因，也是一个主要的危险因素 中风、认知能力下降、抑郁症和可能的阿尔茨海默病（AD）。然而，很少有研究 评估了美国印第安人（AI）的VBI、认知障碍和AD，这些人承受着沉重的风险因素负担 对于这些条件。这种排除是不幸的，因为独特的历史，风险概况，环境 压力源、社会环境和医疗保健系统可能导致不同的疾病模式， 基本上来自其他人群。我们的研究小组进行了迄今为止唯一的一项关于隐性遗传的队列研究。 AI中的VBI。2010-2013年，美国印第安人脑血管疾病及其后果研究完成 标准化的临床检查，神经心理学测试和颅脑MRI对1,000多名年龄 64-95岁，来自3个州的10个部落。2016年，我们开始重新检查幸存的参与者， 方案，通过评估可能的AD进行增强。然而， 国家老龄化研究所为这项后续检查提供资金，仅限于数据收集， 没有为分析分配资源。在本提案中，我们将利用累积的纵向数据 应用复杂的成像和分析方法来量化和评估事件VBI的关联， 神经变性和认知状态的变化。我们的具体目标是 （1）建立老年AI轻度认知功能障碍和痴呆的规范和诊断标准， 并评估事件VBI，脑萎缩，认知能力下降和可能的关联和决定因素， AD;（2）进行聚类分析，以确定新的神经影像学特征，预测老年AI的亚组， 脑萎缩、认知能力下降和可能的AD风险最高;（3）完成严格的职业生涯 发展计划，将申请人定位为独立的研究者和创新的领导者 神经流行病学研究与少数民族人口。该提案利用了一个及时的机会， 第一个基于人口的估计和解决新的科学问题的VBI和认知障碍 在人工智能中，少数人群普遍存在健康差异。