Measurement of Cognitive Function in Older Adults with Sensory Loss

感觉丧失老年人认知功能的测量

• 批准号: 9901422
• 负责人: JENNIFER Anne DEAL
• 金额: $ 24.56万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9901422
• 关键词: Accounting; Adult; Aging; Alzheimer' s disease related dementia; American; Atherosclerosis Risk in Communities; Baltimore; Blindness; Cognition; Cognitive; Cohort Studies; Data; Development; Educational workshop; Elderly; Etiology; Exclusion; Goals; Health Planning; Hearing; Hearing Tests; High Prevalence; Impaired cognition; Impairment; Incidence; Knowledge; Longitudinal Studies; Longitudinal cohort study; Materials Testing; Measurement; Measures; Methodology; Methods; Modeling; Neuropsychology; Outcome; Participant; Persons; Population Study; Prevalence; Prospective cohort study; Protocols documentation; Public Health; Research; Risk; Sensory; Source; Specific qualifier value; Speech; Stimulus; Surveys; Testing; Variant; Vision; Visit; Visual impairment; Work; aged; auditory stimulus; base; cognitive ability; cognitive function; cognitive performance; cognitive testing; cohort; dementia risk; epidemiology study; hearing impairment; indexing; intervention effect; neurocognitive test; performance tests; prevent; prospective; response; standard measure; theories; tool; visual stimulus

ABSTRACT The goal of the proposed project is to determine if estimates of cognitive impairment and Alzheimer’s disease and related dementias (ADRD) are biased among older adults with hearing or vision impairment. The impact of this this potential bias could be significant, as over 55% of Americans 60 years and older have either hearing or vision impairment. The specific aims of this research are to: (1) Identify and adjust for potential bias in estimates of cognitive function due to hearing or vision impairment, and (2) Quantify the across-study variation in methods used to collect and analyze cognitive data in older adults with hearing or vision loss. For aim 1, data from the Baltimore Longitudinal Study on Aging (BLSA) and the Atherosclerosis Risk in Communities Study (ARIC) will be used, as both studies used standard measures of hearing, vision, and cognition. Analyses will use cross-sectional data and an item response theory (IRT) modeling approach to: (1) disentangle the true effect of sensory impairment on cognitive function from the potential bias that sensory impairment may have on cognitive test performance; and (2) if present, correct for this potential bias and re-estimate cognitive impairment and ADRD prevalence. This aim will test the hypothesis that, after accounting for the level of cognitive ability (indexed using historical, longitudinal cognitive test data assessed in the BLSA and ARIC in years prior to the development of sensory impairment), older adults with hearing impairment systematically perform worse on cognitive tests that rely on hearing stimuli, and that older adults with vision impairment systematically perform worse on cognitive tests that rely or vision stimuli, compared to participants without these impairments. Aim 2 includes three steps: (1) Systematically identifying longitudinal cohort studies of older adults that collect cognitive testing data; (2) Administering a survey collecting information on study protocols and perform protocol abstraction to assess how cognitive function is measured and analyzed in older adults with sensory loss; and (3) Comparing the data abstracted from these protocols to assess the variation across studies in: (a) the assessment of hearing or vision, (b) exclusions from cognitive testing and analyses based on sensory impairment, (c) accommodations for sensory loss made during cognitive testing, and (d) adjustment for sensory loss in the analysis of cognitive data. We hypothesize that fewer than 50% of cohort studies surveyed use protocols for collecting and analyzing cognitive data in older adults with hearing or vision loss. The overall results of this project have crosscutting impact, as correct estimates of the prevalence and incidence of ADRD are paramount for public health planning, and etiologic research aimed at identifying approaches to reduce ADRD risk. This work will support: (1) a U13 to develop standard protocols/tools for collecting and analyzing cognitive data in older adults with sensory impairment, and (2) an R01 to implement methodological approaches to “adjust” estimates of cognitive function for sensory impairment using longitudinal data, and a large scale effort to re-calculate these estimates.

摘要 该项目的目标是确定认知障碍和阿尔茨海默病的估计是否 和相关痴呆（ADRD）在有听力或视力障碍的老年人中存在偏见。的影响 这种潜在的偏见可能是显著的，因为超过55%的60岁及以上的美国人听力 或视力受损。本研究的具体目的是：（1）识别和调整潜在的偏见， 估计由于听力或视力障碍引起的认知功能，以及（2）量化研究间的差异 用于收集和分析老年人听力或视力丧失的认知数据的方法。对于目标1， 来自巴尔的摩老龄化纵向研究（BLSA）和社区动脉粥样硬化风险的数据 将使用研究（ARIC），因为两项研究均使用听力、视力和认知的标准测量。分析 将使用横截面数据和项目反应理论（IRT）建模方法：（1）解开真正的 感觉障碍对认知功能的影响，从感觉障碍可能对 认知测试表现;和（2）如果存在，纠正这种潜在的偏见，并重新估计认知 和ADRD患病率。这一目标将检验一个假设，即在考虑了 认知能力（使用BLSA和ARIC中评估的历史纵向认知测试数据进行索引， 感觉障碍发生前10年），系统性听力障碍的老年人 在依赖听觉刺激的认知测试中表现更差， 在依赖视觉刺激的认知测试中，与没有视觉刺激的参与者相比， 这些缺陷。目标2包括三个步骤：（1）系统地识别 收集认知测试数据的老年人;（2）管理一项调查，收集学习信息 协议并执行协议抽象，以评估如何测量和分析老年人的认知功能。 成年人的感觉丧失;（3）比较从这些协议中提取的数据，以评估变化 跨研究：（a）听力或视力评估，（B）认知测试和分析的排除 基于感觉障碍，（c）在认知测试期间对感觉丧失进行调节，以及（d） 在认知数据分析中对感觉丧失进行调整。我们假设只有不到50%的队列 调查的研究使用协议来收集和分析有听力或视力的老年人的认知数据 损失该项目的总体成果具有跨领域影响，因为对流行率的正确估计， ADRD发病率对于公共卫生规划和旨在确定 降低ADRD风险的方法。这项工作将支持：（1）一个U13，以制定标准协议/工具， 收集和分析有感觉障碍的老年人的认知数据，以及（2）实施R 01 方法学途径“调整”估计的认知功能的感觉障碍，使用纵向 数据，并进行大规模的努力，以重新计算这些估计。