Impact and Implications of concurrent hearing and vision impairment on risk for Alzheimer's disease and related dementias and social isolation in older adults

建议奖学金的目标是准备申请人，艾莉森黄，为独立的 研究职业生涯的重点是提供信息的方法，以减少阿尔茨海默病和相关痴呆症的风险 （ADRD）通过了解可改变的感官和社会风险因素。拟议的研究金 由两个相辅相成的部分组成：（1）一个研究项目，旨在评估双重 感觉障碍（DSI，并发听力和视力障碍）对ADRD、社会隔离和 认知训练干预效果;（2）由指导研究、教学和 非正式培训和专业发展。申请人将得到强大的导师团队的支持 在认知老化、感觉障碍、社会隔离、统计学和流行病学方面具有专业知识， 方法.研究培训计划将帮助黄女士a）学习和应用严格的分析方法， 纵向数据; B）加强感官、社会和认知ADRD风险因素的内容专业知识;以及c） 有效地传播她的研究结果，并加强教学和领导技能。 在缺乏有效治疗的情况下，降低ADRD风险的干预措施至关重要。识别和 需要了解可改变的风险因素之间的相互作用如何影响ADRD风险的大小， 为ADRD干预提供信息。有科学前提表明DSI是ADRD的一个强风险因素，但 这方面的研究还存在空白。感觉障碍也会放大并可能与其他ADRD相互作用 风险因素，如社会隔离，以增加风险。除了赋予ADRD风险，感觉障碍 可能影响依赖于听觉/视觉任务的当前ADRD干预措施的疗效，但很少考虑DSI 在干预设计和实施方面。为了填补这些空白，本项目建议使用纵向数据 从国家健康和老龄化趋势研究（NHATS）和高级认知训练， 独立和活力老年人（ACTIVE）随机对照试验，研究：（1） DSI与9年认知变化和痴呆事件;（2）DSI作为随时间推移的社会隔离的危险因素 以及作为社会隔离-认知变化和痴呆事件关联的调节者;以及（3）DSI 作为认知训练干预对10年认知变化和痴呆事件影响的调节剂。 拟议的研究直接涉及NIA的高优先领域。2020-2025年NIA战略 老龄化研究方向呼吁更多的研究如何“多种因素，如......社会 参与.感觉功能障碍相互作用.导致认知能力下降”（目标D-6）， 支持“采取干预措施，治疗、预防或减轻与年龄有关的疾病和状况的影响” (Goal C-3）。拟议研究的结果可能支持将感觉障碍纳入多领域 ADRD干预措施和对促进老年人健康的干预措施中感觉障碍的调节 成年人了

The goal of the proposed fellowship is to prepare the applicant, Alison Huang, for an independent research career focused on informing approaches to reduce risk of Alzheimer’s disease and related dementias (ADRD) through the understanding of modifiable sensory and social risk factors. The proposed fellowship consists of two complementary components: (1) a research project that aims to assess the impact of dual sensory impairment (DSI, concurrent hearing and vision impairment) on risk for ADRD, social isolation, and cognitive training intervention efficacy; and (2) a training plan composed of mentored research, didactic and informal training, and professional development. The applicant will be supported by a strong mentorship team with expertise in cognitive aging, sensory impairment, social isolation, and statistical and epidemiologic methods. The research-training plan will help Ms. Huang a) learn and apply rigorous methods for analysis of longitudinal data; b) strengthen content expertise in sensory, social, and cognitive ADRD risk factors; and c) effectively disseminate her findings and strengthen skills in teaching and leadership. In the absence of effective treatments, interventions to reduce ADRD risk are critical. Identification and understanding of how interactions between modifiable risk factors impact magnitude of ADRD risk is needed to inform ADRD interventions. There is scientific premise to suggest DSI is a strong risk factor for ADRD, yet there is gap in the research in this area. Sensory impairment also amplifies and may interact with other ADRD risk factors, such as social isolation, to increase risk. In addition to conferring ADRD risk, sensory impairment can impact efficacy of current ADRD interventions that rely on auditory/visual tasks yet DSI is rarely considered in intervention design and implementation. To fill these gaps, this project proposes to use longitudinal data from the National Health and Aging Trends Study (NHATS) and the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized control trial to investigate: (1) the associations between DSI and 9-year cognitive change and incident dementia; (2) DSI as a risk factor for social isolation over time and as a moderator of the social isolation – cognitive change and incident dementia associations; and (3) DSI as a moderator of cognitive training intervention effects on 10-year cognitive change and incident dementia. The proposed research directly addresses high priority areas for NIA. The 2020-2025 NIA Strategic Directions for Research on Aging calls for more research on how “multiple factors, such as…social engagement…sensory dysfunction interact to … contribute to cognitive decline” (Goal D-6) and for research to support “interventions for treating, preventing, or mitigating the impact of age-related diseases and conditions” (Goal C-3). Findings from the proposed study may support inclusion of sensory impairment in multi-domain ADRD interventions and accommodations for sensory impairment in interventions that promote health in older adults.