A cross-national comparative study on cardiometabolic risk, education, and cognitive aging

项目总结 阿尔茨海默病和阿尔茨海默病相关痴呆(AD/ADRD) 全球挑战，需要进行研究，以确定认知健康的关键保护因素和风险因素。 来自发展中国家的研究表明，特定年龄段的患病率和重症心脏病发病率的下降 自20世纪80年代以来，认知障碍和痴呆症与教育程度和 改善对心脏代谢风险(CMR)的控制。然而，教育的复杂动态， CMR和认知健康使精确定位从教育或CMR到认知的具体路径的努力复杂化 结果。拟议的研究将使用来自美国卫生与公众服务部的具有代表性的纵向数据 退休研究及其在英国、中国和印度尼西亚的国际姊妹研究以及新数据 从协调认知评估议定书研究中获得的系统和严格的 描述并比较认知功能、认知老化和痴呆症的CMR和教育模式 在四个国家。这些国家约占世界人口的25%，处于不同水平 经济发展和营养转型的阶段，并代表了广泛的历史、文化、 社会、流行病学和医学背景。这项研究之所以重要，是因为跨国 认知健康的关键模式的比较将增强对社会- 环境背景，加上他们根深蒂固的个人特征和经历，影响着 老年时的认知健康。为了实现这一研究目标，K99阶段将包括以下培训 神经心理学，健康和老龄化的国际背景，以及比较研究中的先进技术 使用纵向数据进行分析。培训将在卡罗莱纳人口中心(CPC)举行，地点为 北卡罗来纳大学教堂山分校(北卡罗来纳大学)。CPC是接受必要培训的理想地点 鉴于气候变化方案在全球卫生和卫生研究方面的跨学科性质，拟议的研究 福利、跨学科指导，以及获得北卡罗来纳大学提供的广泛课程的机会。 在K99阶段收集的培训的基础上，R00阶段的目标将是(1)检查 CMR与认知老化和痴呆的教育模式 使用固定效果框架；以及(2)在不同国家之间对比这些模式。 认知老化是一个高度复杂的过程，它受到个人和社会因素的影响 级别。这种比较研究将提供认知健康的全面图景，这是不可能的 在更多的同质性人群中观察，增强了对广泛社会- 环境背景，加上他们根深蒂固的个人特征和经历，影响着 认知老化，并通过这样做，提供了关键的见解，可以用来应对 AD/ADRD全球。

PROJECT SUMMARY Alzheimer's Diseases and Alzheimer's Disease-Related Dementias (AD/ADRD) impose significant global challenges that necessitate research to identify critical protective and risk factors of cognitive health. Research from developing countries shows that the decline in age-specific prevalence and incidence of severe cognitive impairment and dementia since the 1980s parallels the rise in educational attainment and improvements in the control of cardiometabolic risk (CMR). However, the complex dynamics of education, CMR, and cognitive health complicate efforts to pinpoint specific pathways from education or CMR to cognitive outcomes. The proposed research will use representative longitudinal data from the United States Health and Retirement Study and its international sister studies in England, China, and Indonesia, as well as new data obtained from the Harmonized Cognitive Assessment Protocol studies to systematically and rigorously describe and compare the CMR and educational patterns of cognitive function, cognitive aging, and dementia in four countries. These countries comprise about 25 percent of the world's population, are at different levels of economic development and stages of nutritional transition, and represent a wide range of historical, cultural, social, epidemiological, and medical contexts. This research is important because the cross-national comparison of key patterns of cognitive health will enhance the understanding of how broad social- environmental contexts, coupled with their embedded individual characteristics and experiences, affect cognitive health in old age. To accomplish this research goal, the K99 phase will involve training in neuropsychology, the international context of health and aging, and advanced techniques in comparative analysis using longitudinal data. This training will take place at the Carolina Population Center (CPC) at the University of North Carolina at Chapel Hill (UNC). CPC is an ideal location to receive the training necessary for the proposed research, given the interdisciplinary nature of the CPC in terms of global studies of health and wellbeing, and interdisciplinary mentorship, and the access to a wide range of coursework that UNC offers. Building on the training gleaned during the K99 phase, the goal of the R00 phase will be to (1) examine the CMR and educational patterns of cognitive aging and dementia by modeling the longitudinal relationships and using the fixed-effect framework; and (2) contrast these patterns across countries. Cognitive aging is a highly complex process that is influenced by factors at the individual and societal levels. This comparative research will provide a comprehensive picture of cognitive health that cannot be observed in more homogenous populations, enhance the understanding of ways that broad social- environmental contexts, coupled with their embedded individual characteristics and experiences, affect cognitive aging, and, in so doing, provide key insights that can be used to respond to the challenges posed by AD/ADRD worldwide.