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

项目摘要 阿尔茨海默氏病和阿尔茨海默氏病相关痴呆（AD/ADRD）对阿尔茨海默氏病患者的生活造成了重大影响。 全球性挑战，需要研究，以确定关键的保护和认知健康的风险因素。 来自发展中国家的研究表明，特定年龄组的严重疟疾流行率和发病率下降， 自20世纪80年代以来，认知障碍和痴呆症与教育程度的提高平行， 改善心脏代谢风险（CMR）的控制。然而，教育的复杂动态， CMR和认知健康使确定从教育或CMR到认知健康的特定途径的努力复杂化 结果。拟议的研究将使用来自美国卫生和 退休研究及其在英国、中国和印度尼西亚的国际姐妹研究，以及新数据 从协调认知评估方案研究中获得的数据， 描述并比较认知功能、认知老化和痴呆的CMR和教育模式 在四个国家。这些国家约占世界人口的25%，处于不同的发展水平。 经济发展和营养过渡阶段，代表了广泛的历史，文化， 社会、流行病学和医学背景。这项研究很重要，因为跨国公司 认知健康的主要模式的比较将提高对广泛的社会- 环境背景，再加上他们嵌入的个人特征和经验，影响 老年认知健康为了实现这一研究目标，K99阶段将包括以下方面的培训： 神经心理学，健康和老龄化的国际背景，以及比较 使用纵向数据进行分析。这项培训将在卡罗莱纳人口中心举行， 位于查佩尔山的北卡罗来纳州大学。CPC是接受必要培训的理想场所， 考虑到产品总分类在全球卫生研究方面的跨学科性质， 健康，跨学科的指导，以及获得广泛的课程，该课程提供。 在K99阶段收集的培训的基础上，R 00阶段的目标是：（1）检查 认知老化和痴呆的CMR和教育模式，通过建模纵向关系和 使用固定效应框架;（2）对比各国的这些模式。 认知老化是一个高度复杂的过程，受到个人和社会因素的影响 程度.这项比较研究将提供一个全面的认知健康的图片，不能被 在更同质的人群中观察，增强了对广泛的社会- 环境背景，再加上他们嵌入的个人特征和经验，影响 认知老化，并在这样做，提供关键的见解，可用于应对所带来的挑战， 全球AD/ADRD。

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.