DEMENTIA AND DISABILITY IN THAI ELDERLY

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 痴呆症在欠发达社会正变得越来越普遍。适合发展中经济体应用的检测、诊断和治疗痴呆症的方法对于避免痴呆症患者护理中出现健康差距至关重要。泰国老年痴呆和残疾项目(DDP)结合了加州大学洛杉矶分校阿尔茨海默病中心和Mahidol大学神经学部神经退行性疾病和行为神经学科的专业知识，以响应新制定的公共卫生任务(康复和残疾人法案，BE2534)，该任务要求每所大学或医疗中心负责在曼谷指定的地区照顾患者。这项研究将主要在泰国Mahidol大学与Vorapun Senanarong医学博士合作进行，作为NIH#P50 AG16570补助金的延伸。DDP中提出的方法已被Mahidol集水区负责人Udon Kachitorn教授接受，作为检测和描述泰国老年人痴呆症和残疾的手段。2,650名泰国老年人居住在集水区，他们将在6个月的时间里在寺庙、学校和老年俱乐部接受筛查。我们预计将确认130名痴呆症患者和450名认知障碍非痴呆症患者(CIND)。这些患者将接受评估，以确定痴呆症和认知障碍的原因。这些患者加上100名非痴呆、非残疾的对照组将在一年后进行重新评估。我们假设泰国日常生活活动量表将在40%的泰国老年人中发现残疾；在5%的泰国老年人中将出现痴呆症；阿尔茨海默病将在泰国老年人中发现60%的痴呆症；在17%的泰国老年人中将出现CIND；在基线水平的CIND患者中将出现1年的痴呆症发病率；基线水平的痴呆症患者将表现出每年4个泰国精神状况检查点的认知下降；残疾将与认知恶化高度相关。研究的各个阶段(培训、筛选、评估和后续行动)将在3年内完成。我们的计划是雄心勃勃的，大部分费用将由Mahidol大学承担。这项研究的结果对于为残疾和认知障碍的泰国城市老年人制定公共卫生规划的需求至关重要。DDP将作为在曼谷其他集水区实施残疾和痴呆症筛查的典范。主要的外国合作者和加州大学洛杉矶分校阿尔茨海默病中心的首席研究员已经成功地在过去的几个项目上进行了合作，并一起发表了几篇手稿。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Dementia is becoming increasingly common in underdeveloped societies. Methods for detecting, diagnosing, and treating dementia appropriate for application in developing economies is critically important to avoid the emergence of health disparities in care of dementia patients. The Dementia and Disability in Thai Elderly Project (DDP) unites the expertise of the UCLA Alzheimer's Disease Center and the Neurodegenerative Disease and Behavioral Neurology Section of the Division of Neurology of Mahidol University to respond to a newly instituted public health mandate (the Rehabilitation and Disabled Persons Act, BE2534) requiring that each university or medical center take responsibility for the care of patients in their assigned catchment areas in Bangkok. This research will be done primarily in Thailand at Mahidol University in collaboration with Vorapun Senanarong, M.D. as an extension of NIH grant #P50 AG16570. The methodology proposed in the DDP has been accepted by the individual responsible for the Mahidol catchment area, Professor Udom Kachitorn, as the means of detecting and characterizing dementia and disability in Thai elderly. Two thousand-six hundred fifty Thai elderly live in the catchment area and will be screened over a 6-month period in temples, schools, and elderly clubs. We anticipate the identification of 130 individuals with dementia and 450 individuals with cognitive impairment with no dementia (CIND). These patients will be assessed to determine the cause of the dementia and cognitive impairment. These patients plus 100 non-demented, non-disabled controls will be reassessed 1 year later. We hypothesize that the Thai Activities of Daily Living scale will detect disability in 40% of Thai elderly; dementia will be present in 5% of Thai elderly; Alzheimer's disease will account for 60% of the dementia detected in Thai elderly; CIND will be present in 17% of Thai elderly, the 1-year incidence of dementia will be present in those with CIND at baseline; patients with dementia at baseline will exhibit a cognitive decline of 4 Thai Mental Status Examination points per year; and disability will be highly correlated with cognitive deterioration. The phases of the study (training, screening, assessment, and follow-up) will be completed over a 3-year period. Our program is ambitious and substantial cost sharing will be undertaken by Mahidol University. The outcomes of this study are critically important for public health planning of the needs of disabled and cognitively impaired urban Thai elderly. The DDP will serve as a model for the implementation for disability and dementia screening in other catchment areas of Bangkok. The major foreign collaborators and the principal investigator of the UCLA Alzheimer's Disease Center have successfully collaborated on several past projects and have published several manuscripts together.