Marriage, Cognitive Trajectories and ADRD Risk in Late Life

项目摘要 在过去的几十年里，广泛的研究旨在确定风险因素，导致 最常见的阿尔茨海默病(AD)的诱因、治疗和预防策略 痴呆症的类型。这些努力主要集中在最近的行为和 生物因素，但上游社会决定因素认知能力下降与阿尔茨海默病相关 痴呆症(ADRD)还没有被很好地理解。这一拟议项目的总体目标是 确定婚姻--一个重要但被忽视的社会风险/保护因素--与 认知衰退的轨迹和晚年患痴呆症的风险。 长期以来，婚姻一直被认为是最重要的社会关系类型 对成年后的健康有着最重要的意义。然而，令人惊讶的是，科学家们 对婚姻是否以及如何影响认知能力下降和进展知之甚少 阿德勒。婚姻、家庭形成和家庭解体的快速社会变化意味着 越来越多的美国老年人进入晚年，有复杂的婚姻史，这 重塑他们生活的关键方面，反过来可能会影响他们一生中的认知功能。 我们假设，像现在这样的婚姻关系的复杂的生命历程特征 婚姻状况、婚姻解体史和婚姻紧张会影响 认知衰退和痴呆症风险在一个人的一生中通过多方面的经济， 心理社会、行为和生物医学途径。 该项目以创新的跨学科生命历程研究为突破口。 将来自NIH赞助的三个国家纵向数据集的数据连接在一起的设计：(1)健康 和退休研究(HRS)，(2)国家健康和老龄化趋势研究(NHATS)，和(3) 国家社会生活、健康和老龄化项目(NSHAP)审查老年人的完整人生历程 婚姻关系包括婚姻状况、婚姻传记和婚姻质量 认知轨迹和痴呆症。我们将把先进的统计方法应用于 系统研究经济、心理社会、行为和生物医学机制 通过婚姻影响认知轨迹和一生中患痴呆症的风险， 并进一步评估进程中潜在的性别差异。 跨学科研究团队的特点是拥有一批互补的人才 以及在人口健康、认知老龄化、婚姻和社会关系方面的经验， 神经学、神经心理学、生物人口学、流行病学和定量方法 这使他们在执行这一创新项目方面处于独特的地位。

Project Summary In the past decades, extensive research has aimed to identify risk factors, causative agent, treatments and preventive strategies for Alzheimer's disease (AD), the most common type of dementia. These efforts have predominantly focused on proximate behavioral and biological factors, but the upstream social determinants of cognitive decline and AD and related dementias (ADRD) are not well-understood. The overall objective of this proposed project is to ascertain how marriage, an important but overlooked social risk/protective factor, is linked to trajectories of cognitive decline and risk of developing dementia in late life. Marriage has long been identified as the most important type of social relationships that holds the greatest significance for health during adulthood. However, surprisingly, scientists know little about whether and how marriage influences cognitive decline and progression to ADRD. Rapid social changes in marriage, family formation, and family dissolution mean that an increasing number of older Americans are entering late life with complex marital histories, which reshapes key aspects of their lives, and may in turn affect cognitive function over the life course. We hypothesize that the complex life-course traits of marital relationships such as current marital status, histories of marital dissolutions, and marital strain, will influence trajectories of cognitive decline and dementia risk over one’s life course via multifaceted economic, psychosocial, behavioral, and biomedical pathways. This project breaks new ground with an innovative interdisciplinary life-course research design that conjoins data from three NIH-sponsored, national, longitudinal datasets: (1) Health and Retirement Study (HRS), (2) National Health and Aging Trends Study (NHATS), and (3) National Social Life, Health and Aging Project (NSHAP) to examine a full life course picture of marital relationships including marital status, marital biography and marital quality linked to cognitive trajectories and dementia. We will apply advanced statistical methods to systematically examine economic, psychosocial, behavioral and biomedical mechanisms through which marriage influences cognitive trajectories and dementia risk over the life course, and further assess potential gender differences in the processes. The interdisciplinary research team is characterized by a complementary set of talents and experience in population health, cognitive aging, marriage and social relationships, neurology, neuropsychology, bio-demography, epidemiology and quantitative methodologies that uniquely position them to carry out this innovative project.