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， 阿尔茨海默病（AD）是最常见的疾病， 痴呆的类型。这些努力主要集中在近端行为和 生物因素，但上游的社会因素的认知能力下降和AD和相关 痴呆症（ADRD）还不太清楚。本拟议项目的总体目标是 婚姻是一个重要但被忽视的社会风险/保护因素， 认知能力下降的轨迹和老年痴呆症的风险。 婚姻一直被认为是最重要的社会关系类型， 对成年期的健康具有最重要的意义。然而，令人惊讶的是， 关于婚姻是否以及如何影响认知能力下降和发展， ADRD。在婚姻、家庭形成和家庭解体方面的迅速社会变化意味着， 越来越多的美国老年人进入晚年，他们有着复杂的婚姻史， 重塑他们生活的关键方面，并可能反过来影响整个生命过程中的认知功能。 我们假设，婚姻关系中复杂的生命历程特征，如当前的 婚姻状况、婚姻解体史和婚姻紧张，将影响 认知能力下降和痴呆症的风险在一个人的生命过程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开辟了新天地 设计结合了来自三个NIH赞助的国家纵向数据集的数据：（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），以审查一个完整的生命历程的图片， 婚姻关系，包括婚姻状况、婚姻经历和婚姻质量， 认知轨迹和痴呆我们将运用先进的统计方法， 系统地研究经济、社会心理、行为和生物医学机制 婚姻通过它影响认知轨迹和一生中患痴呆症的风险， 并进一步评估这些进程中潜在的性别差异。 跨学科研究团队的特点是人才互补 在人口健康、认知老化、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学 使他们有独特的条件来实施这个创新项目。

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.