Harmonized Diagnostic Assessment of Dementia (DAD) for Longitudinal Aging Study of India (LASI)

 描述(申请人提供)：印度，世界上人口第二多的国家，将很快经历其人口的快速老龄化。到2050年，印度老年人口(60岁)预计将达到3.2亿(大约相当于目前美国总人口的规模)，占总人口的比例从8%增加到20%。越来越多的老年人将导致印度痴呆症患病率大幅上升，远远超过目前占主导地位的私营护理系统的能力。印度的纵向老龄化研究(LASI)是一项针对全国以及印度各邦和联邦领土内代表老年人口的5万名印度人的调查，为研究这一问题和相关问题提供了一个独特的机会。LASI是对该国老年人口的身体、精神、经济和社会福祉进行的最具雄心的全国代表性研究。它与其他健康和退休研究(HRS)调查相协调，提供了一个证据基础，可用于比较旨在支持印度老年人的社会政策与世界其他国家使用的政策的效果。这项拟议研究的目的是为了补充目前的LASI，以估计印度痴呆症和轻度认知障碍(MCI)的患病率。以前在发展中国家识别痴呆症的努力通常依赖于地理受限地区的非代表性样本。在这项申请中，我们的目标是开发一种用于评估痴呆症和MCI的方案，用于正在进行的、具有全国代表性的LASI的社区环境中。为此，我们将首先对印度地区老年医院的LASI受访者中的一个子样本进行深入的认知测试。具体地说，我们将对大约2,000名年龄至少60岁的受访者实施两项领先的痴呆症评估方案-HRS统一认知评估方案(HCAP)和10/66痴呆症方案，并根据他们的第一波认知测试结果以及他们靠近合作的地区老年医院进行评估。根据对方案的预后评估，我们将开发一个简短(15分钟)的痴呆症评估模块，并在第二波中对患有痴呆症和MCI的高概率患者以及参与较早评估的2000人进行评估。使用这些数据，我们将估计印度人口和亚人群的痴呆症和MCI的患病率。我们将向研究界提供在地区老年医院进行的深入认知测试产生的数据，以及在第二波期间管理短期痴呆症评估模块产生的数据，这两个数据都与正在进行的LASI主要调查有关。我们的痴呆症和MCI评估协调方案将使研究人员能够使用10/66方案与印度之前的研究结果进行比较，并与美国、英国、中国和其他实施HRS HCAP方案的国家进行跨国研究。

 DESCRIPTION (provided by applicant): India, the second-most populous country in the world, will soon experience rapid aging of its population. By 2050, India's older population (> 60 years old) is projected to reach 320 million (about the current size of the entire US population), representing an increase from 8 to 20 percent of its total population. The growing number of older people will drive a large increase in the prevalence of dementia in India, far exceeding the capacity of the private care system that currently predominates for the elderly. The Longitudinal Aging Study in India (LASI), a survey of 50,000 Indians representative of the older population across the nation and within its states and union territories, provides a unique opportunity to examine this and related issues. LASI is the most ambitious nationally representative study of the physical, mental, economic, and social well-being of the country's older population. Harmonized with other Health and Retirement Study (HRS) surveys, it offers an evidence base that can be used to compare the effects of social policies aimed at supporting older persons in India with policies used in other countries around the world. The objective of the proposed research is to supplement the current LASI in order to estimate the prevalence of dementia and mild cognitive impairment (MCI) in India. Previous efforts to identify dementia in developing nations have typically relied on non- representative samples in geographically restricted regions. In this application, we aim to develop a protocol for the assessment of dementia and MCI to be used within community settings in the ongoing, nationally representative LASI. To do so, we will first conduct in-depth cognitive testing for a sub-sample of LASI respondents at regional geriatric hospitals in India. Specifically, we will administer two leading dementia assessment protocols - the HRS Harmonized Cognitive Assessment Protocol (HCAP) and the 10/66 Dementia Protocol - to approximately 2,000 respondents at least 60 years of age and stratified by their Wave 1 cognition test results, as well as their proximity to collaborating regional geriatic hospitals where the assessments will occur. Based on prognostic evaluation of the protocols, we will develop a short (15-minute) dementia assessment module and administer it in Wave 2 to persons with a high probability of having dementia and MCI as well as to the 2,000 persons participating in the earlier assessment. Using these data, we will estimate prevalence rates of dementia and MCI in India for the population and sub-populations. We will provide to the research community data generated from the in-depth cognitive testing at regional geriatric hospitals and from the administration of the short dementia assessment module during Wave 2, both linked to the on-going LASI main survey. Our harmonized protocol for dementia and MCI assessment will enable researchers to make comparisons with prior findings in India using the 10/66 protocol as well as to conduct cross-country studies with the United States, England, China, and other countries that implement the HRS HCAP protocol.