Research Infrastructure for the study of Alzheimer's Disease and Alzheimer's Disease-related dementias in older Asian Americans

项目总结 老年亚裔美国人口一直在上升，患阿尔茨海默氏症和阿尔茨海默氏症的风险一直在上升 与疾病相关的痴呆症(AD/ADRD)也在增加。然而，健康结果的大部分差异 被掩盖是因为老年亚裔美国人在临床研究中的代表性明显不足。社交 健康决定因素(SDOH)是个人的个人情况，影响他们的健康和健康- 是存在的。SDOH助长了广泛的健康差距和不平等。将AD/ADRD与SDOH联系起来的研究是 尽管发展迅速，但年长的亚裔美国人仍需要更多证据。此外，还有相对较多的 很少有研究结合与健康相关的风险，如血管状况和生物标记物来了解 SDOH与AD/ADRD之间的联系；目前尚不清楚血管风险因素和/或生物标记物是否介导了这种 两性关系。使用有效的英语/汉语认知测试和与文化相关的测量 社会人口学因素，MPI(LI)研究成功地招募了200多名年长的亚裔美国人参加临床 西奈山阿尔茨海默病研究中心(ADRC)的研究。在这里，学习团队将发展到 包括多学科成员，提出一项为期5年的研究，以发展研究基础设施 老年亚裔美国人中的AD/ADRD。SDOH评估将以英语、普通话和 粤语--亚裔美国老年人最常用的语言。这项研究将回答 以下问题：(1)SDOH措施的中文翻译和文化适应是否有效 AD/ADRD研究中新的和现有的年长亚裔美国人？(2)我们能否识别行为、环境、 与AD/ADRD相关的社会、遗传和神经生物学因素？(3)神经生物学过程 与环境、社会文化、行为和其他人口统计因素交叉影响AD/ADRD 结果呢？研究小组将成立一个科学顾问委员会，为 拟议的研究，特别是在(1)社会科学领域；(2)AD/ADRD的临床表型；(3)痴呆症 对亚裔美国人的研究；(4)AD/ADRD的危险因素和生物标记物。该团队还将合作 与关键的社区利益攸关方合作，确保SDOH评估在文化和语言上都是合适的。 招聘目标设定为300名老年亚裔美国人完成一项全面的痴呆症评估 包括SDOH测量。将开发新的、基于理论的SDOH指数来描述年长的亚洲人 美国人分为正常组、MCI组和AD/ADRD组。在300名参与者中，研究小组的目标是重新评估 100名参与者进行为期1年的随访，收集200个生物标记物样本进行分子图谱分析，包括 基因组测序、RNA测序和蛋白质组学。一种集成网络生物学和机器学习的方法 基于此的方法将被用于开发高预测性的诊断和预后分子生物标记物 AD/ADRD。UH2阶段将用于开发研究基础设施和评估工具 有必要在UH3阶段结束时申请更大规模的RO1项目。

PROJECT SUMMARY The older Asian American population has been rising, with the risk of Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias (AD/ADRD) also increasing. However, most of the disparities in health outcomes are masked because older Asian Americans are significantly underrepresented in clinical research. Social determinants of health (SDOH) are an individual’s personal circumstances that influence their health and well- being. SDOH contribute to wide health disparities and inequities. Research linking AD/ADRD to SDOH is expanding rapidly, yet much evidence is still needed in older Asian Americans. Additionally, there are relatively few studies incorporating health related risks, such as vascular conditions, and biomarkers to understand the link between SDOH and AD/ADRD; it remains unclear if vascular risk factors and/or biomarkers mediate such a relationship. Using validated cognitive tests in English/Chinese and culturally relevant measures of sociodemographic factors, the study MPI (Li) successfully enrolled over 200 older Asian Americans in clinical research at the Alzheimer’s Disease Research Center (ADRC) at Mount Sinai. Here, the study team will grow to include multidisciplinary members, proposing a 5-year study to develop a research infrastructure for studying AD/ADRD in older Asian Americans. The SDOH assessment will be available in English, Mandarin, and Cantonese – the most common spoken languages among Asian American older adults. This study will answer the following questions: (1) Do Chinese translation and cultural adaptation of SDOH measures effectively recruit new and existing older Asian Americans in AD/ADRD research? (2) Can we identify behavior, environmental, social, genetic, and neurobiological factors associated with AD/ADRD? (3) How neurobiological processes intersect with environmental, sociocultural, behavioral, and other demographic factors to affect AD/ADRD outcomes? The study team will establish a scientific advisory board to provide scientific perspectives for the proposed study, particularly in the areas of (1) Social science; (2) Clinical phenotypes of AD/ADRD; (3) Dementia research in Asian Americans; and (4) Risk factors and biomarkers for AD/ADRD. The team will also collaborate with key community stakeholders to ensure that the SDOH assessment is culturally and linguistically appropriate. Recruitment goal is set to be 300 older Asian Americans to complete a comprehensive dementia evaluation that includes SDOH measurement. Novel, theory based SDOH indices will be developed to characterize older Asian Americans in the normal, MCI, and AD/ADRD groups. Of the 300 enrollees, the study team aims to re-evaluate 100 participants for a 1-year follow-up and collect 200 biomarker samples for molecular profiling, including whole genome sequencing, RNA-sequencing and proteomics. An integrative network biology and machine learning based approach will be employed to develop highly predictive diagnostic and prognostic molecular biomarkers of AD/ADRD. The UH2 phase will be used to develop the research infrastructure and assessment tools necessary to apply for a larger RO1 project at the end of the UH3 phase.