Influences of Early and Later Life Events on Cognition and All-Cause Dementia in China

摘要 预期寿命的增加导致老年人口规模迅速增加，预计将导致阿尔茨海默氏病和阿尔茨海默氏病相关痴呆症的发病率急剧上升，从目前全世界约4 700万人增加到2050年可能超过1.4亿人。 然而，最近的人口研究发现，在一些国家，阿尔茨海默氏病和与阿尔茨海默氏病有关的痴呆症的发病率低于以前的预测，但在另一些国家，发病率较高。 生活方式因素以及环境因素可能会减少或增加个人患痴呆症的风险。 我们建议进一步了解中国老年认知功能减退和阿尔茨海默病以及阿尔茨海默病相关痴呆（以下简称痴呆）的保护性和危险因素。 我们提出了一种新的风险因素的生命过程模型，建立在柳叶刀委员会最近提出的模型基础上，该模型将痴呆风险与早期和中期因素联系起来，在历史，制度和物理环境的背景下，包括肥胖，糖尿病听力损失，视力障碍，吸烟，饮酒，抑郁症，身体不活动，社会孤立和社会经济地位。 具体而言，该项目旨在使用中国新的回顾性生活史访谈数据，进一步研究可能导致晚年认知和痴呆风险的早期和中期个人，家庭，社区和外部因素。

Abstract Rising life expectancy is contributing to rapid increases in the size of the older population and is expected to lead to a sharp rise in Alzheimer’s disease and Alzheimer’s disease related dementias from about 47 million people worldwide today, to potentially more than 140 million in 2050. However, recent population studies have found that the incidence of Alzheimer’s disease and Alzheimer’s disease related dementias is lower than that indicated by previous projections in some countries, but greater in others. Lifestyle factors as well as environmental factors might reduce or increase an individual’s risk of developing dementia. We propose to advance our understanding of protective and risk factors for late-life cognitive decline and Alzheimer’s disease and Alzheimer’s disease-related dementias (hereafter referred to as dementia) in China. We propose a novel life-course model of risk factors, building on the recently proposed model by the Lancet commission, which links dementia risk to early and mid-life factors, within the context of historical, institutional, and physical environments, including obesity, diabetes hearing loss, visual impairment, smoking, drinking, depression, physical inactivity, social isolation, and socioeconomic status. Specifically, this project aims to further study early and mid-life personal, family, community, and external factors that may contribute to late-life cognition and dementia risk using new, retrospective life-history interview data in China.