Measurement of cognition and functional decline in Latinx older adults for detection of Alzheimer’s Disease and Related Dementias: A mixed-methods approach

测量拉丁裔老年人的认知和功能下降以检测阿尔茨海默病和相关痴呆症：混合方法

• 批准号: 10569697
• 负责人: Emily Marie Briceno
• 金额: $ 19.17万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10569697
• 关键词: Adult; Affect; Age; Aging; Alzheimer disease detection; Alzheimer' s disease related dementia; Assessment tool; Attenuated; Cognition; Cognitive; Cognitive aging; Collaborations; Communities; Data; Data Analyses; Data Collection; Data Pooling; Diagnosis; Disparity; Education; Educational Status; Educational workshop; Elderly; Environment; Ethnic Origin; Exhibits; Funding; Goals; Grant; Growth; Health; Health Disparities Research; Health and Retirement Study; Hispanic; Impaired cognition; Individual; International; Intervention; Investigation; Knowledge; Language; Latina; Latino; Latinx; Latinx population; Leadership; Linguistics; Measurement; Measures; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methodology; Methods; Mexican Americans; Michigan; Neuropsychology; Outcome; Participant; Performance; Population; Prevalence; Protocols documentation; Psychometrics; Public Health; Qualitative Methods; Qualitative Research; Research; Research Personnel; Resources; Respondent; Risk; Risk Factors; Sampling; Series; Stroke; Training; United States National Institutes of Health; Universities; brain health; career; career development; cognitive ability; cognitive interview; cognitive testing; cohort; ethnic difference; follow-up; functional decline; health data; health disparity; health equity; improved; informant; instrument; novel; population based; public health priorities; research and development; skills; sociocultural determinant; symposium; training opportunity

Accurate and valid measurement of cognitive and functional decline for the detection of Alzheimer’s Disease and Related Dementias (AD/ADRD) in Latino/a/x older adults is a critical public health priority. The Latinx population is rapidly growing and aging in the U.S. with enormous expected growth of AD/ADRD in older Latinx adults in the coming years. It is unknown whether cognitive assessment instruments measure cognitive health with equal precision and validity across Latinx and non-Latinx white (NLW) older adults, which is a critical barrier to the accurate detection of AD/ADRD, its determinants, and its impact. This study will use a mixed-methods approach to evaluate the validity and equivalence of measures of cognitive and functional decline in Latinx and NLW older adults, using the Harmonized Cognitive Assessment Protocol (HCAP) cognitive test battery (HCAP-R) and informant ratings of cognitive and functional decline (HCAP-I). Specific Aim 1 will examine the extent to which the HCAP-R and HCAP-I exhibit statistical evidence of measurement bias across years of education, assessment language (English/Spanish), and ethnicity (Latinx/NLW), using a series of psychometric analyses. Data from the Health and Retirement Study (HRS)-HCAP study will be combined with data from the Brain Attack Surveillance in Corpus Christi (BASIC)-Cognitive study for this analysis. Specific Aim 2 will utilize longitudinal data from the BASIC-Cognitive study to examine whether the HCAP-R is equally predictive of longitudinal trajectories of informant-rated cognitive and functional decline (HCAP-I) between Latinx and NLW older adults and whether adjustment for statistical measurement bias eliminates any differences in this predictive equivalence. Specific Aim 3 will perform new data collection using a qualitative methodology (cognitive interviewing) to examine the linguistic and cultural validity of HCAP-R and HCAP-I items in a sample of Mexican American older adults with varying levels of education and Spanish language use. These data will provide a novel integration of mixed methods (psychometric, longitudinal prediction of cognitive and functional decline, and qualitative) to inform the equivalence and validity of the HCAP across culturally, linguistically, and educationally diverse older adults. This K23 program will provide PI Dr. Briceño with training to develop expertise in psychometric and longitudinal data analysis, qualitative research, population-based cognitive aging and health disparities research, and research leadership. Training will occur through individual mentoring, formal workshops and seminars, and international conferences. The K23 mentors are international leaders in Latinx brain health equity, psychometrics, population-based cognitive aging, and cross-cultural neuropsychological assessment of AD/ADRD. The K23 will provide Dr. Briceño with expertise and preliminary data to submit an R01 and to become an independent researcher in cognitive health disparities in AD/ADRD. The University of Michigan provides an ideal environment to conduct the proposed research and career development, with abundant resources, facilities, training opportunities, and collaboration.

准确且有效的测量认知和功能下降，以检测阿尔茨海默氏病和 拉丁裔/A/X老年人的相关痴呆症（AD/ADRD）是至关重要的公共卫生优先事项。拉丁裔人口是 美国迅速增长和衰老，在未来 年。尚不清楚认知评估工具是否以平等的精度来衡量认知健康和 拉丁裔和非Latinx白人（NLW）老年人的有效性，这是准确检测的关键障碍 AD/ADRD，其决定者及其影响。这项研究将使用混合方法方法来评估有效性和 使用协调 认知评估方案（HCAP）认知测试电池（HCAP-R）和认知和功能的线人评分 下降（HCAP-I）。具体目标1将检查HCAP-R和HCAP-I表现出统计证据的程度 多年教育，评估语言（英语/西班牙语）和种族（Latinx/NLW）的测量偏见，使用 一系列心理测量分析。健康和退休研究（HRS）-HCAP研究的数据将与 Corpus Christi（基本）认知研究中的大脑攻击监视数据的数据。具体目标2将 利用基础认知研究中的纵向数据检查HCAP-R是否同样预测 Latinx和NLW较老的线人评分认知和功能下降（HCAP-I）的纵向轨迹 成人以及调整统计测量偏差是否消除了这种预测性的任何差异 等价。特定目标3将使用定性方法（认知访谈）进行新的数据收集 在墨西哥裔美国人样本中检查HCAP-R和HCAP-I项目的语言和文化有效性 随着教育和西班牙语的使用程度不同。这些数据将提供混合方法的新颖集成 （心理测量，纵向预测认知和功能下降，定性），以告知等效性和 HCAP在文化，语言和教育上多样化的老年人的有效性。这个K23程序将提供 PiBriceño博士接受了培训，以发展心理测量和纵向数据分析，定性研究的专业知识， 基于人群的认知衰老和健康差异研究以及研究领导。培训将通过 个人指导，正式的研讨会和半读和国际会议。 K23导师是国际的 拉丁裔大脑健康公平，精神计量学，基于人群的认知衰老和跨文化的领导者 AD/ADRD的神经心理学评估。 K23将为Briceño博士提供专业知识和初步数据 提交R01并成为AD/ADRD认知健康差异的独立研究人员。大学 密歇根州提供了一个理想的环境，以绝对进行拟议的研究和职业发展 资源，设施，培训机会和协作。