At-home computerized assessment of normal cognitive aging and age-related cognitive decline in older African Americans, Hispanics, and rural non-Hispanic whites

尽管到2060年，非洲裔美国人、西班牙裔美国人和农村社区的居民将构成 大多数美国阿尔茨海默病(AD)患者，这些人群在AD中长期以来一直被忽视 研究研究和临床试验。在这一大规模快速跟踪SBIR应用中，我们建议收集 300名健康老年人(60岁)的标准化纵向加州认知评估组合(CCAB)数据 )四个未得到充分服务的人群中的个人：(1)非裔美国人：(2)说英语的美国人 拉美裔；(2)说西班牙语的美国拉美裔；和(4)农村的非拉美裔白人(Nhw) 社区。参与者将在加利福尼亚州和德克萨斯州南部招募。我们将比较以下各项的结果 每组都有主要来自郊区白人人口的现有规范数据。 CCAB包括34个创新的计算机化认知测试和问卷，这些测试和问卷使用手机 能够在患者家中进行远程医疗测试的网络。CCAB测试介绍和测试材料如下 提供人工智能增强的文本到语音的语音和口头响应分析，并达成共识 自动语音识别(CASR)，具有无与伦比的转录准确性。为招聘提供便利，并 因为CCAB测试是在参与者的家中进行的，所以测试吞吐量增加了。CCAB已经 旨在方便翻译成其他语言。在这里，我们将测试说西班牙语的美国居民 使用CCAB-Español，这是CCAB的西班牙语版本，针对美国西班牙语方言进行了优化。 在第一阶段，我们将招募非裔美国人和西班牙裔考官，保证西班牙人 CCAB的翻译适合美国拉美裔人口，并开始测试。在第二阶段，我们将 继续进行招生测试，之后每隔一年测试参与者收集纵向常模 并找出预测随后认知衰退的表现模式。每个CCAB的风俗常模 测试将采用传统的分析方法，并辅以项目反应理论的因素分析 提高得分敏感度，消除得分偏差。标准CCAB数据的获取将降低获取 民族少数民族进行神经心理评估的障碍有六个原因：(1)家庭CCAB 测试不会因新冠肺炎关闭而中断；(2)在家进行CCAB测试可最大限度地减少移动性和 运输挑战；(3)CCAB-Español将解决缺乏规范良好、可扩展的西班牙语的问题 为美国拉美裔人口进行考试，并方便接触西班牙语考官；(4)CCAB 远程医疗测试将为被忽视的城市和农村社区提供认知评估； (5)CCAB测试可将认知评估的成本障碍降低70%以上；(6)CCAB将 通过在熟悉的家庭环境中对参与者进行测试，减少参与研究的文化障碍 通过使用对民族敏感的非裔美国人和西班牙裔考官。

Although by 2060 African Americans, Hispanics, and residents of rural communities will constitute the majority of US patients with Alzheimer’s disease (AD), these populations have long been neglected in AD research studies and clinical trials. In this large scale fast-track SBIR application, we propose to gather normative longitudinal California Cognitive Assessment Battery (CCAB) data from 300 healthy older (ages 60 to 89) individuals in each of four underserved populations: (1) African Americans: (2) English-speaking US Hispanics; (2) Spanish-speaking US Hispanics; and (4) non-Hispanic white (nHW) residents of rural communities. Participants will be recruited in California and South Texas. We will compare the results from each group with existing normative data from a primarily suburban white population. The CCAB includes 34 innovative computerized cognitive tests and questionnaires that utilize cellphone networks to enable telemedical testing in patients’ homes. CCAB test introductions and test materials are delivered with AI-enhanced text-to-speech voices and verbal responses are analyzed with consensus automatic speech recognition (CASR) with unexcelled transcription accuracy. Recruitment is facilitated and testing throughput is increased because CCAB tests are administered in participants’ homes. The CCAB has been designed to facilitate translation into other languages. Here, we will test Spanish-speaking US residents with CCAB-Español, a Spanish version of the CCAB optimized for US Spanish dialects. During Phase I, we will recruit African American and Hispanic examiners, assure that the Spanish translation of the CCAB is adapted for the US Hispanic population, and begin testing. During Phase II we will continue enrollment testing and thereafter test participants at one-year intervals to gather longitudinal norms and identify performance patterns that predict subsequent cognitive decline. Ethnoracial norms for each CCAB test will be developed using traditional analysis and supplemented with Item response theory factor analysis to improve scoring sensitivity and eliminate score bias. The acquisition of normative CCAB data will lower access barriers to neuropsychological assessment among ethnoracial minorities for six reasons: (1) At-home CCAB Testing will not be interrupted by COVID-19 lockdowns; (2) At-home CCAB testing minimizes mobility and transportation challenges; (3) CCAB-Español will address the lack of well-normed, scalable Spanish-language tests for the US Hispanic population and facilitate access to Spanish-speaking examiners; (4) CCAB telemedical testing will provide access to cognitive assessments in neglected urban and rural neighborhoods; (5) CCAB testing can reduce cost barriers to cognitive assessment by more than 70%; (6) The CCAB will reduce cultural barriers to research participation by testing participants in their familiar home surroundings and by using ethnoracially sensitive African American and Hispanic examiners.