A global epidemiology of cognitive impairment and dementia due to Alzheimer's disease and related disorders: the COSMIC Collaboration

国际联盟(COSMIC)的记忆队列研究完全可以实现 “减少痴呆症风险的循证实践”、“早期和适当的诊断”、“研究”的目标 世界卫生大会#年全球行动计划认可的“创新和创新”和“跨国公平”。 2017-2025年痴呆症的公共卫生应对措施。宇宙汇聚了多个特征良好的 世界各地关于认知老化和痴呆症的基于人群的纵向队列研究 痴呆症和痴呆前期综合征的分析流行病学，使用协调数据进行汇集 分析和个体参与者数据荟萃分析。自2017年9月NIA/NIH首次资助以来， COSMIC的成员已经增加到来自39个国家的54项研究，其中包括35项来自中低等国家的研究 收入国家(LMIC)，另外25个正在谈判中，总样本量为175,199(85,186 白人和90,013非白人-39,610名亚洲人，15,476名黑人，34,832名西班牙裔，96名其他人)，预计将增长到 30万。因此，一个庞大的国际研究社区得以合作调查 轻度认知障碍(MCI)和痴呆症的全球流行病学。在接下来的五年里，这一力量 将利用独特的联盟来绘制到2020年确定的12个可改变的痴呆症风险因素 柳叶刀委员会。一些新的风险和弹性因素将被深入研究，建成和经济 环境、空气污染、社会健康和脆弱性。MCI和痴呆症的发病率将在#年确定。 在特定人群中开发了不同的地区和痴呆症风险模型。宇宙将研究这个角色 通过协调神经成像生物标记物来诊断脑血管疾病。它将研究预测的效用， 非欧洲人群中的遗传标记。它将调查诊断和疾病监测的潜力 阿尔茨海默病的血浆生物标志物在不同人群中的研究。宇宙正在打造新的合作伙伴关系。它 正在与达沃斯阿尔茨海默氏症合作组织(DAC)合作，开发数字、遗传和流体 在代表性不足的人群中，基于生物标记物的痴呆表型。与Dementias合作 英国平台(DPUK)，COSMIC正在开发澳大利亚Dementias平台(DPAU)以供共享 来自世界各地研究人员的宇宙研究的参与者水平数据。DPUK和阿尔茨海默氏症 疾病数据倡议(ADI)，它正在开发一个用于管理和协调痴呆症的本体 国际数据共享的相关变量。与健康指标研究所和 评估，COSMIC将记录全球痴呆症风险因素的负担。与 DAC、DPUK、ADI和全球脑健康研究所(GBHI)，它正在开发一种培训和教育 提高LMIC研究能力的计划。凭借其协作方法、数据共享和全球 COSMIC正在创建一种明显的全球痴呆症流行病学，这是满足 2017年世界卫生大会的雄心勃勃的目标和世界各地痴呆症风险人群的希望。

The Cohort Studies of Memory in an International Consortium (COSMIC) is perfectly positioned to achieve the goals of “evidence-based practice for dementia risk reduction”, “early and appropriate diagnosis”, “research and innovation” and “transnational equity” endorsed by the World Health Assembly’s Global Action Plan on the public health response to dementia, 2017-2025. COSMIC brings together multiple well-characterized population-based longitudinal cohort studies of cognitive aging and dementia from around the world to address the analytical epidemiology of dementia and pre-dementia syndromes, using harmonized data to conduct pooled analyses and individual participant data meta-analyses. Since its initial funding by the NIA/NIH in Sep 2017, COSMIC’s membership has grown to 54 studies from 39 nations, including 35 studies from low- and middle- income countries (LMIC), with an additional 25 in negotiation, and a combined sample size of 175,199 (85,186 White and 90,013 non-White - 39,610 Asian, 15,476 Black, 34,832 Hispanic, 96 other), expected to grow to 300,000. A large international community of researchers has thus been enabled to collaboratively investigate the global epidemiology of mild cognitive impairment (MCI) and dementia. In the next five years, the power of this unique consortium will be harnessed to map the 12 modifiable risk factors of dementia identified by the 2020 Lancet Commission. Some novel risk and resilience factors will be studied in-depth, the built and economic environments, air pollution, social health, and frailty. The incidence of MCI and dementia will be determined in diverse regions and risk models for dementia in specific populations developed. COSMIC will examine the role of cerebrovascular disease by harmonizing neuroimaging biomarkers. It will study the predictive utility of genetic markers in non-European populations. It will investigate the diagnostic and disease-monitoring potential of plasma biomarkers for Alzheimer’s disease in diverse populations. COSMIC is forging new collaborations. It is collaborating with the Davos Alzheimer’s Collaborative (DAC) to develop digital, genetic, and fluid biomarker-based dementia phenotypes in under-represented populations. In collaboration with Dementias Platform UK (DPUK), COSMIC is developing the Dementias Platform Australia (DPAU) for sharing participant level data from COSMIC studies with researchers world-wide. With DPUK and the Alzheimer’s Disease Data Initiative (ADDI), it is developing an ontology for the curation and harmonization of dementia related variables for international data-sharing. In collaboration with the Institute of Health Metrics and Evaluation, COSMIC will document the global burden of risk factors for dementia. In collaboration with the DAC, DPUK, ADDI and the Global Brain Health Institute (GBHI), it is developing a training and education program to increase research capacity in LMICs. With its collaborative approach, data sharing, and global network, COSMIC is creating a demonstrably global epidemiology of dementia that is needed to meet the ambitious goals of the 2017 World Health Assembly and the hopes of people at risk of dementia everywhere.