Project 1 - Cognitive Function and Dementia

项目 1 - 认知功能和痴呆症

• 批准号: 10627332
• 负责人: LISA F BERKMAN
• 金额: $ 64.43万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10627332
• 关键词: Address; Affect; Africa South of the Sahara; African; Age Years; Aging; Algorithms; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Alzheimer’s disease biomarker; Biological; Biological Markers; Birth; Blood; Calibration; Categories; Characteristics; Child; Cognition; Cognitive; Collaborations; Communities; Consensus; Country; Credentialing; Data; Dementia; Diagnosis; Education; Educational process of instructing; Elderly; Epidemiology; Generations; Glial Fibrillary Acidic Protein; Goals; Health; Health and Retirement Study; Health system; Incidence; Income; International; Linguistics; Longitudinal Studies; Magnetic Resonance Imaging; Measurement; Measures; Nerve Degeneration; Neurobehavioral Manifestations; Neurobiology; Neuropsychological Tests; Neuropsychology; Outcome; Parents; Participant; Pathway interactions; Pattern; Performance; Phenotype; Plasma; Population; Population Study; Prevalence; Prevention strategy; Protocols documentation; Psychometrics; Research; Resources; Respondent; Risk; Risk Factors; Role; Sampling; Severities; Shapes; Sister; Social Change; Social Conditions; Social Network; Social support; South Africa; South African; Surveys; Symptoms; Techniques; Translating; Validity and Reliability; Variant; Woman; Work; aging brain; aging population; blood-based biomarker; cognitive change; cognitive function; cognitive reserve; cognitive testing; cohort; data harmonization; dementia risk; diagnostic algorithm; epidemiologic data; experience; global health; informal learning; innovation; insight; life history; literacy; low and middle-income countries; magnetic resonance imaging biomarker; men; mild cognitive impairment; neuroimaging; neuropathology; novel; skills; social; social determinants; social factors; tau-1

Project 1: Cognitive Function and Dementia—Abstract The greatest impact of Alzheimer’s disease and related dementias (ADRD) is likely to be experienced in low- and middle-income countries (LMICs). Sub-Saharan Africa, in particular, is projected to encounter a dramatic increase in dementia prevalence and there is a growing need for rigorous population-based studies of ADRD in this region. Health, Aging and Dementia in South Africa: A Longitudinal Study (HAALSI) addresses core issues in dementia epidemiology in older South Africans. We implement measures harmonized with the global Health and Retirement Study (HRS) and Harmonized Cognitive Assessment Protocol (HCAP) networks to enable cross-national comparisons of dementia and its risk factors. Project 1 (Cognitive Function and Dementia) leverages our deeply phenotyped HAALSI Agincourt cohort to identify causal pathways underlying cognitive trajectories and applies well-validated neuropsychological assessments to a nationally representative sample. These data will provide the first national estimates of dementia prevalence in South Africa. We do this through tightly coordinated work across four overlapping cohorts. Our original HAALSI Agincourt cohort comprised 5059 respondents ≥40 years of age, for whom we collected three waves of data; this renewal will add two additional waves. HAALSI-HCAP Agincourt (n≈700) is an enriched subcohort that adds detailed neuropsychological testing, neuroimaging, and blood biomarkers of ADRD; this renewal adds one additional wave of HAALSI-HCAP Agincourt (wave 3). We propose to field a new, nationally representative study of 4500 men and women (plus partners) and a HAALSI-HCAP National survey (n≈624). Project 1 has 3 aims. Aim 1 focuses on characterizing the incidence and progression of mild cognitive impairment (MCI) and dementia in relation to neurodegeneration and ADRD neuropathology in the enriched Agincourt-HCAP cohort. We examine longitudinal change in magnetic resonance imaging (MRI) markers of brain aging and incorporate plasma markers of ADRD (i.e., Ab, p-tau, NfL, GFAP) to assess associations with dementia symptoms. In Aim 2, we refine and validate the HAALSI Global Cognitive Screen, HAALSI-HCAP, and HAALSI dementia algorithms for South African nationwide surveys of dementia. We collaborate with Project 4 to conduct a baseline National HAALSI-HCAP wave to generate national prevalence estimates for dementia and MCI. In Aim 3, we examine the impact of social factors, including novel indicators of educational quality and social connection on participants’ cognitive function and change trajectories. We explore informal educational experiences of special relevance in the context of rapid social changes in South Africa, including self-taught literacy and effects of children’s educational attainment on cognition in older parents. Optimizing all four cohorts (HAALSI Agincourt, HAALSI-HCAP Agincourt, HAALSI National, HAALSI-HCAP National) we identify distinct biological and social conditions that affect late-life cognitive function in South Africa. HAALSI provides rich, well-harmonized data to better understand modifiable factors in ADRD and inform global prevention strategies.

项目1：认知功能与痴呆症-摘要 阿尔茨海默病和相关痴呆(ADRD)的影响最大的可能是低血压病患者。 和中等收入国家(LMIC)。尤其是撒哈拉以南的非洲，预计将遇到戏剧性的 痴呆症患病率增加，在#年越来越需要对ADRD进行严格的基于人群的研究 这个地区。南非的健康、老龄化和痴呆：一项针对核心问题的纵向研究(HAALSI) 南非老年人中的痴呆症流行病学问题。我们实施与全球协调一致的措施 健康和退休研究(HRS)和协调认知评估协议(HCAP)网络 能够对痴呆症及其危险因素进行跨国比较。项目1(认知功能和 痴呆症)利用我们深具表型的HAALSI Agin Court队列来确定 认知轨迹，并将经过充分验证的神经心理学评估应用于国家代表 样本。这些数据将首次提供南非痴呆症患病率的国家估计。我们这样做 通过在四个相互重叠的群体中密切协调工作。我们最初的哈尔西·阿金库尔队列 包括5,059名≥40岁的受访者，我们为他们收集了三波数据；此次续签将 增加两个额外的波浪。HAALSI-HCAP AGINCORE(n≈700)是一个丰富的子队列，增加了详细的 ADRD的神经心理测试、神经成像和血液生物标记物；此次更新增加了一个额外的 HAALSI-HCAP阿金库尔浪(浪3)。我们建议对4500人进行一项新的、具有全国代表性的研究 男性和女性(加上伴侣)和HAALSI-HCAP全国调查(n≈624)。项目1有3个目标。目标1 重点描述轻度认知障碍(MCI)和痴呆症的发生率和进展 丰富的Agin Court-Hcap型队列中神经退行性变和ADRD神经病理的关系。我们检查 脑老化的磁共振成像标记物和合并血浆的纵向变化 ADRD的标志物(即Ab、p-tau、NFL、GFAP)评估与痴呆症状的相关性。在目标2中，我们 改进和验证HAALSI全球认知屏幕、HAALSI-HCAP和HAALSI痴呆症算法 南非全国痴呆症调查。我们与项目4合作进行基准国家 HAALSI-HCAP波，以生成全国痴呆症和MCI患病率估计。在目标3中，我们检查 社会因素的影响，包括教育质量的新指标和社会联系 参与者的认知功能和变化轨迹。我们探索特殊的非正式教育经验 在南非迅速社会变化的背景下的相关性，包括自学扫盲和#年的影响 大龄父母子女的认知教育程度。优化所有四个队列(哈尔西·阿金库尔， HAALSI-HCAP Agin Court，HAALSI National，HAALSI-HCAP National)我们识别不同的生物和社会 影响南非晚年认知功能的条件。HAALSI提供丰富、协调良好的数据 更好地了解ADRD中的可改变因素，并为全球预防战略提供信息。