Longitudinal Epidemiology

P1摘要 新型冠状病毒SARS-CoV-2在全球范围内传播，造成了毁灭性的后果。我们 初步数据和几项已发表的研究强烈表明，在60岁以上的成年人中， 感染性认知功能障碍存在于近一半的受影响的人中，无论其严重程度如何 急性COVID-19疾病。考虑到阿尔茨海默氏症患者的数量已经令人担忧并不断增加， 痴呆症和相关痴呆症（ADRD）在全球范围内，我们必须调查和了解 SARS-CoV-2可能使老年人处于进行性认知能力下降的更高风险中 甚至ADRD。我们已经组建了一个国际调查联盟， 并分析广泛的高质量临床、生物标志物、基因组和神经成像数据。这项研究， SARS-CoV-2感染和祖先基因组变异之间的相互作用 阿尔茨海默病（ISAVRAD），提出了一个五个地点，国际，双臂（患者和对照）， 纵向（基线、18个月和36个月）设计，入组4，300名有和无SARS病史的个体- 二型冠状病毒ISAVRAD项目1将描述纵向过程、流行病风险/复原力因素， 环境相互作用可预测SARS-CoV-2后认知功能下降和进展为ADRD 60岁以上来自祖先和混合人群的成年人感染。具体而言，项目1将 纵向比较有和没有暴露于SARS-CoV-2的老年人的认知能力下降率 感染（目标1）。我们假设认知变化在本质上是渐进的， 基于临床痴呆评定评分和神经认知表现的ADRD。对于感染组，我们 将根据COVID-19症状的严重程度以及嗅觉丧失的存在和严重程度， 假设嗅觉减退/嗅觉丧失，而不是急性COVID-19严重程度，将预测 认知障碍和ADRD进展的可能性（目标2）。最后，使用 神经影像学和项目2和3，我们将确定SARS-CoV-2诱导的认知能力下降的预测因子。我们 假设特定的症状（嗅觉缺失-嗅觉减退）将与相关的神经影像学改变（在 嗅觉皮层网络）和风险将受到遗传祖先的影响，以预测最高的风险， 认知能力下降和新发ADRD（目的3）。

P1 Abstract The novel coronavirus, SARS-CoV-2, spread worldwide, resulting in devastating consequences. Our preliminary data and several published studies strongly suggest that, in adults over 60 years of age, post- infectious cognitive impairment is present in nearly half of affected people, potentially regardless of the severity of acute COVID-19 illness. Given the already alarming and increasing numbers of persons with Alzheimer's dementia and related dementias (ADRD) globally, it is essential that we investigate and understand the degree and manner and in which SARS-CoV-2 may place older persons at higher risk of progressive cognitive decline and even ADRD. We have put together an international consortium of investigators uniquely poised to collect and analyze a broad range of high quality clinical, biomarker, genome, and neuroimaging data. The study, entitled Interaction between SARS-CoV-2 Infection and Ancestral genomic Variations in the Risk of Alzheimer's Disease (ISAVRAD), proposes a five-site, international, two-arm (patients and controls), longitudinal (baseline, 18 and 36-months) design enrolling 4,300 individuals with and without history of SARS- CoV-2. Project 1 of ISAVRAD will describe the longitudinal course, epidemiological risk/resiliency factors, and environmental interactions predictive of cognitive decline and progress to ADRD following SARS-CoV-2 infection in adults over 60 years of age from ancestral and admixed populations. Specifically, Project 1 will longitudinally compare the rate of cognitive decline in older adults with and without exposure to SARS-CoV-2 infection (Aim 1). We hypothesize that cognitive changes will be progressive in nature and increase rates of ADRD based on Clinical Dementia Rating scores and neurocognitive performance. For the infected group, we will compare outcomes by severity of COVID-19 symptoms and the presence and severity of anosmia, under the hypothesis that that hyposmia/anosmia, but not acute COVID-19 severity, will predict the presence and likelihood of progression of cognitive impairment and ADRD (Aim 2). Finally, working with the Neuroimaging,and Projects 2 and3, we will identify predictors of SARS-CoV-2-induced cognitive decline. We hypothesize that specific symptoms (anosmia-hyposmia) will segregate with related neuroimaging changes (in the olfactory cortical network) and risk will be influenced by genetic ancestry to predict the highest risk of cognitive decline and new onset ADRD (Aim 3).