Measurement and Analysis of Aging, Cognition and Alzheimer's Disease and Related Dementia (ADRD) Risk Factors at Midlife in the Kenya Life Panel Survey (KLPS)

项目概要/摘要 在撒哈拉以南非洲，阿尔茨海默病的研究严重不足：现有的少数估计表明， 目前的流行率较低，但不断变化的风险因素预测，在今后20年内，流行率可能翻一番。我们 建议在肯尼亚生活中研究阿尔茨海默病和相关痴呆症（AD/ADRD）的风险因素 小组调查（KLPS），一个独特的，丰富的肯尼亚成年人的表型队列， 儿童，谁是随机儿童健康干预（学校为基础的驱虫）的参与者。的 现有数据集包含有关健康、认知、教育、人口统计、社会态度和劳动力的信息 1998年（8-15岁）至2021年（31-39岁）首次调查的6,500多名肯尼亚人的市场结果。 因此，KLPS提供了一个不寻常的机会来研究认知，以及AD/ADRD和相关疾病的决定因素。 风险因素，在整个生命过程中，在儿童期，青年期和中年期进行直接测量。 本项目建议在KLPS第5轮老化模块（KLPS-5A）中进行额外的现场访谈，以收集 详细的“中年基线”认知和衰老相关健康数据，以及AD/ADRD风险信息 因素，参与者中，谁将是35至43岁的调查时。一个新颖的方面是 将这些中年指标与丰富的现有童年和成年早期纵向数据联系起来， 认知评估（成就和认知测试分数），以及教育成果，健康 状态和行为，以及经济结果（例如，收入、移民、职业复杂性） 而不是在以后的生活中回忆。通过结合最先进的认知测量， 新的中年时间点与广泛的认知措施和暴露已经收集，我们希望， 将KLPS确立为非洲对生命过程痴呆症决定因素的首要研究。很少有调查 包括从童年到老年的详细数据，这些数据将打开多个 调查痴呆症与生命过程中的不利因素有关的途径。我们将公开所有数据 跨学科的研究人员。 另一个值得注意的特点是能够利用随机儿童健康的实验变异 已记录的干预措施对成人生活水平和几个风险因素有意义的影响， 痴呆症，以更好地了解生命过程中的途径和公共卫生干预措施的范围， 降低AD/ADRD风险。小学驱虫方案向下列儿童提供驱虫药物： 从1998年开始在蠕虫高流行率（>90%）地区随机选择学校：10至20年后 治疗后，干预措施对自我报告的健康状况、教育程度、成人生活质量、 标准;城市居民身份和在非农业部门的职业。这种设置提供了一种不寻常的 有机会通过实验测试有效的儿童健康干预措施对AD/ADRD的影响程度 风险和中年健康和认知，正如许多相关文献所表明的那样。

Project Summary/Abstract Alzheimer’s disease is severely under-studied in Sub-Saharan Africa: the few existing estimates suggest that prevalence is currently low but changing risk factors predict that it could double in the next 20 years. We propose to study risk factors for Alzheimer’s disease and related dementias (AD/ADRD) in the Kenya Life Panel Survey (KLPS), a unique, richly phenotyped cohort of Kenyan adults who have been followed since childhood, and who were participants in a randomized child health intervention (school-based deworming). The existing dataset contains information on health, cognition, educational, demographic, social attitudes, and labor market outcomes for over 6,500 Kenyans first surveyed in 1998 (at ages 8-15) through 2021 (ages 31-39). KLPS thus provides an unusual opportunity to study cognition, and the determinants of AD/ADRD and related risk factors, over the life course, with direct measurement during childhood, young adulthood, and midlife. This project proposes an additional field interview in the KLPS Round 5 Aging Module (KLPS-5A) to collect detailed “midlife baseline” cognition and aging-related health data, as well as information on AD/ADRD risk factors, among participants, who will be 35 to 43 years old at the time of survey. One novel aspect is the ability to link these midlife measures to rich existing longitudinal data from childhood and early adulthood, including cognitive assessments (achievement and cognitive test scores), as well as educational outcomes, health status and behaviors, and economic outcomes (e.g., earnings, migration, occupational complexity) collected contemporaneously rather than via recall in later life. By combining state-of-the-art cognitive measures at this new midlife timepoint with the extensive cognitive measures and exposures already collected, we hope to establish KLPS as the premier African study of life-course dementia determinants. There are very few surveys globally that include such detailed data from childhood to old age, and these data would open up multiple avenues for investigating dementias tied to life-course disadvantages. We will make all data publicly available to researchers across disciplines. Another notable feature is the ability to utilize experimental variation from a randomized child health intervention that has been documented to meaningfully affect adult living standards and several risk factors for dementia, to better understand pathways over the life course and the scope for public health interventions to reduce AD/ADRD risk. The Primary School Deworming Program provided deworming medication to randomly-selected schools starting in 1998 in a region with high worm prevalence (>90%): 10 to 20 years after treatment, the intervention had positive effects on self-reported health, educational attainment; adult living standards; urban residential status, and occupation in the non-agricultural sector. This setting offers an unusual opportunity to experimentally test the extent to which an effective child health intervention can affect AD/ADRD risks and midlife health and cognition, as much of the associational literature suggests.