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)

项目摘要/摘要 在撒哈拉以南非洲，阿尔茨海默氏症的研究严重不足：现有的少数估计表明 目前患病率较低，但不断变化的风险因素预测，在未来20年内，患病率可能翻一番。我们 建议研究肯尼亚生活中阿尔茨海默病和相关痴呆(AD/ADRD)的危险因素 小组调查(KLPS)，这是一个独特的、表型丰富的肯尼亚成年人队列，自那以来一直受到关注 他们是儿童健康干预(学校驱虫)的参与者。这个 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)首次接受调查的6500多名肯尼亚人的市场结果。 因此，KLPS提供了一个研究认知和AD/ADRD及其相关决定因素的不同寻常的机会 风险因素，在整个生命过程中，通过在童年、青壮年和中年期间的直接测量来衡量。 该项目建议在KLPS第五轮老龄化模块(KLPS-5A)中增加一次实地访谈，以收集 详细的“中年基线”认知和老龄化相关健康数据，以及有关AD/ADRD风险的信息 调查时年龄在35岁至43岁之间的参与者中的因素。一个新的方面是能力 为了将这些中年衡量标准与丰富的儿童和成年早期纵向数据联系起来，包括 认知评估(成绩和认知测试分数)，以及教育成果、健康 收集的地位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通过回忆。通过将最先进的认知手段结合在一起 随着广泛的认知测量和暴露已经收集的新的中年时间点，我们希望 将KLPS确立为非洲对终生痴呆症决定因素的首要研究。很少有调查 在全球范围内，包括从童年到老年的如此详细的数据，这些数据将打开多个 调查痴呆症的途径与生命进程的不利之处有关。我们将公开所有数据 给跨学科的研究人员。 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量 已有记录的干预措施有意义地影响成年人的生活水平和几个危险因素 痴呆症，以更好地了解生命过程中的途径和公共卫生干预的范围 降低AD/ADRD风险。小学驱虫计划为以下人员提供驱虫药物 从1998年开始在蠕虫高流行地区(90%)随机选择的学校：10到20年后 治疗后，干预对健康自评量表、教育程度、成人生活有积极影响 标准；城市居住状况，以及非农业部门的职业。这种设置提供了一种不同寻常的 有机会通过实验测试有效的儿童健康干预对AD/ADRD的影响程度 风险、中年健康和认知，正如许多协会文献所暗示的那样。

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.