National Trends in Brain Health: a Follow-Up Study of CIND and Dementia in the US

描述（由申请人提供）：我们建议通过进行一项新的衰老、人口统计学和记忆研究（亚当斯2010）来研究美国认知障碍和痴呆的患病率趋势，该研究使用与2001-2003年进行的原始NIA资助研究相似的方法。这项新研究将利用原始的亚当斯研究团队，亚当斯及其母公司健康与退休研究（HRS）的国家实地调查基础设施，以及从过去8年的亚当斯工作中吸取的经验教训，创建一个独特的公开数据资源，可供多学科研究团队使用，以研究认知障碍和痴呆症的患病率，原因和后果，以及它们在21世纪世纪头十年的变化。该项目的具体目标是：1）在1000名年龄> 70岁的HRS受访者的子样本中进行认知的家庭临床评估，并建立正常、无痴呆的认知障碍（CIND）或痴呆的共识诊断; 2）向研究界提供亚当斯2010子样本的数据集，其中包含来自内部的信息。家庭评估，可与HRS的所有先前和未来波相关联，包括HRS生物标志物数据、HRS物理测量、医疗保险管理数据、HRS死者访谈和国家死亡指数;以及3）使用亚当斯2010数据导出用于评估所有HRS受访者年龄> 70岁的CIND和痴呆的统计模型，利用亚当斯中CIND和痴呆症的“金标准”临床诊断与认知和身体功能的核心HRS调查指标之间的交叉行走。然后，该模型可以与未来的HRS波一起使用，以具有成本效益的方式跟踪美国人口的认知健康。拟议的亚当斯2010与原始亚当斯和正在进行的HRS一起，将提供第一个全国代表性数据，以评估美国CIND和痴呆症的患病率和趋势。考虑到CIND和痴呆症对个人、家庭和社会的广泛影响，以及未来几十年老年痴呆症患者数量的预计大幅增长，拟议的项目旨在创建一套前所未有的全国代表性数据，以支持对痴呆症患病率、风险因素和结果等关键问题的多学科研究，这确实是一个“重大机遇”。" 公共卫生相关性：认知障碍和痴呆症在老年人中极其常见，并导致残疾，给家庭、医疗保健系统以及医疗保险、医疗补助和社会保障等公共项目带来巨大的成本和负担。拟议的研究将收集数据，从而更好地了解美国痴呆症的患病率，原因和结果的趋势，因此，随着我们现在进入老年人口增长最快的时期，将对公共卫生和公共政策产生重大影响。

DESCRIPTION (provided by applicant): We propose to study US trends in the prevalence of cognitive impairment and dementia by performing a new Aging, Demographics, and Memory Study (ADAMS 2010) that uses a similar methodology to that employed for the original NIA-funded study performed in 2001-2003. This new study will leverage the original ADAMS research team, the established national fieldwork infrastructure of the ADAMS and its parent Health and Retirement Study (HRS), and the lessons learned from the past 8 years of ADAMS work to create a unique publicly-available data resource that can be used by multi-disciplinary research teams to study the prevalence, causes, and consequences of cognitive impairment and dementia, and changes in them over the first decade of the 21st century. The specific aims of the project are to: 1) Conduct in-home clinical assessments of cognition in a sub-sample of 1000 HRS respondents age > 70, and establish a consensus diagnosis of normal, cognitive impairment without dementia (CIND), or dementia; 2) Provide to the research community a data set on the ADAMS 2010 sub-sample that contains information from the in- home assessments which can be linked to all prior and future waves of the HRS, including HRS biomarker data, HRS physical measures, Medicare administrative data, the HRS decedent interview, and the National Death Index; and 3) Use ADAMS 2010 data to derive a statistical model for assessing CIND and dementia for all HRS respondents age > 70, utilizing the cross- walk between the "gold-standard" clinical diagnoses of CIND and dementia in the ADAMS and the core HRS survey measures of cognition and physical function. This model can then be used with future HRS waves to cost-effectively track population cognitive health in the US. The proposed ADAMS 2010, in conjunction with the original ADAMS and the on-going HRS, will provide the first nationally representative data to assess the prevalence and trends of CIND and dementia in the US. Given the wide-ranging impact of CIND and dementia on individuals, families, and society, and the projected large growth in the number of older adults with dementia in the coming decades, the proposed project to create an unprecedented set of nationally-representative data that can support multi-disciplinary research on key questions regarding dementia prevalence, risk factors and outcomes is truly a "Grand Opportunity." PUBLIC HEALTH RELEVANCE: Cognitive impairment and dementia are extremely common among older adults and result in disability that generates significant costs and burdens for families, the health care system, and public programs such as Medicare, Medicaid, and Social Security. The proposed research will collect data that will lead to a better understanding of trends in the prevalence, causes, and outcomes of dementia in the US and will, therefore, have major public health and public policy implications as we now enter the period of the most rapid growth of the elderly population in our history.