The ARIC-PET Amyloid Imaging Study

描述（由申请人提供）：随着美国人口的老龄化，开发痴呆症预防和治疗的重要性日益明显。有证据表明，某些血管风险因素，如高血压，吸烟和糖尿病，特别是当它们发生在中年时，可能会导致老年痴呆症的风险，甚至可能导致阿尔茨海默氏痴呆症（AD），这是痴呆症最常见的原因。因此，解决与血管疾病相关的影响因素可能是预防痴呆症的重要因素。目前尚不清楚的是，血管风险因素是否真的会导致导致AD的大脑变化（特别是β-淀粉样蛋白斑块），或者阿尔茨海默病和大脑血管变化是否会使痴呆症恶化。本研究将探讨这两个假设。ARIC-PET淀粉样蛋白成像研究是社区动脉粥样硬化风险（ARIC）研究的辅助研究，ARIC研究是一项大型研究，25年前开始，涉及代表4个不同美国社区的16，000名个体。在2011-2013年，作为目前资助的ARIC神经认知（ARIC-NCS）研究的一部分，幸存者将接受神经学评估，认知评估，并在一个子集，脑MRI。我们将招募另一个子集，210名来自杰克逊，MS或哈格斯敦，MD的70-90岁认知正常或轻度认知障碍（MCI）的个体，接受18 F-AV-45 PET扫描，18 F-AV-45是一种用于识别大脑中β-淀粉样蛋白的标记物。在研究的最后2年，参与者将接受随访认知评估。该研究将确定：1）血管风险因素和标志物，尤其是中年人的血管风险因素和标志物是否与β-淀粉样蛋白结合增加相关，这表明血管疾病直接导致大脑中的AD变化，或2）大脑中的β-淀粉样蛋白沉积与血管风险因素和标志物结合是否有助于认知障碍和痴呆的发展。研究结果可能有助于优化未来对有痴呆症风险的轻度认知障碍患者的治疗和预防试验。如果在血管疾病和β-淀粉样蛋白斑块沉积之间发现强相关性，这将为积极的风险因素治疗提供支持，作为降低认知能力下降和痴呆发病率的手段。

DESCRIPTION (provided by applicant): With the aging of the U.S. population, the importance of developing preventions and treatments for dementia is increasingly apparent. Evidence suggests that certain vascular risk factors like hypertension, smoking and diabetes, especially when they occur in midlife, may contribute to risk for dementia in late life, and possibly even to Alzheimer's dementia (AD), the most common cause of dementia. Thus, addressing the contributing factors related to vascular disease may be an important element in dementia prevention. What is not well understood is whether vascular risk factors actually cause the changes in the brain that cause AD (specifically, β-amyloid plaques) or if having both Alzheimer's and vascular changes in the brain together makes the dementia worse. This study will explore these two hypotheses. The ARIC-PET Amyloid Imaging Study is an ancillary study of the Atherosclerosis Risk in Communities (ARIC) study, a large study involving, at its start 25 years ago, 16,000 individuals representative of 4 diverse U.S. communities. In 2011-2013, as part of the currently funded ARIC Neurocognitive (ARIC-NCS) study, the survivors will undergo neurologic evaluation, cognitive assessment, and, in a subset, brain MRI. We will recruit a further subset, 210 individuals aged 70-90 years from Jackson, MS or Hagerstown, MD with either normal cognition or mild cognitive impairment (MCI), to undergo a PET scan with 18F-AV-45, which is a marker used to identify β-amyloid in the brain. In the last 2 years of the study, participants will undergo follow-up cognitive evaluation. The study will determine: 1) whether vascular risk factors and markers, especially from midlife, are associated with increased β-amyloid binding, which would indicate that vascular disease directly contributes to AD changes in the brain, or 2) whether β-amyloid deposits in the brain in combination with vascular risk factors and markers contribute to cognitive impairments and development of dementia. Study results may help optimize future treatment and prevention trials in individuals with mild cognitive impairment who are at risk for dementia. If strong associations are found between vascular disease and β-amyloid plaque deposition, this will provide support for aggressive risk factor treatment as a means to decrease cognitive decline and incidence of dementia.