The ARIC-PET Amyloid Imaging Study

描述（由申请人提供）：随着美国人口老龄化，发展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，尤其是发生在中年时，可能会增加晚年患痴呆症的风险，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导致了大脑中导致阿尔茨海默病的变化（特别是β-淀粉样斑块），还是大脑中同时存在阿尔茨海默病和血管变化会使痴呆症恶化。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，这是一项大型研究，在25年前开始，涉及美国4个不同社区的16,000名代表。2011-2013年，作为目前资助的ARIC神经认知研究（ARIC- ncs）的一部分，幸存者将接受神经学评估、认知评估，并在一个子集中进行脑MRI。我们将进一步招募210名年龄在70-90岁、认知正常或轻度认知障碍（MCI）的Jackson， MS或Hagerstown， MD患者，接受18F-AV-45 PET扫描，这是一种用于识别大脑中β-淀粉样蛋白的标志物。在研究的最后两年，参与者将接受后续认知评估。该研究将确定：1)血管危险因素和标志物，特别是中年人，是否与β-淀粉样蛋白结合增加有关，这将表明血管疾病直接导致大脑AD的变化，或者2)大脑中β-淀粉样蛋白沉积与血管危险因素和标志物是否共同导致认知障碍和痴呆的发展。研究结果可能有助于优化未来对轻度认知障碍患者的治疗和预防试验，这些患者有患痴呆症的风险。如果发现血管疾病与β-淀粉样斑块沉积之间存在强烈关联，这将为积极的危险因素治疗提供支持，作为减少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.