ARIC Neurocognitive Study (ARIC-NCS) Renewal UNC 4 of 5

 描述(由申请人提供)：ARIC神经认知研究(ARIC-NCS)更新1/5约翰霍普金斯华盛顿县野战中心首席研究员(约瑟夫·科雷什，医学博士)。理论基础：痴呆症和轻度认知障碍(MCI)给美国老龄化人口带来了巨大且日益严重的健康和社会负担，ARIC特别适合提供有关血管方面的关键信息，而且可能是可以预防的，对痴呆症和MCI发病率的贡献。进展：ARIC NCS(访问5：2011-13)对70岁的ARIC参与者进行了一系列认知测试-，所有研究目标都达到或超过了，完成了6,538次考试，2009年磁共振成像(非裔美国人为520人)，大量痴呆症和轻度认知障碍病例目前正在审理中。早期论文在数据收集完成后一个月内提交，有希望的工作正在进行中(约50份手稿提案)。收集晚年认知功能衰退的数据是必要的，而且时间敏感，因为该队列的年死亡率约为5%(平均年龄78岁)。设计：随访认知测试(约30年f/u，2015-2018年)，在认知能力下降开始在几个领域出现或加速的年龄段，从而在ARIC队列中提供许多额外的、不同的结果(1986-1989年招募的15,792名年龄在45-65岁之间的男性和女性，随后进行详细检查)。结果：更新中针对的晚年认知结果不同于现在ARIC NCS基线测试中提供的一次性静态认知表现测量。A.整体认知能力、执行功能/处理速度、记忆力和语言的下降--在~4214，即V5后~4年期间进行评估(比以前的访问更全面，与旧的心血管研究类似，以前的访问具有更有限的3个测试组；在最老的子集中进行第二次访问)。B.MCI和痴呆症的发病率-使用NCS V5之后建立的程序检测约1,521例痴呆症1,134例MCI事件(2011-2013年；扩大ARIC的半年通话；应答率~90%)。C.从MCI到痴呆症的进展--跟踪V5中发现的1,402例MCI病例。目的：我们将研究大量可改变的中年微血管疾病和动脉粥样硬化的血管危险因素和措施，这些都是其他认知研究中没有的，因为它们对晚年认知能力下降和身体功能的影响做出了贡献。我们将在访问5中研究详细的3T脑MRI成像作为风险 老年人认知能力下降的因素。我们将确定这些关联在非洲裔美国人中是否与白人ARIC参与者不同，在非洲裔美国人中，纵向认知数据几乎不存在，血管负担较高。我们将分享所有ARIC附件(附录4)的这些数据，包括在整个生命周期内的详细遗传和生化研究。摘要：这次NCS访问(V6：2015-2018；V7：2017-2018在最老的子集中)将促进对晚年认知下降的潜在可改变的血管贡献的了解，并为大型研究人员社区的其他协同辅助研究提供基石，否则这些研究是不可能的。

 DESCRIPTION (provided by applicant): ARIC Neurocognitive Study (ARIC-NCS) Renewal 1 of 5 Johns Hopkins Washington County Field Center Principal Investigator (Josef Coresh, MD, PhD). Rationale: Dementia and mild cognitive impairment (MCI) pose a large and increasing health and societal burden on the aging US population and ARIC is uniquely suited to contribute critical information on the vascular, and potentially preventable, contributions to dementia and MCI incidence. Progress: ARIC NCS (Visit 5: 2011-13) measured a battery of cognitive tests on ARIC participants aged 70- 89 and all study goals were met or exceeded, completing 6,538 exams, 2009 MRIs (520 in African-Americans) with a large number of dementia and Mild Cognitive Impairment (MCI) cases currently being adjudicated. Early papers were submitted within a month of completion of data collection and promising work is ongoing (~50 manuscript proposals). Collection of cognitive decline in late-life is needed and time sensitive since the cohort is experiencing ~5% annual mortality (mean age 78 years). Design: Follow-up cognitive testing (~30-year f/u, 2015-2018), at ages where cognitive decline begins to manifest across several domains or accelerates, thus providing many additional, diverse outcomes in the ARIC cohort (15,792 men and women ages 45-65 recruited in 1986-1989 and followed with detailed examinations). Outcomes: The late life cognitive outcomes targeted in the renewal differ from the one-time static measures of cognitive performance now available from the ARIC NCS baseline exam. A. Decline in global cognitive ability, executive function/processing speed, memory, and language - assessed during in ~4214, ~4 years after V5 (more comprehensive than possible in previous visits which had a more limited 3 test battery similar to older cardiovascular studies; 2nd visit in oldest subset). B. Incidence of MCI and dementia - detect ~1,521 dementia 1,134 MCI incident cases using procedures established after NCS V5 (2011-2013; expanded ARIC's semi-annual calls; response rate ~90%). C. Progression from MCI to dementia - following the 1,402 MCI cases identified at V5. Aims: We will study a wealth of modifiable vascular risk factors and measures of microvascular disease and atherosclerosis in midlife, many not available in other studies of cognition, for their contribution to late life cogntive decline and physical function. We will study the detailed 3T brain MRI imaging at visit 5 as a risk factor for cognitive decline at older age. We will determine if any of these associations are different in African- Americans, where longitudinal cognitive data are nearly non-existent and vascular burden is high, than in white ARIC participants. We will share these data all ARIC ancillaries (Appendix 4), including detailed genetic and biochemical studies across the lifespan. Summary: This NCS visit (V6: 2015-2018; V7: 2017-2018 in oldest subset) will advance knowledge about the potentially modifiable vascular contribution to cognitive decline in late life and provide the cornerstone for other synergistic ancillary studies by a large community of investigators which would not otherwise be possible.