Clinical, Imaging, and Pathological Studies in the Oldest Old: The 90+ Study

项目摘要 这项90岁以上的研究是2003年1月1日开始的，作为以人群为基础的样本，最年长的休闲幸存者 世界队列研究(路易斯安那州立大学，1981年至1984年入学)。这项90多人的研究有1800多名参与者，是 世界上规模最大、时间最长的老年痴呆症、认知功能减退、残疾和虚弱的研究。大家都过来了 90岁是人口中速度最快的部分，对公共健康的影响最大，因为患痴呆症的风险 这些人的比例非常高，百岁老人的比例达到了惊人的40%。然而，许多年纪最大的老人 在他们的第十个十年或更长时间内保持卓越的认知表现(认知韧性)，通常是在 存在神经病变(存在病理情况下的认知弹性)。生活方式，共病 条件、遗传和其他因素都与这种认知韧性有关，但还没有得到很好的研究。在……里面 在这一应用中，我们扩展了我们的研究，以调查这些非凡个体的认知韧性。在目标1中，我们 考虑早期(LWCS早期30年)和晚期(90岁以上)的生活方式和其他与认知有关的因素 恢复力。研究了在病理存在的情况下维持优越认知能力的相关因素。 在目标2中。在我们的成像研究中，利用我们的大量90岁以上的老年人，我们前瞻性地遵循 与MRI和PET相关的非痴呆者评估痴呆症发病率和认知减退率 生物标记物在目的3。我们分析了低水平的多种神经病理变化在表达 最后，通过这项申请，我们将招募最后一批符合我们研究条件的LWCS参与者， 并完全确定90+研究中以前确定的所有结果(痴呆症、CIND、MCI、虚弱、 残疾和死亡率)。我们将向公众提供这个跨越近40年的数据集供研究使用 社区(Aim5)。 凭借我们广泛的数据库，独一无二的大量具有良好特征的个人，广泛和 多学科纵向跟踪，以及创新的神经病理和神经成像研究，我们是 非常适合研究老年人的痴呆症和恢复力。确定与认知相关的因素 韧性和痴呆症，包括可改变的生活方式因素和成像生物标记物，将有助于我们的 了解老龄化在健康和疾病中的作用，并为促进成功老龄化的干预提供潜在的目标。

Project Summary The 90+ Study was initiated January 1, 2003 as a population-based sample of oldest-old survivors of the Leisure World Cohort Study (LWCS, enrollment 1981-1984). With more than 1,800 participants, The 90+ Study is one of the largest and longest studies in the world of dementia, cognitive decline, disability, and frailty in the oldest-old. People over 90 are the fastest segment of the population and have the greatest public health impact as the risk of dementia is extraordinarily high in these individuals, reaching a staggering 40% per year in centenarians. However, many oldest old maintain superior cognitive performance well into their tenth decade and beyond (cognitive resilience), often in the presence of neuropathological changes (cognitive resilience in the presence of pathology). Lifestyle, co-morbid conditions, genetics, and other factors have been implicated in this cognitive resilience, but have not been well studied. In this application, we extend our studies to investigate cognitive resilience in these remarkable individuals. In Aim 1, we consider early (30 years earlier in the LWCS) and late (at age 90+) lifestyle and other factors in relation to cognitive resilience. Factors related to the maintenance of superior cognitive abilities in the presence of pathology are investigated in Aim 2. Taking advantage of our large cohort of 90+ year-olds in our imaging studies, we prospectively follow individuals without dementia to estimate incidence of dementia and rates of cognitive decline in relation to MRI and PET biomarkers in Aim 3. We analyze the role of low levels of multiple neuropathologic changes in the expression of dementia in Aim 4. Finally, with this application, we will recruit the last living LWCS participants eligible for our study, and complete ascertainment of all previously established outcomes in The 90+ Study (dementia, CIND, MCI, frailty, disability, and mortality). We will make this dataset spanning almost four decades publically available to the research community (Aim5). With our extensive database, unique large cohort of well-characterized individuals, extensive and multidisciplinary longitudinal follow-up, and innovative neuropathological and neuroimaging investigations, we are ideally positioned to do studies of dementia and resilience in the oldest-old. Identifying factors related to cognitive resilience and dementia, including modifiable lifestyle factors and imaging biomarkers, would contribute to our understanding of aging in health and disease and provide potential targets for interventions to promote successful aging.