Arterial stiffness, brain morphology, cognition, and dementia in U.S. Hispanics/Latinos

认知障碍和阿尔茨海默病及相关痴呆（ADRD）是紧迫的公共卫生 随着人口老龄化的担忧。在美国，西班牙裔/拉丁裔有更高的MCI和ADRD风险， 与其他人口群体一样，预计他们将对预期增长作出不成比例的贡献。 轻度认知障碍（MCI）和ADRD。解释这种差异的因素尚不清楚。更高阶中心 动脉硬化被认为改变了大脑中的微血管结构和功能， 在老年白色和黑人成人中，存在小血管疾病、认知障碍和ADRD风险。没有 迄今为止的报告已经在大量不同的西班牙裔/拉丁裔人口中研究了这些关联。同样， 性别、肥胖、代谢综合征和2型糖尿病在这些相关性中的重要作用还没有 被评估。美国西班牙裔/拉美裔人的心脏代谢风险因素负担很高， 具有更大的动脉僵硬度和ADRD风险，并可能导致MCI的健康差异， ADRD。我们建议在2019 - 2022年访视3检查的辅助研究中解决这些差距，约为9，297 西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）的参与者，这是一项正在进行的队列研究 美国西班牙裔/拉丁裔的特征。我们建议增加脉搏波速度，一个非侵入性动脉 访视3期间≥ 45岁的受试者的僵硬度测量（n~7，020）。所有其他数据都将可用 HCHS/SOL及其两项辅助研究。拉丁美洲人神经认知老化的研究 （SOL-INCA）将提供队列的认知表现和MCI和痴呆分类数据 访视3时成员年龄≥ 45岁（约6，272）。INCA-MRI将提供脑磁共振成像（MRI） 队列成员样本数据（2017 - 2019年，n~2，800）。 研究目的如下：目的1。评估中心动脉僵硬度与脑血管病的关系 小血管疾病（脑白色高信号、白色完整性和梗死） 性目标2.估计中央动脉僵硬度与特定领域整体认知功能的相关性 在≥ 45岁的受试者中按性别分类。目标3.评估中心动脉僵硬度与MCI的相关性 以及≥ 45岁受试者中总体和性别的ADRD。为了所有的目的，我们将评估肥胖，代谢， 综合征和2型糖尿病作为潜在的调节剂。 这项具有成本效益的辅助研究将首次提供关于中央神经元与神经元之间关系的新信息。 在西班牙裔/拉丁美洲人的大样本中， 患有严重的代谢障碍此外，纳入中年人将提供 深入了解显性疾病发作前的早期干预机会。了解动脉如何 僵硬影响认知障碍，ADRD将为识别潜在的 干预目标，减少健康差距，促进认知弹性。

Cognitive impairment and Alzheimer's disease and related dementias (ADRD) are pressing public health concerns as the population ages. In the U.S., Hispanics/Latinos have a higher MCI and ADRD risk compared with other population groups, and they are expected to contribute disproportionately to the expected increase in mild cognitive impairment (MCI) and ADRD. Factors explaining this disparity are unknown. Higher central arterial stiffness is posited to alter microvasculature structure and function in the brain contributing to cerebral small vessel disease and with cognitive impairment and risk of ADRD in older white and black adults. No reports to date have examined these associations in a large, diverse Hispanic/Latino population. Similarly, the important roles of sex, obesity, the metabolic syndrome, and type 2 diabetes in these associations have not been assessed. U.S. Hispanics/Latinos have a high burden of cardiometabolic risk factors that are associated with both greater arterial stiffness and risk of ADRD and could contribute to the health disparity in MCI and ADRD. We propose to address these gaps in an ancillary study to the 2019-2022 Visit 3 examination of ~9,297 participants in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), an ongoing cohort study of well-characterized U.S. Hispanic/Latinos. We propose to add pulse wave velocity, a non-invasive arterial stiffness measurement, to participants ≥45 years old during Visit 3 (n ~7,020). All other data will be available from HCHS/SOL and its two ancillary studies. The Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) will provide data on cognitive performance and MCI and dementia classification for cohort members ≥45 years old at Visit 3 (~6,272). INCA-MRI will provide brain magnetic resonance imaging (MRI) data on a sample of cohort members (2017-2019, n ~2,800). The study aims are the following: Aim 1. Estimate the association of central arterial stiffness and cerebral small vessel disease (cerebral white matter hyperintensities, white matter integrity, and infarcts) overall and by sex. Aim 2. Estimate the association of central arterial stiffness and domain-specific cognitive function overall and by sex in participants ≥45 years old. Aim 3. Estimate the association of central arterial stiffness and MCI and ADRD overall and by sex in participants ≥45 years old. For all aims, we will evaluate obesity, the metabolic syndrome, and type 2 diabetes as potential modifiers. This cost-efficient ancillary study will, for the first time, contribute novel information on the association of central arterial stiffness and brain structure and function in a large sample of Hispanic/Latinos, a population burdened with a high levels of metabolic impairments. Additionally, the inclusion of middle-aged adults will provide insights into opportunities for early intervention prior to onset of overt disease. Understanding how arterial stiffness influences cognitive impairment and ADRD will contribute novel information on identifying potential targets for intervention, reducing health disparities, and the promoting cognitive resilience.