Subjective Cognitive Decline and Objective Cognitive Trajectories in Older Hispanics/Latinos

项目摘要/摘要 该项目直接与NIA的战略目标保持一致，即1)为早期开发改进的方法 检测和诊断致残疾病和与年龄相关的衰弱状况，以及2)识别 在缺乏服务的人群中，采取适当的疾病、疾病和残疾预防以及健康老龄化战略。 随着老年人口的持续增长，预计将有越来越多的老年人生活在 患有阿尔茨海默病和相关的痴呆症。因此，确定认知障碍的早期风险标志是当务之急。 在症状出现之前下降。尽管拉美裔/拉美裔(以下简称拉美裔) 调查早期风险的研究显示，与非西班牙裔白人相比，轻度认知障碍的风险增加 在美国这一不断增长且服务不足的细分市场(美国)人口稀缺。一种潜力 阿尔茨海默病的早期危险标志是主观认知下降(SCD)，用来描述自我 与之前的状态相比，报告的认知功能的感知变化。虽然这个表达方式， SCD的报告和预测价值可能会因文化/种族背景、文化适应、 在教育水平方面，在非西班牙裔白人群体之外进行的研究很少。事实上，大多数 现有的西班牙裔SCD研究是在西班牙进行的，西班牙的人口文化差异很大 这项拟议的研究将有助于推动SCD研究，通过表征 认知和生物标记物与美国拉美裔SCD的横断面相关性，并通过建立其预测性 三年来认知变化的价值。为了实现这一点，我们将前瞻性地管理一个经过验证的SCD 问卷，对文化敏感的认知测试组合，情绪问卷(即抑郁)，以及文化- 可能影响认知正常(N=100)或轻度认知的西班牙裔老年人群SCD的相关措施 损害(N=100)。我们还将从参与者的线人那里获得SCD报告，以确定其差异 预测认知衰退的能力。参与者招募将利用两个地点的现有队列： 加州大学圣地亚哥分校Shiley-Marcos阿尔茨海默病研究中心(ADRC)和 1佛罗里达州ADRC。我们将调查自我和告密者SCD报告是否与并发的、客观的 认知功能(调整相关协变量)，并检查基线SCD报告是否预测 认知3年以上。此外，我们将使用ADRC收集的现有生物标记物以及新的 以血液为基础的生物标志物，以调查SCD是否与淀粉样蛋白β和载脂蛋白Eε4等位基因状态相关。 此外，我们还将调查文化适应、健康素养、原籍国和测试语言是否也 由于人口统计变量(年龄、性别、教育年限)影响SCD报告。调查结果将表征 美国拉美裔人SCD的认知和生物标记物概况和预测价值，有助于完善SCD测量， 并找出SCD报告中可能带来更大下降风险的个体差异。

Project Summary/Abstract This project is directly aligned with the NIA’s strategic goals of 1) developing improved approaches for the early detection and diagnosis of disabling illnesses and age-related debilitating conditions and 2) identifying appropriate strategies for disease, illness, and disability prevention and healthy aging among the underserved. As the older adult population continues to grow, it is expected that an increasing number of seniors will be living with Alzheimer’s disease and related dementias. As such, it is imperative to identify early risk markers of cognitive decline prior to symptom manifestation. Although Hispanics/Latinos (henceforth referred to as Hispanics) are at increased risk for mild cognitive impairment compared to non-Hispanic Whites, research investigating early risk markers in this growing and underserved segment of the United States (U.S.) population is lacking. One potential early risk marker of Alzheimer’s disease is subjective cognitive decline (SCD), which is used to describe self- reported perceived changes in cognitive function compared to a previous state. Although the expression, reporting, and predictive value of SCD may vary due to factors such as cultural/ethnic background, acculturation, and education level, little research has been conducted outside of non-Hispanic White cohorts. In fact, most existing SCD research with Hispanics has been conducted in Spain, whose population is very culturally different than Hispanics living in the U.S. The proposed study will help advance SCD research by characterizing the cognitive and biomarker correlates of SCD in U.S. Hispanics cross-sectionally, and by establishing its predictive value for cognitive change over three years. To achieve this, we will prospectively administer a validated SCD questionnaire, a culturally sensitive cognitive test battery, mood questionnaires (i.e., depression), and culturally- relevant measures that may influence SCD to older Hispanics with normal cognition (N=100) or mild cognitive impairment (N=100). We will also obtain SCD reports from participant’s informants to determine its differential ability to predict cognitive decline. Participant recruitment will leverage on existing cohorts at two sites: The University of California San Diego Shiley-Marcos Alzheimer’s Disease Research Center (ADRC) and the 1Florida ADRC. We will investigate if self and informant SCD reports are associated with concurrent, objective cognitive function (adjusting for relevant covariates) and examine if baseline SCD reports predict change in cognition over 3 years. Moreover, we will use existing biomarkers collected by the ADRCs, as well as novel blood-based biomarkers, to investigate if SCD is associated with amyloid-β and apolipoprotein E ε4 allelic status. Furthermore, we will investigate if acculturation, health literacy, country of origin, and language of testing, as well as demographic variables (age, sex, years of education) influence SCD reporting. Findings will characterize the cognitive and biomarker profile and predictive value of SCD in U.S. Hispanics, help refine SCD measurement, and identify individual differences in SCD reporting that may confer greater risk for decline.