EPIDEMIOLOGY OF DEMENTIA IN THE FRAMINGHAM STUDY

描述（改编自申请人的摘要）：我们计划确定 第9至11个十年中痴呆症的发病率和类型 人生，最老的。在这个增长最快的地区， 人群，对流行病学和临床表现知之甚少 老年痴呆症Fractionary研究队列，现在包括667名男性和女性，年龄 78至104岁（平均年龄85.1岁），记录为无痴呆症。研究 自1976年以来，痴呆症一直在进行中，当时一项全面的 神经心理电池管理和无痴呆症队列， 鉴定从那以后，我们通过以下方式发现了新的痴呆症病例： 简易精神状态检查（MMSE）筛查，每两年进行一次，随后进行 全面的神经学和神经心理学评估 我们将对667名病人中的大部分人重新进行神经心理学测试 无痴呆幸存者，估计约182例受试者将同意 脑部核磁共振扫描认知表现和下降的措施，因为 1976年至1978年的神经心理学电池，将涉及：半定量 测量总脑容量和局部脑容量，白色高信号 （WMHI）体积、无症状性脑梗死（SCI）和MR扫描上的每搏输出量。 利用现有的大脑捐赠计划，系统的半定量 这些受试者的脑的神经病理学研究将与MRI相关， 认知表现和下降，以及先前测量的风险因素。 使用在本报告所述期间前瞻性和系统性收集的数据， 最近的研究是2年前，最远的是50年前 之前，我们计划将生活方式变量、医疗信息、实验室检查 措施，记录的医疗疾病和认知功能的发病率 可能患有AD和血管性痴呆我们将确定所有新的病例 老年痴呆症的这些老年幸存者的这一一般人口样本， 未来五年痴呆症可能更经常地由血管疾病引起， 老年人的AD。根据核磁共振，神经和 神经心理学评估（以及少数基于神经病理学评估） 研究），我们将能够确认诊断和确定机制 这些受试者的痴呆症。我们也将处于一个独特的位置 将痴呆症的先兆和先前的心血管疾病与痴呆症联系起来， 血管性痴呆，并确定血管因素的贡献， AD痴呆

DESCRIPTION (Adapted from the Applicant's Abstract): We plan to determine the incidence and type of dementia in persons in the 9th through the 11th decades of life, the oldest-old. In this most rapidly growing portion of the population, little is known about the epidemiology and clinical manifestations of dementia. The Framingham Study cohort, now includes 667 men and women, ages 78 to 104 years (mean age 85.1) documented to be free of dementia. The study of dementia in Framingham has been underway since 1976 when a comprehensive neuropsychological battery was administered and a dementia-free cohort was identified. We have since identified new cases of dementia by means of Mini-Mental State Exam (MMSE) screening, administered biennially, followed by a comprehensive neurological and neuropsychological evaluation. We will re-administer the neuropsychology battery to most of the 667 dementia-free survivors and estimate approximately 182 subjects will consent to an MRI scan of the brain. Measures of cognitive performance and decline, since the neuropsychology battery in 1976-78, will be related to: semiquantitative measures of total and regional brain volumes, white matter hyperintensity (WMHI) volume, silent cerebral infarcts (SCI) and stroke volume on MR scans. Utilizing the existing brain donation program, systematic semiquantitative neuropathological study of the brains of these subjects will be related to MRI, cognitive performance and decline, and, previously measured risk factors. Using data collected prospectively and systematically over the course of the Framingham Study, as recently as 2 years before and as remotely as 50 years ago, we plan to relate lifestyle variables, medical information, laboratory measures, documented medical illness and cognitive functioning to the incidence of probable AD and vascular dementia. We will identify all new cases of dementia in these elderly survivors of this general population sample during the next five years. Dementia may result more often from vascular disease than from AD in persons of advanced age. Based on MRI, neurological and neuropsychological evaluations, (and in a small number based on neuropathologic study) we will be able to confirm the diagnosis and determine the mechanism underlying the dementia in these subjects. We will also be in a unique position to relate precursors of, and prior cardiovascular disease to dementia including vascular dementia and to determine the contribution of vascular factors to the dementia of AD.