RISK FACTORS IN VERY LATE ONSET ALZHEIMERS DISEASE

这项研究的目的是确定心血管危险因素， 尤其是可修改的，在很晚的时候风险会增加 首发认知功能减退、痴呆和阿尔茨海默病(AD)。不像 最近在阿尔茨海默病遗传学方面的快速进展，几乎没有 明确确定了年龄以外的非遗传因素为AD的危险因素。 然而，最近的证据表明，心血管风险因素可能是 与痴呆症和阿尔茨海默病的关联非常耐人寻味，不仅是因为 这种因素的广泛流行，特别是在非常年长的人中， 可能合理地占了很大一部分案件的比例，但也 因为它们中的许多都是可以修改的。因此，如果心血管风险 确定这些因素确实会增加患痴呆症和阿尔茨海默病的风险 在这一领域提供了真正的公共卫生收益的前景。搜索 因为这样的风险因素在年龄最大的老年人中可能是有价值的，因为 阿尔茨海默病和其他痴呆的发病率在这一组中处于高峰， 遗传因素似乎起到的作用很小，这表明这一群体 可能最有可能暴露出其他潜在的更容易处理的风险 各种因素。这项为期五年的研究将集中在520多名高龄老人的队列中 (平均年龄85岁)公寓楼里的非痴呆症居民 独立老人之家(Kitay House)和附属疗养院(犹太人 安老院及安老院)。在Kitay House，在1-4岁， 临床支持核心将识别和评估非痴呆患者 每年将由核心连续跟踪的居民 评估以确定认知功能下降的发生率，AD， 血管性和其他痴呆症。同样，一小部分非痴呆症患者 JHHA的居民也将被确定并进行连续评估。一个 该项目的目的将是收集心血管危险因素 这些居民通过医生体检获得的信息 和病史，生物分析，图表审查，和直接 采访。这些数据将有助于测试我们的 假设这些因素会增加认知能力下降的风险， 一般的痴呆症和阿尔茨海默病。对这些风险因素的评估 混合性痴呆症和血管性痴呆症也很有趣，但这些目的 是附属的，因为这类案件的数量可能 规模要小，提供的统计力量有限。

The purpose of the study is to identify cardiovascular risk factors, especially modifiable ones, associated with increased risk in very late onset cognitive decline, dementia, and Alzheimer's disease (AD). Unlike the recent rapid progress in the genetics of AD, there is virtually no definitively identified non-genetic risk factor for AD other than age. However, recent evidence suggesting cardiovascular risk factors may be associated with dementia and AD is highly intriguing not only because the widespread prevalence of such factors, especially in the very old, might plausibly account for a large proportion of cases, but also because many of them are modifiable. Hence if cardiovascular risk factors do indeed increase risk for dementia and AD, identifying them offers the prospect of real public health gains in this area. The search for such risk factors among the oldest old may be valuable because the incidence of AD and other dementias is at its peak in this group and genetic factors appear to play a minimal role suggesting that this group may be most likely to reveal other, potentially more tractable risk factors. The five year study will focus on a cohort of 520+ very elderly (mean age >85) non-demented residents of an apartment complex for the independent elderly (Kitay House) and an affiliated nursing home (Jewish Home and Hospital for the Aged [JHHA]). At Kitay House, in years 1-4, the Clinical Support Core will identify and assess non-demented residents who will be followed annually by the Core in serial assessments to determine the incidence of cognitive decline, AD, vascular and other dementias. Similarly, a smaller group of non-demented residents of the JHHA will also be ascertained and serially assessed. An aim of the project will be to collect cardiovascular risk factor information from these residents through a physician's physical examine and medical history, biological assays, chart review, and direct interviews. These data will then facilitate the testing of our hypothesis that these factors increase the risk of cognitive decline, dementia in general, and AD. An evaluation of these risk factors for mixed dementia and vascular dementia is also of interest, but these aims are subsidiary, because it is possible that the number of such cases may be small, providing limited statistical power.