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， 特别是可改变的，与非常晚的风险增加有关。 发病认知下降、痴呆和阿尔茨海默病（AD）。不像 近年来AD遗传学的快速进展，几乎没有 明确确定的AD非遗传风险因素，而不是年龄。 然而，最近的证据表明，心血管危险因素可能是 与痴呆症和AD相关的研究非常有趣，不仅因为 这些因素的普遍存在，特别是在老年人中， 可能占案件的很大比例，但也 因为它们中的许多是可以修改的。因此，如果心血管风险 这些因素确实会增加痴呆症和AD的风险， 提供了这一领域真实的公共卫生收益的前景。搜索 对于这些风险因素中最古老的老年人可能是有价值的，因为 AD和其他痴呆症的发病率在这一群体中处于高峰， 遗传因素似乎起着最小的作用，这表明， 可能最有可能揭示其他潜在的更易处理的风险 因素这项为期五年的研究将重点关注520多名高龄老人 (mean年龄>85岁）的非痴呆居民的公寓楼， 独立老人（Kitay House）和附属养老院（犹太人） 老人院及医院（JHHA）。在Kitay House，在1-4年级， 临床支持核心将识别和评估非痴呆 这些居民将每年接受核心调查， 评估以确定认知下降、AD、 血管性痴呆和其他痴呆。同样，一小群非痴呆的 JHHA的居民也将被确定和连续评估。一个 该项目的目的是收集心血管危险因素， 通过医生的身体检查， 和病史，生物测定，图表审查，并直接 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， 痴呆症和AD。对这些风险因素的评估 混合型痴呆和血管性痴呆也是令人感兴趣的，但这些目标 是次要的，因为这类案件的数量可能 要小，提供有限的统计能力。

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.