SOCIAL FACTORS AND EPIDEMIOLOGY OF COGNITIVE DECLINE

描述(由申请人提供)：Shadlen博士的目标是成为痴呆症流行病学文献的主要贡献者。她的研究兴趣包括研究种族和社会参与度对认知能力下降和痴呆症的影响。在此K08奖项期间，她将在华盛顿大学提高她的研究和培训技能。建议的课程包括：1)线性建模和生存分析课程，2)纵向研究设计经验，3)拨款管理经验。埃里克·B·拉森博士将监督她的研究和培训。伊塔马尔·B·阿布拉斯博士将提供老年专业知识和学术职业指导。顾问包括Annette Fitzpatrick博士和David Siscovick博士。与白人相比，黑人阿尔茨海默病的发病率可能高出两倍。这种差异的原因没有得到很好的解释。最近的研究表明，生活方式与痴呆症的临床表现之间存在关联。生活方式投入是维持当前幸福状态或促进理想未来的有目的活动的表现。如果低生活方式参与度在黑人中更普遍，那么这可能会增加患痴呆症的风险。这项拟议的工作将利用在3602名心血管健康研究(CHS)记忆项目参与者的流行病学队列中进行的六年前瞻性观察。这项研究中提出的问题可能会建议采取干预措施，以减少认知能力下降，从而延缓痴呆症的进展。其具体目的是：1)检验生活方式投入在预测认知衰退轨迹中的相关性并确定其效用；2)检验生活方式投入的各种可操作定义的领域，并比较它们预测随后发生痴呆症的能力；3)确定生活方式投入的分布模式是否存在种族差异，以及它们与认知衰退和偶发痴呆的关联；以及4)评估生活方式投入与生存的关联。导师临床科学家发展奖将使Shadlen博士能够1)获得高级流行病学技术方面的正式培训，2)分析国家、多中心、多种族数据库，3)测试社会因素对神经退行性疾病流行病学有直接影响的模型。因此，这些项目将使Shadlen博士能够实现她的5年目标，即将她在种族差异、痴呆症和流行病学方面的兴趣综合成一个独立的、发人深省的研究计划。

DESCRIPTION (provided by applicant): Dr Shadlen aims to become a leading contributor to the body of literature on dementia epidemiology. Her research interests include examining the influence of ethnicity and social engagement on cognitive decline and dementia. During the period of this K08 award, she will enhance her research and training skills at the University of Washington. The proposed program includes: 1) coursework in linear modeling and survival analysis, 2) experience in design of longitudinal studies, 3) experience in grant management. Dr. Eric B. Larson will oversee her research and training. Dr. Itamar B. Abrass will provide geriatric expertise and academic career guidance. Consultants include Drs. Annette Fitzpatrick, and David Siscovick. The incidence of AD may be two-fold higher among Blacks compared to Whites. Reasons for this discrepancy are not well explained. Recent studies suggest that there is an association between lifestyle engagement and clinical expression of dementia. Lifestyle engagement is the manifestation of purposeful activities that maintains a current state of well being or promotes a desirable future. If low lifestyle engagement is more common among Blacks, then, this may contribute to increased risk of developing dementia. The proposed work will capitalize on six years of prospective observation in an epidemiological cohort of 3602 Cardiovascular Health Study (CHS) Memory Project participants. Questions addressed in this study may suggest interventions to reduce cognitive decline, hence delaying the progression to dementia. The specific aims are: 1) To examine the associations and determine the utility of measures of Lifestyle Engagement in predicting the trajectory of cognitive decline; 2) To examine various operationally defined domains of lifestyle engagement and compare their abilities to predict subsequent incident dementia; 3) To determine whether there are ethnic differences in the pattern of distribution of lifestyle engagement and their associations with cognitive decline and incident dementia; and 4) To evaluate the association of Lifestyle Engagement and survival. The Mentored Clinical Scientist Development Award will enable Dr Shadlen to 1) obtain formal training in advanced epidemiological techniques, 2) analyze a national, multi-center, multiethnic database, and 3) test a model that social factors have direct effects on the epidemiology of neurodegenerative disease. Hence, these projects will allow Dr Shadlen to achieve her 5-year goal of synthesis of her interests in racial differences, dementia, and epidemiology into an independent, thought-provoking research program.