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对认知能力下降和痴呆症的影响。 在此期间，K 08奖，她将提高她的研究和培训技能在华盛顿大学。 拟议方案包括：1）线性建模和生存分析课程，2）纵向研究设计经验，3）基金管理经验。 埃里克博士B。拉森将监督她的研究和培训。 伊塔玛B博士。Abrass将提供老年医学专业知识和学术职业指导。 顾问包括安妮特菲茨帕特里克博士和大卫西斯科维克。 与白人相比，黑人中AD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，生活方式参与和痴呆症的临床表现之间存在关联。 生活方式参与是有目的的活动的表现，这些活动保持了当前的健康状态或促进了理想的未来。 如果低生活方式参与在黑人中更常见，那么，这可能会导致痴呆症风险增加。 这项工作将利用对3602名心血管健康研究（CHS）记忆项目参与者的流行病学队列进行为期6年的前瞻性观察。 本研究中解决的问题可能建议采取干预措施来减少认知能力下降，从而延缓痴呆症的进展。 具体目标是：1）检查相关性并确定生活方式参与的测量在预测认知下降轨迹中的效用; 2）检查各种操作定义的生活方式参与领域并比较其预测随后发生的痴呆的能力;第三章确定生活方式参与的分布模式是否存在种族差异及其与认知能力下降和痴呆事件的关联;（4）评估生活方式参与与生存的关系。 指导临床科学家发展奖将使Shadlen博士能够1）获得先进流行病学技术的正式培训，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博士实现她的5年目标，将她对种族差异，痴呆症和流行病学的兴趣合成为一个独立的，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.