EPIDEMIOLOGY OF AGING AND DEMENTIA - AUTOPSY RESEARCH

描述(改编自申请者摘要)：我们的目的是获得 通过以下途径更好地了解认知衰退和痴呆症的原因 对约280名男性尸检的死亡时脑结构的研究 健康，疾病，认知功能，遗传和生理素质， 中年时期暴露在一长串个人和环境因素中 通过反复面谈和审查来确定其前瞻性 间隔30年以上。添加到之前已收集的类似数据 (来自NIA合同的资金)可供进行的尸检总数 分析将约为640。研究对象是日本裔美国男性。 夏威夷78岁以上的老人参加过火奴鲁鲁之心 该计划自1965年开始实施以来。定义结构特征的方法 将包括大体尸检、显微镜检查和核磁共振检查 修复了解剖前的大脑问题。在固定之前，脑部的多个样本 组织和脑脊液将被取出并冷冻以供进一步研究。具体的 待研究的结构终点包括神经原纤维的密度 缠结、老年斑、神经性斑块和路易小体；小血管 中风，大血管中风，动脉壁结构的明确变化 (中小型血管)；脑大小/萎缩(分为灰色和白色 物质)和特定大脑区域(海马体、杏仁核、内侧核)的体积 颞叶，总的新皮质)。分析将集中在：(1)身体解剖 痴呆症临床诊断的验证，(2)“新”的发展 血管性痴呆的神经病理学标准，(3)风险识别 预测阿尔茨海默病、血管性痴呆和个体的因素 提到的结构端点，以及(4) 结构端点，因为它们反映了 痴呆症的发病机制。使用的所有方法都将允许与 另一项关于欧洲血统女性的研究产生了相应的数据 修女研究)。所有信息和材料将被存档，以供将来研究 使用。

DESCRIPTION (Adapted from the Applicant's Abstract): Our purpose is to gain a better understanding of the causes of cognitive decline and dementia through the study of brain structures at death in approximately 280 autopsied men whose health, illnesses, cognitive functioning, genetic and physiologic constitution, and midlife exposures to a long list of personal and environmental factors have been prospectively defined through repeated interview and examination over a 30+ year interval. When added to similar data already collected with prior funding (from an NIA contract) the total number of autopsies available for analysis will be approximately 640. The subjects are Japanese-American men in Hawaii aged 78+ years at death who have participated in the Honolulu Heart Program since it began in 1965. The methods for defining structural features will include gross autopsy, microscopic examination, and MRI examination of the fixed brain before dissection. Prior to fixation, multiple samples of brain tissue and CSF will be removed and frozen for future study. The specific structural endpoints to be studied include densities of neurofibrillary tangles, senile plaques, neuritic plaques, and Lewy bodies; small vessel strokes, large vessel strokes, defined changes in arterial wall architecture (medium and small vessels); brain size/atrophy (segmented into gray and white matter), and volumes of specified brain regions (hippocampus, amygdala, mesial temporal lobe, total neocortex). Analyses will be focused on: (1) autopsy verification of clinical diagnoses of dementia, (2) development of "new" neuropathologic criteria for vascular dementia, (3) identification of risk factors predicting Alzheimer's disease, vascular dementia, and the individual structural endpoints mentioned, and (4) inter-relationships among the structural endpoints as they reflect interacting processes involved ~n the pathogenesis of dementia. All methods used will allow comparisons with corresponding data generated by another study in European-ancestry women (the Nun Study). All information and materials will be archived for future research use.