Epidemiology of Brain Aging in the Very Old

我们有三个基本目标：（1）检查尸检时确定的脑结构特征与死亡前数年和数月内的临床诊断、认知功能和运动功能的关系，（2）评估候选危险因素与偶发轻度认知障碍（MCI）、阿尔茨海默病（AD）、血管性痴呆（VsD）、锥体外系运动体征（EMS）的关联，和帕金森病（PD），（3）估计这些相同终点的年龄特异性发病率，将现有估计扩展到生命的第十个十年。这些将通过檀香山-亚洲老龄化研究（哈斯）在两个完整的检查周期中持续运行来完成，并提供新病例与最近确定的事件病例进行分析。所有累积的数据和材料将被添加到现有的NIA-Kuakini哈斯档案中，供NIA和其他校外网站的合作科学家使用，以促进这一独特资源的保存和未来利用。我们的结构-功能研究主要集中在4个主要的、不同的、与衰老相关的脑结构变化：阿尔茨海默病过程（由神经元缠结和神经炎斑块指示）、脑血管疾病（梗死和动脉壁结构）、与衰老相关的萎缩（全身和局部）和路易体过程（与黑质变性、PD、EMS和皮质路易体疾病相关）。每一个终点都被设想为与其中一个终点联系最紧密，而其他一个或多个终点的贡献则各不相同。风险因素研究将包括：检查先前确定为与流行终点相关的因素，以确定其与事件终点的关联;使用1986-93年期间收集的信息搜索“新”风险因素;以及评估多导睡眠图、嗅觉测试和反应时间测试的最新数据，作为早期或即将发生的AD或PD的指标。一个密切相关的NIA赠款将支持从2000年6月1日至2005年5月30日与神经病理学有关的尸检采集、进行和数据管理活动。NIA对当前哈斯操作的合同支持定于2001年6月30日结束。

We have three fundamental aims: (1) to examine relationships of structural brain characteristics determined at autopsy with clinical diagnoses, cognitive function, and motor function in the years and months prior to death, (2) to assess associations of candidate risk factors with incident mild cognitive impairment (MCI), Alzheimer's disease (AD), vascular dementia (VsD), extrapyramidal motor signs (EMS), and Parkinson's disease (PD), and (3) to estimate age-specific incidence rates for these same endpoints, extending existing estimates into the tenth decade of life. These will be accomplished by continuing operation of the Honolulu-Asia Aging Study (HAAS) through two full examination cycles, providing new cases for analysis in combination with recently identified incident cases. All accrued data and materials will be added to the existing NIA-Kuakini HAAS Archive, to be made available to collaborating scientists at the NIA and at other extramural sites, to 'facilitate preservation and future utilization of this unique resource. Our structure-function research is focused on 4 major, distinct, aging-related structural brain changes: the Alzheimer process (indicated by neurofibrillary tangles and neuritic plaques), cerebrovascular disease (infarcts and arterial wall architecture), aging-related atrophy (general and regional), and the Lewy body process (associated with nigral degeneration, PD, EMS, and cortical Lewy body disease). Each endpoint is envisioned as linked most strongly to one of these, with variable contributions from one or more of the others. The risk factor research will include: examination of factors previously identified as associated with prevalent endpoints for their associations with incident endpoints; a search for "new" risk factors using information collected between 1986-93; and evaluation of recent data from Polysomnography, tests of olfaction, and tests of reaction time as indicators of incipient or imminent AD or PD. A closely related NIA grant will support autopsy acquisition, conduct, and data management activities related to neuropathology from June 1, 2000 through May 30, 2005. NIA contract support of current HAAS operations is scheduled to end June 30, 2001.