Kerala-Einstein study: Risk factors for cognitive decline

描述（由申请人提供）：这项修订后的R21资助旨在促进合作研究，研究生活在印度喀拉拉邦的老年人认知能力下降的危险因素。我们的研究地点是喀拉拉邦的Kozhikode和Thiruvananthapuram市。该提案将由阿尔伯特·爱因斯坦医学院神经学家Verghese博士指导，他是喀拉拉邦人，并将与印度主要研究生医学机构之一Thiruvananthapuram Sri Chitra Tirunal研究所行为神经病学部门主任Mathuranath博士和Kozhikode婴儿纪念医院神经病学主任Salam博士合作。我们将这次合作命名为“喀拉拉邦-爱因斯坦研究”。我们的总体目标是：1)发展美国和喀拉拉邦研究人员之间的持续合作；2)在喀拉拉邦建立一个基于现有研究和临床设施的研究网络；3)为未来的联合提案展示可行性并生成初步数据，以解决与年龄相关的认知和运动结果。研究能力建设活动包括制定统一的诊断程序，开发和验证文化公平工具，如基于图片的记忆障碍筛查（研究1），支持研究培训，创建计算机化数据库，以及探索建立脑库的可行性。喀拉拉邦老年人的痴呆症患病率为1.3%至5.3%。据报道，喀拉拉邦的心血管疾病发病率也在上升。心血管危险因素、脑血管疾病和痴呆经常共存，但这些问题之间的关系是巧合还是因果关系尚不清楚。我们建议研究心血管疾病以及其他风险因素（步态异常、低教育和休闲活动）在喀拉拉邦老年人痴呆症中的作用。在为期2年的研究期间，我们将在Kozhikode的400名成人临床样本的病例对照研究（研究2）中检查这些变量，以及纵向参与Thiruvananthapuram正在进行的队列研究的2000多名老年人（研究3）。喀拉拉邦-爱因斯坦的研究有可能对喀拉拉邦和美国未来的研究和临床实践产生重大影响，并将为未来长期研究与年龄相关的认知和运动能力下降的风险因素奠定基础，利用本提案制定的合作安排。公共卫生相关性：这项R21资助旨在促进美国和印度研究人员之间的合作研究，以研究生活在印度喀拉拉邦的老年人认知能力下降的危险因素，特别是心血管疾病。我们的研究地点在喀拉拉邦的Kozhikode和Thiruvananthapuram。我们还建议发展研究基础设施和培训初级教师，以维持未来的研究工作。

DESCRIPTION (provided by applicant): This revised R21 grant is designed to foster collaborative research to study risk factors for cognitive decline among older adults living in the Indian state of Kerala. Our research sites are the cities of Kozhikode and Thiruvananthapuram in Kerala. The proposal will be directed by Dr Verghese, a neurologist at the Albert Einstein College of Medicine and a native of Kerala in collaboration with Dr. Mathuranath, Director, Division of Behavioral Neurology at the Sri Chitra Tirunal Institute, Thiruvananthapuram, one of India's premier postgraduate medical institutes and Dr Salam, Director of Neurology at Baby Memorial Hospital, Kozhikode. We have entitled this collaboration, 'The Kerala-Einstein Study'. Our overall goals are: 1) develop sustained collaborations between US and Kerala researchers; 2) create a research network in Kerala building on existing research and clincial facilities; and 3) Show feasibility and generate preliminary data for future joint proposals to address age related cognitive and motor outcomes. Research capacity building activities include developing uniform diagnostic procedures, developing and validating culture fair instruments such as a picture-based memory impairment screen (Study 1), supporting research training, creating computerized databases, and exploring the feasibility of establishing brain banking. The prevalence of dementia in Kerala seniors is 1.3 to 5.3%. An increasing prevalence of cardiovascular disease has also been reported in Kerala. Cardiovascular risk factors, cerebrovascular disease, and dementia often coexist, but it is unclear if the relation between these problems is coincidental or causal. We propose to examine the role of cardiovascular disease as well as other risk factors (gait abnormalities, low education, and leisure activities) for dementia in Kerala seniors. Over the 2-year study period, we will examine these variables in a case control study in a clinic-based sample of 400 adults in Kozhikode (Study 2) as well as longitudinally in over 2000 older adults participating in an ongoing cohort study in Thiruvananthapuram (Study 3). The Kerala-Einstein study has the potential to have a major impact on future research and clinical practice in Kerala and USA, and will build the foundation for future long term studies of risk factors for age related cogitive and motor decline utilizing collaborative arrangements developed through this proposal. PUBLIC HEALTH RELEVANCE: This R21 grant is designed to foster collaborative research between US and Indian investigators to study risk factors, especially cardiovascualr diseases, for cognitive decline among older adults living in the Indian state of Kerala. Our research sites are in the cities of Kozhikode and Thiruvananthapuram in Kerala. We also propose to develop research infrastructure and train junior faculty to sustain future research efforts.