Epidemiology of Mild Cognitive Impairment and Dementia in China

描述（由申请人提供）到2050年，美国将有900万人被诊断患有AD，这一预测令人震惊;更令人生畏的是，到2025年，中国将有3400万AD病例。美国和中国之间千丝万缕的联系确保了中国的影响将影响美国。由于中国在很大程度上仍然没有意识到AD或其他类型的痴呆症是神经系统疾病，这种知识的缺乏将阻碍潜在的预防/治疗策略，这些策略可以降低肯定会上升的成本。心脏病研究（FHS）估计，将发病时间推迟5年将使一个人的患病风险降低50%，但中国缺乏足够的知识来采取措施降低患病风险。FHS几十年来一直在进行轻度认知障碍（MCI，AD的前驱期）和AD与痴呆的流行病学研究。这项名为“中国轻度认知障碍和痴呆症的流行病学”的试点资助的目标是在中国建立类似的队列研究时，模拟FHS研究流行和偶发痴呆症的方法。我们建议在中国广州和广西省的农村和城市地区实施测试方案。方法包括进行健康检查，以测量先前与MCI和AD风险增加有关的已知和新的风险因素，以及神经心理学测试组合以确定基线认知状态。还将建立监测技术，以确定流行的痴呆症和纵向跟踪事件病例。中国目前的痴呆患病率和发病率研究表明，中国的AD/痴呆率低于美国，但方法学差异限制了这些结果的可推广性。此外，随着中国老年人口的快速增长，近年来痴呆症的发病率与前十年相比有所增加。了解中国人痴呆的模式及其相关因素有助于设计有效的干预方案。此外，比较研究的长期影响将是深入了解AD等复杂疾病的环境x基因相互作用的机会。这项研究将为在中国全面实施研究奠定基础，也可能有助于刺激中国在AD和痴呆方面的进一步研究。 公共卫生相关性：中国轻度认知障碍和痴呆的流行病学研究是一项队列研究，旨在确定中国南方农村和城市地区轻度认知障碍（MCI）和阿尔茨海默病（AD）以及其他类型痴呆的流行和偶发病例。以Frachial Heart研究的临床前和临床痴呆研究为模型，长期目标是确定与中国人群中MCI，AD和其他痴呆亚型风险增加相关的风险因素和生物标志物。这项队列研究的建立将大大提高对中国AD/痴呆的认识，并为确定环境和基因在痴呆疾病发展中的作用提供重要的比较数据。.

DESCRIPTION (provided by applicant Projections that 9 million people in the US will be diagnosed with AD by the year 2050 is staggering; even more daunting are estimates that China will have 34 million AD cases by the year 2025. The inextricable links between the U.S. and China ensure that what effects China will affect the US. With China still largely unaware of AD or other types of dementia as neurologic disorders, this lack of knowledge will prevent potential prevention/treatment strategies that can abate the costs that are certain to rise. The Framingham Heart Study (FHS) estimates that delaying the onset of disease by 5 years will reduce a person's risk of disease by 50%, but China is not sufficiently knowledgeable to take steps to reduce risk of disease. FHS has been conducting epidemiological study of mild cognitive impairment (MCI, a prodromal stage of AD) and AD and dementia for decades. The goal of this pilot grant entitled "Epidemiology of Mild Cognitive Impairment and Dementia in China", is to model FHS' methods for studying prevalent and incident dementia in establishing a similar cohort study in China. We propose to implement the test protocol in both rural and urban areas of Guangzhou and Guangxi provinces in China. Methods include administering a health examination that will measure known and novel risk factors that have been previously linked to increase risk of MCI and AD, as well as a neuropsychological test battery to determine baseline cognitive status. Surveillance techniques for identifying prevalent dementia and tracking incident cases longitudinally will also be established. Current prevalence and incidence studies of dementia in China suggest that rates of AD/dementia are lower in China than in the US, but methodological variations limit generability of these findings. Further, with a rapidly growing elderly population in China, incidence rates of dementia have increased in recent years compared to the previous decade. Understanding the pattern of dementia among the Chinese and associated factors would help design effective intervention programs. Further, the long term implications of comparative studies will be opportunities to gain insight into the environmental x gene interactions that underlie a complex disease such as AD. The proposed study will lay the groundwork for a full-implementation study in China and may also help stimulate further Chinese research in AD and dementia. PUBLIC HEALTH RELEVANCE: The proposed pilot study, Epidemiology of Mild Cognitive Impairment and Dementia in China, seeks to establish a cohort study to identify prevalent and incident cases of mild cognitive impairment (MCI) and Alzheimer's disease (AD) and other types of dementia in rural an urban regions of southern China. Modeled after the Framingham Heart Study's studies of preclinical and clinical dementia, the long-term aims are to determine risk factors and biomarkers linked to increased risk of MCI, AD and other dementia subtypes within the Chinese population. The establishment of this cohort study will greatly enhance the understanding of AD/dementia in China, as well as provide important comparative data for identifying the role that environment and genes play in development of dementing illnesses. .