Does the Neighborhood Environment Modify Genetic Risk for Cognitive Decline?

描述（由申请人提供）：痴呆症是老年人中常见的致残性脑部疾病，其后果包括独立性、功能下降、机构化和死亡率。以前的研究已经确定了多种生物，遗传， 以及与认知障碍和衰退相关的行为因素。例如，载脂蛋白E（ApoE）基因中一种相对常见的多态性，即e4等位基因，与认知能力下降密切相关，并且与其他人群相比，在阿尔茨海默病患者中显著更高。最近，一个平行的文献已经超越了个人层面的因素，考虑社会和建筑环境的作用。发现表明 居住在社会经济条件优越的社区可以促进认知功能和/或缓冲认知下降，部分原因是它们有更大密度的物理资源（娱乐中心、健身房、公园、步行道）以及促进身体活动和促进精神刺激的社会和机构资源（图书馆、书店、社区中心、社交俱乐部）。然而，一个有趣的问题仍然是，是否有特定的老年人亚群，他们可能特别受益于居住在资源密集型社区，因为他们携带e4等位基因，认知能力下降的风险更高。我们建议对来自芝加哥健康与老龄化项目的数据进行二次分析，该项目是一项前瞻性的基于人群的队列研究，研究对象是芝加哥市的老年人，在16年的时间内（1993-2009年）接受了5次调查。除了是一项收集痴呆症遗传标记（APOE e4等位基因）的纵向研究外，该研究还收集了客观测量的详细环境数据（包括公园，树木，图书馆，教堂，社区中心的存在）。因此，这些数据提供了一个理想的机会来研究邻里环境在改变有遗传风险的老年人认知能力下降方面的可能作用。 公共卫生相关性：据估计，美国70岁以上的人中有540万人患有认知障碍，其后果包括生活质量、功能下降、机构化和死亡率。虽然认知严重受损的人可能集中在机构，但大多数认知受损的老年人生活在社区。这项拟议的研究建立在早期工作的基础上，这些工作证明了生活在资源密集型社区的认知益处，通过检查这些益处是否在减弱遗传风险的老年人的认知能力下降方面特别突出。

DESCRIPTION (provided by applicant): Dementia is a common and disabling brain disorder among older adults that has consequences for independence, functional decline, institutionalization, and mortality. Previous research has identified multiple biological, genetic, and behavioral factors that are associated with cognitive impairment and decline. For example, a relatively common polymorphism in the apolipoprotein E (ApoE) gene, the e4allele, is strongly associated with cognitive decline and is significantly higher among those with Alzheimer's disease compared to rest of the population. Recently, a parallel literature has looked beyond individual-level factors to consider the role of the social and built environment. Findings suggest that residence in socioeconomically advantaged neighborhoods may promote cognitive function and/or buffer cognitive decline in part through their greater density of physical resources (recreational centers, gyms, parks, walking paths) as well as social and institutional resources (libraries, bookstores, community centers, social clubs) that promote physical activity and facilitate mental stimulation. However, an interesting question remains as to whether there are specific sub-populations of older adults who may especially benefit from residence in resource-intensive neighborhoods by virtue of the fact that they are at higher risk for cognitive decline because they carry the e4 allele. We propose to conduct a secondary analysis of data from the Chicago Health and Aging Project, a prospective NIA-funded population based cohort study of older adults in the city of Chicago who were surveyed 5 times over a 16 year period (1993-2009). In addition to being a longitudinal study collecting genetic markers for dementia (APOE e4allele), the study also collected objectively measured, detailed environmental data (including the presence of parks, trees, libraries, churches, community centers). As such, the data provide an ideal opportunity to examine the possible role of neighborhood environments in modifying cognitive decline among older adults who are genetically at risk. PUBLIC HEALTH RELEVANCE: An estimated 5.4 million people in the U.S. over age 70 have cognitive impairment, with consequences for quality of life, functional decline, institutionalizatin, and mortality. Although people with severe impairment in cognition may be concentrated in institutions, the majority of older adults with cognitive impairment live in the community. The proposed research builds on earlier work demonstrating the cognitive benefits of living in resource intensive neighborhoods, by examining whether these benefits are particularly salient in attenuating cognitive decline among older adults who are genetically at risk.