Integrating neuroimaging with studies of cognitive aging in the Dominican Republi

描述（由申请人提供）：在我们位于北方曼哈顿的中心进行的研究一直表明，认知障碍和痴呆症的患病率和发病率在老年加勒比西班牙裔（主要来自多米尼加共和国）中高于高加索人。尽管这一观察结果是一致的，但造成这种健康差异的原因仍然难以捉摸。来自低收入和中等收入国家（如多米尼加共和国）的个人可能面临更高的风险，因为社会经济因素，独特的遗传风险因素和脑血管疾病的高代表性的相互影响。拟议的工作，响应PAR-11-031，发展中国家的脑疾病：整个生命周期的研究，旨在通过与多米尼加共和国圣地亚哥的研究人员合作，将高分辨率磁共振成像（MRI）整合到正在进行的认知老化遗传研究中，最终了解这种差异的来源。磁共振成像可用于量化小型和大型脑血管疾病（例如，梗塞、白色高信号、微出血）和检查神经变性的标志物（例如，海马萎缩）。阿尔茨海默病遗传学研究所（EFIGA; NIH R37 AG 015473 PI：R。Mayeux）[阿尔茨海默病遗传影响的家族研究]是一项阿尔茨海默病（AD）的大规模纵向遗传研究，包括来自有和没有强烈病史的家族的AD患者和非AD患者;有超过4，500名活跃的老年人参与者，其中超过2，700人居住在圣地亚哥。我们拟定的试点研究将在圣地亚哥收集来自EFIGA的70名活跃参与者的MRI扫描，并将MRI数据与作为母项目一部分收集的临床和遗传数据相结合。我们将探讨脑血管疾病和神经退行性变的标志物与人口统计学因素，认知功能/诊断和遗传学的关系。我们将为在圣地亚哥进行的认知老化和遗传学的前瞻性大规模MRI项目建立可行性和试点数据。作为这里提议的努力的一部分，我们将努力建立地方能力，以获得标准化的磁共振成像数据，并为涉及老年人的研究进行磁共振成像分析。最后，我们的目标是通过临床指导，正式的教学法，正在进行的积极合作，和研讨会介绍正式和非正式的跨学科认知老化研究的培训机会。拟议的项目将导致一个强有力的合作，准备揭示加勒比西班牙裔之间的认知老化的差距来源。 公共卫生相关性：次优认知老化正在成为一种真正的流行病，特别是在拉丁美洲，那里的痴呆症患病率是全球最高的。拟议的项目将磁共振成像纳入正在进行的认知老化研究在圣地亚哥，多米尼加共和国，最终目标是了解什么因素导致健康的差异，在加勒比海西班牙裔人之间的认知障碍。将神经影像学整合到认知老化的研究中，可以通过识别新的和特定的干预和预防治疗靶点来改善老年人群的认知结果。

DESCRIPTION (provided by applicant): Ongoing research in our center in Northern Manhattan has consistently shown that the prevalence and incidence of cognitive impairment and dementia are greater among older Caribbean Hispanics, predominantly from Dominican Republic, than among Caucasians. Despite the consistency of this observation, the causes for this health disparity remain elusive. Individuals from low and middle income countries, such as Dominican Republic, may be at increased risk because of the interacting influences of socioeconomic factors, unique genetic risk factors, and high representation of cerebrovascular disease. The proposed work, in response to PAR-11-031, Brain disorders in the developing world: Research across the lifespan, seeks ultimately to understand the sources of this disparity by building a collaboration with investigators in Santiago, Dominican Republic to integrate high resolution magnetic resonance imaging (MRI) into ongoing genetic studies of cognitive aging. Magnetic resonance imaging can be used to quantify small and large cerebrovascular disease (e.g., infarct, white matter hyperintensities, microbleeds) and to examine markers of neurodegeneration (e.g., hippocampus atrophy). The Estudio Familiar de Influencia Genetica de Alzheimer (EFIGA; NIH R37 AG015473 PI: R. Mayeux) [Family Study of the Genetic Influence of Alzheimer's Disease] is a large scale longitudinal genetic study of Alzheimer's disease (AD) comprising individuals with and without AD from families with and without strong histories of the disease; there are over 4,500 active older adult participants, over 2,700 of whom reside in in Santiago. Our proposed pilot study will collect MRI scans in Santiago on 70 active participants from EFIGA and integrate MRI data with clinical and genetic data collected as part of the parent project. We will explore the relationships of markers of cerebrovascular disease and neurodegeneration with demographic factors, cognitive function/diagnosis, and genetics. We will establish feasibility and pilot data for a prospective, large-scale MRI project of cognitive aging and genetics, carried out in Santiago. As part of the efforts proposed here, we will work towards establishing the local capacity to acquire standardized MRI data and carry out MRI analysis for research involving older adults. Finally, we aim to introduce formal and informal training opportunities on interdisciplinary cognitive aging research via clinical preceptorship, formal didactics, ongoing active collaboration, and a symposium. The proposed project will result in a strong collaboration poised to uncover sources of disparities of cognitive aging among Caribbean Hispanics. PUBLIC HEALTH RELEVANCE: Suboptimal cognitive aging is becoming a true pandemic, particularly in Latin America, where the prevalence of dementia is the highest globally. The proposed project will integrate magnetic resonance imaging into ongoing studies of cognitive aging in Santiago, Dominican Republic, with the ultimate goal of understanding what factors contribute to health disparities in cognitive impairment among Caribbean Hispanics. Integration of neuroimaging into studies of cognitive aging may improve cognitive outcomes in an aging population through the identification of novel and specific treatment targets for intervention and prevention.