Epidemiology and Development of Alzheimer's Disease (EDAD)

描述(由申请人提供)：这项R21探索性/发展资助提案的主要目的是将堪萨斯大学阿尔茨海默病和记忆计划(KU AMP)的临床研究基础设施扩展到哥斯达黎加的医疗系统，并为评估和治疗阿尔茨海默病(AD)建立哥斯达黎加的临床研究专业知识。由于发病率增加(更早发现)和疾病存活期延长，发展中国家的AD患病率将增长最快。一个协调一致的国际研究小组将实施一项全面的、经验上严格的测量战略，以评估拉丁美洲健康老龄化和痴呆症的环境决定因素和组织决定因素。通过在KU AMP培训哥斯达黎加大学的教师，KU AMP是一家由美国联邦政府资助的大型研究机构，我们将发展所需的拉丁美洲专业知识，以维持哥斯达黎加的前瞻性记忆和老龄化研究。我们在堪萨斯大学通过临床研究方法和数据分析方面的教学计划来补充这一经验性培训。我们的长期目标是促进KU AMP和类似的哥斯达黎加大学研究中心之间的合作伙伴关系，以开发一项关于哥斯达黎加阿尔茨海默氏症和记忆计划的可持续的纵向研究(UCR AMP)。在短期内，我们建议进行临床研究最佳实践的试点项目培训 这将评估圣何塞国立老年病医院和两家乡村医院的300名哥斯达黎加老年人。具体地说，我们考察了哥斯达黎加流行病学数据中发现的死亡率优势，该数据表明，生活方式和环境因素保护低收入和中低收入农村人口部门免受与年龄相关的神经认知和身体衰退的影响。我们假设，生活方式因素(传统的和现代的)提供了更好的心血管健康，这是健康大脑老化的保护因素。城市和农村CR老年人的组间对比将揭示健康老龄化和不健康老龄化的显著缓和生活方式因素，这些因素将与心血管健康的衡量标准相互作用。我们的研究在一个独特且研究不足的拉丁美洲人群中调查了心血管危险因素与生活方式因素之间的关键相互作用。这一试点项目还将使其评估工具与美国现有的关于拉丁美洲健康和老龄化的纵向研究协调一致，以便可以比较几个国际地点的研究结果。随着这个项目的成熟，它将成为一个拉美裔美国研究方法中心的基础。

DESCRIPTION (provided by applicant): The primary aim of this R21 exploratory/developmental grant proposal is to extend the clinical research infrastructure of the University of Kansas' Alzheimer and Memory Program (KU AMP) to the Costa Rican healthcare system and build Costa Rican clinical research expertise for the assessment and treatment of Alzheimer's disease (AD). Rates of AD prevalence will increase fastest in developing nations due to increased incidence (earlier detection) and increased duration of survival with disease. A coordinated international team of researchers will implement a comprehensive and empirically rigorous measurement strategy for the assessment of the environmental versus organismic determinants of healthy aging and dementia in Latin Americans. By training University of Costa Rica faculty at KU AMP, a large US federally funded research facility, we will develop the needed Latin American expertise to sustain a prospective memory and aging study in Costa Rica. We supplement this experiential training with a proven didactic program on clinical research methods and data analysis at the University of Kansas. Our long term goal is to foster the partnership between KU AMP and analogous University of Costa Rica research centers to develop a sustainable longitudinal study of Costa Rican Alzheimer and Memory Program (UCR AMP). In the short term we propose a pilot project training in best practices for clinical research that will assess 300 older adult Costa Ricans in the national hospital for geriatrics in San Jose and in two rural hospitals. Specifically, we examine a mortality advantage found in Costa Rican epidemiological data that indicates lifestyle and environmental factors protect lower and low-middle class rural population sectors against age-related neurocognitive and physical decline. We hypothesize that lifestyle factors (traditional versus modern) afford greater cardiovascular health which is the protective factor in healthy brain aging. Between-group contrasts of urban versus rural CR elders will reveal significant moderating lifestyle factors of healthy versus unhealthy aging, and these factors will interact with measures of cardiovascular health. Our research investigates the critical interaction of cardiovascular risk factors with lifestyle factor in a unique and understudied population of Latin Americans. This pilot project will also harmonize its assessment instrumentation with existing US longitudinal studies of Latin American health and aging so that findings from several international sites can be compared. As this project matures it will serve as the foundation for a center of Hispanic American research methods.