Association of Alcohol and Nutrition with Cognition and Brain Structure in Aging

随着美国老年人口的迅速增长，更好地了解酒精和营养如何相互作用以防止或加速认知能力下降和与年龄相关的大脑变化可能对公共卫生产生深远的影响。很大一部分成年人经常饮酒，但人们对中年和晚年饮酒如何影响老年人的认知功能和大脑完整性知之甚少。 甚至更少的是知道营养，可能与酒精在行为和生理水平上相互作用，影响认知功能和大脑结构。这项跨学科的建议，涉及流行病学，认知神经科学，神经影像学和生物统计学的专家，将分析现有的以及新收集的数据，从一个大型的，基于人口的NIH资助的老年人队列研究，现在在其第39年，苏格兰皇家银行（兰乔贝尔纳多研究，苏格兰皇家银行;博士巴雷特康纳，PI）。苏格兰皇家银行有一个非常丰富的数据库，用于探索中年和晚年饮酒与认知功能的关系。它包含酒精摄入量的测量，包括在约25年的时间内对给定参与者获得多达7次的饮酒频率、数量和类型的数据，在约20年的随访期内对给定参与者获得多达6次的评估不同认知领域的认知功能测试，和详细的饮食信息，从多达三个管理的哈佛Willett食物频率问卷超过10年。它还包含大量与医疗健康相关的变量、经验证的药物使用、情绪和生活方式测量，这将允许控制许多潜在的混淆协变量和效应修饰符。对这些现有数据的分析将使我们能够确定当前和先前的酒精使用如何关联 随着时间的推移，老年人的认知功能发生变化，营养如何影响这些关联，同时控制相关协变量，如教育水平，吸烟，体育活动，医疗状况（如糖尿病，心血管疾病），心血管疾病风险因素和药物。我们还将使用最先进的图像采集和分析程序，从基线时显示一系列酒精使用的RBS参与者的子集（n=300）中收集一组全面的敏感结构MRI和弥散张量成像（DTI）数据。这将使我们能够研究过去和现在的饮酒与晚年大脑结构完整性的测量结果之间的关系，并评估营养是否会改变这些关联，同时控制许多协变量。这项研究将增加酒精和饮食对老年人认知功能和大脑健康的关联的基本知识，并可能导致生活方式的建议，以促进成功的认知和大脑老化。由于与年龄相关的认知障碍是老年人丧失独立性和生活质量下降的主要原因，并且由于对认知障碍个体的护理给社会带来了巨大的经济负担，因此，更好地了解可改变的行为是否以及如何影响衰老中的认知功能可能会产生巨大的公共卫生影响。

DESCRIPTION (provided by applicant): With the rapidly growing elderly U.S. population, a better understanding of how alcohol and nutrition interact to protect against or accelerate cognitive decline and age-related brain changes could have profound implications for public health. A large proportion of the adult population regularly consumes alcohol but little is known about how mid and later life alcohol use impacts cognitive function and brain integrity in old age. Even less is known about whether nutrition, which may interact with alcohol at behavioral and physiological levels, influences cognitive function and brain structure. This interdisciplinary proposal, involving experts in epidemiology, cognitive neuroscience, neuroimaging and biostatistics will analyze existing as well as newly collected data from a large, population-based NIH-funded cohort study of older adults, now in its 39th year, the RBS (The Rancho Bernardo Study, RBS; Dr. Barrett-Connor, P.I.). The RBS has an exceptionally rich database for exploring the association of mid and late life alcohol consumption with cognitive function. It contains measures of alcohol intake, including data on frequency, amount and type of alcohol consumed obtained up to 7 times on a given participant over ~25 year period, cognitive function tests assessing different cognitive domains obtained up to 6 times on a given participant over ~20 year follow-up period, and detailed dietary information from up to three administrations of the Harvard Willett Food Frequency questionnaire over ~10 years. It also contains a large number of medical health-related variables, validated medication use, mood and lifestyle measures, which will allow control for numerous potentially confounding covariates and effect modifiers. Analysis of this existing data will allow us to determine how current and prior alcohol use relates to change in cognitive function over time in older adults and how nutrition influences these associations, while controlling for relevant covariates such as education level, smoking, physical activity, medical status (e.g. diabetes, cardiovascular disease), cardiovascular disease risk factors, and medications. We will also collect a comprehensive set of sensitive structural MRI and diffusion tensor imaging (DTI) data, using state-of-the-art image acquisition and analysis procedures, from a subset (n=300) of RBS participants who showed a range of alcohol use at baseline. This will allow us to examine how past and current alcohol use relates to measures of late-life brain structural integrity, and assess whether nutrition modifies these associations, whie controlling for numerous covariates. This study will increase basic knowledge of the association of alcohol and diet on cognitive function and brain health in the elderly, and could result in lifestyle recommendations to promote successful cognitive and brain aging. Because age-related cognitive impairment is a major contributor to loss of independence and lower quality of life in older adults, and because care for cognitively impaired individuals places an enormous financial burden on society, improved understanding of whether and how modifiable behaviors affect cognitive function in aging could have enormous public health impact.