English Longitudinal Study of Ageing: renewal 2014

 描述(申请人提供)：痴呆症和其他形式的认知障碍是美国和其他国家的主要健康问题。临床研究提供了关于机制、病理和临床过程的宝贵信息，但迫切需要关于痴呆症和轻度认知障碍患病率的高质量人口数据，以便规划服务、预测未来需求、估计痴呆症护理成本，并了解这些情况对个人及其家庭的影响。将痴呆症方面的工作嵌入到老龄人口的纵向研究中尤其有利，因为它可以调查这些问题发展的认知、生物学和社会前因和后果。在协调的纵向老龄化研究中，对痴呆症和认知障碍的跨国比较提供了宝贵的证据，有助于理解国家差异背后的过程，并在确定适当的政策应对措施方面至关重要。英国老龄化纵向研究(ELSA)是健康和退休研究的姊妹研究中最成熟的，因为它自2002年以来一直在进行，已经收集了6波完整的数据收集。这些研究在社会、经济、行为和遗传数据方面密切协调，因此非常适合对英国和美国的痴呆症和轻度认知障碍进行直接比较。这项申请的目的是在ELSA收集关于ELSA人群子集的认知和相关过程的详细数据，使用与将在HRS中管理的措施协调的增强评估方案。评估将包括比ELSA常规波收集的更广泛的认知测量，以及对分层随机抽样的1000名65岁及以上的ELSA参与者的线人的采访。在与HRS团队的合作下，这些将被用来开发对痴呆症、轻度认知障碍和健康认知功能进行分类的算法。将这些测量方法与ELSA中的常规认知测量方法进行比较，可以推断出ELSA人群的总体情况。然后，我们将能够直接比较ELSA和HRS中这些问题的流行率。我们还将对痴呆症估计的有效性进行研究，方法是对医学研究委员会认知功能和老龄化研究(一项英国领先的痴呆症人口研究)收集的数据进行反向验证，并在ELSA内测试新措施与通过英国医院事件和初级保健统计获得的客观临床数据之间的关联。另一项重要的工作将涉及量化ELSA的减员对认知障碍估计的影响，使用多种方法对留在研究中和退出研究的人之间的相关差异进行三角测量。该数据集将为未来对预测认知损害的因素以及痴呆症的社会和经济后果的分析提供宝贵的材料。

 DESCRIPTION (provided by applicant): Dementia and other forms of cognitive impairment are major health problems in the USA and other countries. Clinical studies provide invaluable information about mechanisms, pathology and clinical course, but there is an urgent need for high quality population data concerning the prevalence of dementia and mild cognitive impairment in order to plan services, predict future needs, estimate the costs of dementia care, and understand the impact of these conditions on individuals and their families. Embedding work on dementia into longitudinal studies of aging populations is particularly advantageous, since it permits investigations of cognitive, biological, and social antecedents and consequences of the development of these problems. Cross- national comparisons of dementia and cognitive impairment within harmonized longitudinal aging studies provide invaluable evidence contributing to understanding of the processes underlying national differences, and are crucial in determining the appropriate policy response. The English Longitudinal Study of Ageing (ELSA) is the most mature of the sister studies to the Health and Retirement study, since it has been in progress since 2002 and has already collected 6 complete waves of data collection. The studies are closely harmonized in terms of social, economic, behavioral and genetic data, so are well placed for making direct comparisons of dementia and mild cognitive impairment in England and the USA. The purpose of this application is to collect detailed data in ELSA on cognition and related processes on a subset of the ELSA population using an enhanced assessment protocol harmonized with measures that will be administered in the HRS. The assessment will include more extensive cognitive measures than are collected in regular waves of ELSA together with interviews with informants on a stratified random subsample of 1,000 ELSA participants aged 65 and older. In collaboration with the HRS team, these will be used to develop algorithms to classify dementia, mild cognitive impairment and healthy cognitive function. Comparisons between these measures and the regular cognition measures in ELSA will allow extrapolation to the ELSA population in general. We will then be able to make direct comparisons of the prevalence of these problems in ELSA and the HRS. We will also carry out studies of the validity of dementia estimates by carrying out back-validation against data collected in the Medical Research Council Cognitive Function and Ageing Study, a leading UK population study of dementia, and by testing associations within ELSA between the new measures and the objective clinical data obtained through UK Hospital Episode and Primary Care Statistics. Another important strand of work will involve quantifying the impact of attrition from ELSA on estimates of cognitive impairment, using a number of methods to triangulate on relevant differences between people who remain in the study and drop out. The dataset will provide invaluable material for future analyses of factors predicting cognitive impairment and of the social and economic consequences of dementia.