Epidemiology and Development of Alzheimer's Disease (EDAD)

描述（由申请人提供）：该R21探索性/发展性赠款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医疗保健系统，并建立哥斯达黎加临床研究专业知识，用于评估和治疗阿尔茨海默病（AD）。由于发病率增加（早期发现）和疾病生存期延长，发展中国家的AD患病率将增长最快。一个协调的国际研究小组将实施一项全面和严格的测量策略，以评估拉丁美洲健康老龄化和痴呆症的环境与器官决定因素。通过在美国联邦政府资助的大型研究机构KU AMP培训哥斯达黎加大学的教师，我们将开发所需的拉丁美洲专业知识，以维持在哥斯达黎加的前瞻性记忆和衰老研究。我们在堪萨斯大学的临床研究方法和数据分析方面提供经过验证的教学计划，以补充这种体验式培训。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伙伴关系，以开发哥斯达黎加阿尔茨海默病和记忆计划（UCR AMP）的可持续纵向研究。在短期内，我们提出了一个试点项目，培训临床研究的最佳实践 该研究将对圣何塞国家老年病医院和两所农村医院的300名哥斯达黎加老年人进行评估。具体而言，我们研究了哥斯达黎加流行病学数据中发现的死亡率优势，这些数据表明生活方式和环境因素保护了中低阶层农村人口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（传统与现代）提供更好的心血管健康，这是健康大脑老化的保护因素。城市与农村CR老年人的组间对比将揭示健康与不健康老龄化的显著调节生活方式因素，这些因素将与心血管健康措施相互作用。我们的研究调查了拉丁美洲独特和未充分研究的人群中心血管危险因素与生活方式因素的关键相互作用。该试点项目还将使其评估工具与美国现有的拉丁美洲健康和老龄化纵向研究相协调，以便可以比较几个国际站点的结果。随着该项目的成熟，它将成为西班牙裔美国人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.