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

描述(申请人提供)：随着美国老年人口的快速增长，更好地了解酒精和营养如何相互作用来防止或加速认知能力下降和与年龄相关的大脑变化可能会对公共健康产生深远的影响。很大一部分成年人经常饮酒，但人们对中老年饮酒对认知功能和老年大脑完整性的影响知之甚少。 营养可能在行为和生理层面上与酒精相互作用，是否会影响认知功能和大脑结构，人们对此知之甚少。这项跨学科的提案涉及流行病学、认知神经科学、神经成像和生物统计学的专家，将分析NIH资助的一项大型老年人队列研究的现有数据和新收集的数据，该研究目前已进入第39个年头，名为RBS(The Ranco Bernardo Study，RBS；Dr.Barrett-Connor，P.I.)。苏格兰皇家银行有一个极其丰富的数据库，可以探索中老年饮酒与认知功能的联系。它包含酒精摄入量的衡量标准，包括在~25年期间对给定参与者进行最多7次酒精消费的频率、数量和类型的数据，在~20年随访期内对给定参与者进行最多6次的不同认知领域的认知功能测试，以及在~10年期间最多三次使用哈佛大学威利特食物频率问卷的详细饮食信息。它还包含大量与医疗健康相关的变量、有效的用药、情绪和生活方式指标，这将允许控制许多潜在的混杂协变量和效果修饰物。对现有数据的分析将使我们能够确定目前和以前饮酒的关系 研究老年人认知功能随时间的变化以及营养如何影响这些关联，同时控制相关的协变量，如教育水平、吸烟、体力活动、医疗状况(如糖尿病、心血管疾病)、心血管疾病危险因素和药物。我们还将使用最先进的图像采集和分析程序，从RBS参与者的子集(n=300)中收集一套全面的敏感结构MRI和扩散张量成像(DTI)数据，这些参与者在基线时显示了一系列的酒精使用情况。这将使我们能够检查过去和现在的饮酒与晚年大脑结构完整性的衡量标准之间的关系，并评估营养是否改变了这些关联，从而控制了许多协变量。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影响的基本知识，并可能产生促进成功认知和大脑老化的生活方式建议。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，而且照顾认知受损的个人给社会带来了巨大的经济负担，因此提高对可改变的行为是否以及如何影响老年认知功能的理解可能会对公共健康产生巨大的影响。

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.