Determinants of Midlife & Longitudinal Change in Cognitive Function: CARDIA Study

描述(由申请人提供)：几乎没有人知道在早期生活中暴露于关键风险因素如何影响认知功能及其在以后生活中的衰退。有证据表明，导致痴呆的神经病理过程，特别是阿尔茨海默病和血管性痴呆，在临床特征显现之前几十年就开始了。最近的研究令人信服地证明，中年风险因素，特别是那些与心血管疾病和生活方式因素有关的因素，对以后的生活认知有实质性的影响。然而，关于早年，例如年轻人，危险因素及其对中年和晚年认知的影响，我们知之甚少。我们建议通过对正在进行的CARDIA研究进行一项创新的辅助研究来解决这一差距。CARDIA是一项多点前瞻性研究，涉及5115名黑人和白人成年人，年龄在基线(1985-86年)的18-30岁之间，他们最近完成了第七次(第25年)随访，其中测量了认知测试和大脑核磁共振成像，并将参加2015-16年的第30年考试。我们建议重复和加强对3100名参与者进行的30年访问的认知测试。在美国的第一个此类研究中，我们建议估计关键血管、代谢和生活方式因素的30年轨迹，并通过MRI量化大脑区域体积，以评估它们与成年后认知水平和变化的关系。此外，我们将使用已经收集的全基因组遗传数据来调查遗传变异与认知的关系，这些变异已知会影响这些风险因素和脑MRI结果。科学目标的完成将有助于确定认知变化在中年开始发生的时间，生命历程方法的使用将使我们能够研究从早期生活开始的长期暴露，希望研究风险因素改变的潜在影响。这项提议很有说服力

DESCRIPTION (provided by applicant): Almost nothing is known about how exposure to key risk factors in early life influences cognitive function and its decline later in life. Evidence suggests that the neuropathologic process leading to dementia, especially Alzheimer disease and vascular dementia, begins decades before clinical features become apparent. Recent research has convincingly demonstrated that mid-life risk factors, especially those related to cardiovascular disease and lifestyle factors, have a substantial impact on later life cognition. However, much less is known about earlier, e.g. young adult, risk factors and their effect on cognition in mid-life and later. We propose to address this gap by conducting an innovative ancillary study to the ongoing CARDIA study. CARDIA is a multisite prospective study of 5,115 black and white adults, aged 18-30 years at baseline (1985-86), who recently completed their seventh (year 25) follow-up in which cognitive testing and brain MRIs were measured and who will be participating in a year 30 exam in 2015-16. We propose to repeat and augment the cognitive testing for the year 30 visit on an estimated 3100 participants. In the first study of it kind in the United States, we propose to estimate 30-year trajectories of key vascular, metabolic and lifestyle factors, and quantify brain region volumes by MRI to assess their relationship to level and change in cognition in adulthood. In addition, we will use already collected genome-wide genetic data to investigate the association of genetic variants, which are known to influence these risk factors and brain MRI outcomes, with cognition. Completion of the scientific aims will help determine when cognitive changes begin to occur in mid-life and the use of a life course approach will allows us to study long-term exposure, from early life onward, in hopes of studying the potential effect of risk factor modification. The proposal has great