Epidemiology of Alzheimer's Disease and Cognition: Innovative Approaches to Global Harmonization

开发敏感和有效的阿尔茨海默病(AD)、痴呆和认知功能指标 低识字率和低收入国家具有挑战性，需要创造性的方法来补充 标准的神经心理学电池。在这项提案中，我们的目标是采用创新的方法来 评估认知，并对照标准认知电池、医疗和告密者进行验证 3例HRS姐妹APOE的评估、脑功能的MRI评估和遗传分析 国家：南非(HAALSI)、美国(HRS/COG)和爱尔兰(Tilda)。南非的经济处于低谷 老年人的识字率、不同程度的书面语言使用和不同的文化线索 与西方工业化国家相比。为了评估在这种情况下的认知，我们评估 认知功能利用对一系列认知的非语言和最小数值评估 域名。通过平板电脑给药，反应会被记录下来，并立即评分。平板电脑- 基于评估的评估将根据协调认知评估协议(HCAP)进行验证 由HRS在HAALSI、Tilda和HRS/COG制定(目标1)。来自MRI和 遗传分析提高了有效性。增加了临床和线人访谈，以开发AD和 痴呆症风险评分(目标2)。我们进行了年龄和教育分层的验证和协调 三个队列中各300名年龄在50-79岁之间的男性和女性样本(n=900)。 新的‘下一代’仪器正在开发中，我们现在需要关于他们的信息 与标准认知评估相比较的有效性。协作中的其他心理测量评估 使用Pitch(R01AG051170，Jones Pi)将有助于完善这些措施。发展人行横道 这些指标与其他常用指标之间的关系在SISTER集合中具有特别重要的意义 与健康和退休研究相关的研究，其中明确的目标是允许进行比较 跨国家，特别是在阿尔茨海默病和痴呆症方面。Tilda和HAALSI提供了特殊的优势 因为他们有来自早期波的丰富的额外的神经心理和健康数据 在受教育程度不同的老年人口中。我们的建议有两个目的： 目的1.评估牛津语言控制认知测验的效度 与使用HRS/COG、Tilda和HAALSI相同平台的HCAP措施的关系 1.a.评估牛津大学评估的内容、标准和结构效度 1.B.在心理测量分析的基础上开发一系列精细化的项目 1.C.开发一套较短和协调的项目，具有良好的心理测量特性 目标2.根据补充信息在每个国家制定一个共同的痴呆症风险评分 从代理人/告密者和临床评估中收集。这一风险评分将得到协调和验证。

Developing sensitive and valid indicators of Alzheimer's Disease (AD), dementia and cognitive function in low literacy and low income countries is challenging and requires creative approaches to complement standard neuropsychological batteries. In this proposal, we aim to incorporate an innovative approach to assessing cognition and to validate it against standard cognitive batteries, medical and informant assessments, brain function assessed from MRI's and genetic analyses of APOE in 3 HRS sister countries: South Africa (HAALSI), United States (HRS/COG), and Ireland (TILDA). South Africa has a low literacy rate in older people, varying degrees of use of written language and different cultural cues compared to Western industrialized countries. In order to assess cognition in this setting, we assess cognitive function leveraging non-verbal and minimally numeric assessments for a range of cognitive domains. Through administration via tablets, responses are recorded and scored immediately. The tablet- based assessments will be validated in relation to the Harmonized Cognitive Assessment Protocol (HCAP) developed by HRS across HAALSI, TILDA and HRS/COG (Aim 1). Additional information from MRI's and genetic analyses increase validity. Clinical and informant interviews are added to develop an AD and dementia risk score (Aim 2). We conduct the validations and harmonization in age and education stratified samples of 300 men and women 50 -79 years old in each of the three cohorts (n=900). Novel `next generation' instruments are being developed and we now need information regarding their validity compared to standard cognitive assessments. Additional psychometric evaluation in collaboration with PITCH (R01AG051170, Jones PI) will aid in refining these measures. Developing cross-walks between these measures and other commonly used indices is of special importance in the set of sister studies related to the Health and Retirement Study where the explicit goals are to permit comparisons across countries, especially with regard to AD and dementia. TILDA and HAALSI offer specific advantages in calibration because they have had rich additional neuropsychological and health data from earlier waves across an educationally diverse older population. We have two aims in our proposal: Aim 1. To assess the validity of the Oxford based language controlled cognitive measures in relation to the HCAP measures using identical platforms for HRS/COG, TILDA and HAALSI 1.a. to evaluate content, criterion and construct validity of Oxford assessments against 1.b. to develop a refined battery of items based on the psychometric analyses 1.c. to develop a shorter and harmonized set of items that have good psychometric properties Aim 2. To develop a common dementia risk score in each country based on the additional information gathered from proxy/informants and a clinical evaluation. This risk score will be harmonized and validated.