Natives Engaged in Alzheimer's Research

总体：摘要 美国印第安人/阿拉斯加原住民(AI/ANS)和夏威夷原住民和太平洋岛民(NHPI)越来越多 关注阿尔茨海默病和相关的痴呆症，因为这些情况很快就会产生重大影响 在他们的社区。尽管AI/ANS和NHPI都有较高的ADRD风险因素，包括 高血压和2型糖尿病，在过去的5年中，他们的预期寿命提高了多达30年 几十年，导致其人口中65岁以上的人口比例增加了两倍。不幸的是，医疗保健 服务于AI/ANS和NHPI的系统没有为相关的临床、社会和经济负担做好准备 和ADRD在一起。参与阿尔茨海默氏症研究中心的原住民将是唯一一个包括AI/ANS或 自1984年国家老龄研究所开始对P01进行编目以来，夏威夷原住民就一直在为P01进行分类。总部设在华盛顿 州立大学，与迈阿密大学、杨百翰大学和其他几个专业的合作者 大学，以及AI/AN和NHPI社区合作伙伴，我们将创建一个创新计划，以 了解、干预和缓解我们的重点人群所经历的与ADRD相关的健康差距。 我们的3个研究项目将由行政、研究方法、招聘和聘用、 和Biosecimen核心。该中心还将建立一个由土著研究人员领导的8个卫星中心网络 这涵盖了90%的人工智能/AN和NHPI所在的地区。这些卫星中心将确保我们的工作 我们的传播努力是全国性的，有助于创建准备进行研究的队列。该中心将 联合社会、临床和行为科学领域的学者。值得注意的是，12名AI/AN或NH/PI专业人员 承诺以调查人员或顾问的身份参与。因此，我们的具体目标是：1)在一个群体中- 随机试验，测试文化知识提供者培训和“痴呆症友好型诊所”的有效性 ADRD伴轻度认知障碍的AI/AN患者的检测和适当处理的干预 至少20家为人工智能/ANS提供服务的城市和农村诊所的损害；2)在一项分组随机对照试验中 呼啦圈干预对主观性认知障碍老年患者认知功能下降的预防作用 夏威夷群岛的障碍或轻度认知障碍；3)在一项观察性研究中，在 2个阻塞性睡眠呼吸暂停和认知障碍远程预约社区，然后进行 随机对照试验，测试改善睡眠呼吸暂停治疗依从性的干预措施 或保护认知功能；4)从唾液样本中提取基因DNA，对基因频率进行分类 ADRD风险标记，并使用2700+AI/ANS中的生物样本计算ADRD的多基因风险分数 和NHPI；以及5)创建创新的P01，以了解、干预和缓解以下方面的ADRD差距 AI/ANS和NHPI。我们的领导力、资源和经验提供了前所未有的机会 国家老龄研究所对代表不足的少数群体的研究优先事项，如《国家老龄问题研究报告》所述 计划解决阿尔茨海默氏症，并直接回应其对使科学劳动力多样化的兴趣。

OVERALL: ABSTRACT American Indians/Alaska Natives (AI/ANs) and Native Hawaiians and Pacific Islanders (NHPIs) are increasingly concerned about Alzheimer’s disease and related dementias, as these conditions will soon have a major impact on their communities. Although AI/ANs and NHPIs share a high prevalence of ADRD risk factors, including hypertension and type 2 diabetes, their life expectancies have improved by as much as 30 years over the last 5 decades, resulting in a tripling of their populations’ share of people ages 65+. Unfortunately, the healthcare systems that serve AI/ANs and NHPIs are unprepared for the clinical, social, and economic, burdens associated with ADRD. The Natives Engaged in Alzheimer’s Research Center will be the only P01 to include AI/ANs or Native Hawaiians since the National Institute on Aging started cataloging P01s in 1984. Based at Washington State University, with collaborators at the University of Miami, Brigham Young University, and several other major universities, as well as with AI/AN and NHPI community partners, we will create an innovative program to understand, intervene on, and mitigate ADRD-related health disparities experienced by our priority populations. Our 3 Research Projects will be supported by Administrative, Research Methods, Recruitment and Engagement, and Biospecimen Cores. The Center will also feature a network of 8 Satellite Centers led by Native researchers that encompass areas where 90% of AI/ANs and NHPIs reside. These Satellite Centers will ensure that our work and our dissemination efforts are national in scope and help to create research-ready cohorts. The Center will unite scholars across social, clinical, and behavioral sciences. Notably, 12 AI/AN or NH/PI professionals have committed to participate as Investigators or Consultants. Thus, our Specific Aims are to: 1) In a group- randomized trial, test the effectiveness of a culturally informed provider training and “dementia-friendly clinic” intervention for detection and appropriate management of AI/AN patients with ADRD and mild cognitive impairment in at least 20 urban and rural clinics serving AI/ANs; 2) In a group-randomized controlled trial, test the effectiveness of a Hula intervention for preventing cognitive decline in NHPI elders with subjective cognitive impairments or mild cognitive impairment in the Hawaiian Islands; 3) In an observational study, screen AIs in 2 remote reservation communities for obstructive sleep apnea and cognitive impairment, then conduct a randomized controlled trial to test an intervention to improve adherence to sleep apnea treatment for improving or preserving cognitive function; 4) Genotype DNA from saliva samples, catalog the frequency of genetic markers for ADRD risk, and calculate polygenic risk scores for ADRD using biospecimens from 2,700+ AI/ANs and NHPIs; and 5) Create an innovative P01 to understand, intervene on, and mitigate ADRD disparities in AI/ANs and NHPIs. Our leadership, resources, and experience offer an unprecedented opportunity to address the National Institute on Aging’s research priorities for underrepresented minorities, as articulated in the National Plan to Address Alzheimer's Disease, and to respond directly to its interest in diversifying the scientific workforce.