Education and the Life-Course Pathways of Cognitive Impairment, Dementia, and Cognitive Decline in the United States and Mexico

项目总结 建议研究的目的是描述和跨国比较生命历程。 美国影响认知、认知障碍、痴呆症和认知衰退的途径 墨西哥。这位私人侦探约瑟夫·萨恩兹博士在德克萨斯大学获得了人口健康科学博士学位。 他在医学部接受流行病学和流行病学方法方面的培训。Saenz博士已经 在研究墨西哥的健康差异和美国的墨西哥裔人口方面有丰富的经验 各州。约瑟夫目前是加州大学戴维斯老年学学院的博士后研究员。 在南加州大学，他开始研究这些人群的认知能力。拟议中的培训 将加强PI对认知测量的理解，并使他接触到 认知老化在不同的学科中使用，包括人口学，心理学， 神经心理学和生物学。教育是认知功能的强烈预测因素，认知障碍 无痴呆症(CIND)，晚年痴呆。教育可能影响认知障碍的临床表现 通过影响大脑结构的强度和结构直接发挥作用，并通过提供更多的 认知储备，以补偿大脑中的病理变化。然而，教育也可能会影响 通过间接途径的认知，包括职业、收入、财富、医疗保健途径和慢性疾病 条件。考虑到美国和墨西哥的老龄化，了解这些途径具有非常重要的意义 以及认知障碍的社会和经济代价。因为衰老是一个生命过程 这发生在更大的背景下，重要的是考虑更大的人口、经济和政治 在整个生命过程中，不同国家的环境会影响认知的发展和衰退。此外，通过 认识到这些不同的背景，未来的工作可能会设计和实施认知干预 更准确地迎合了它们所适用的背景。这些结果也揭示了 发展中国家和发达国家的认知老龄化。虽然墨西哥的老龄化研究(墨西哥健康 和老龄化研究)和美国(健康和退休研究)使用了不同的认知测量方法 用于测量和分类正常认知、CIND和痴呆的功能和方法，建议 研究利用新收集的认知功能协调评估来开发 可比较的认知测量和对CIND和痴呆症的定义。我会调查直接和 在整个生命过程中，教育影响认知功能的间接途径， 使用多项概率回归模型、生长曲线模型、 以及线性回归模型，将CIND和痴呆症、认知衰退和认知功能作为 贯穿整个生命过程的变量的函数。南加州大学是接受必要的培训的理想地点 建议考虑到老年学中心的多学科性质，全球老龄化研究，重点是认知 和痴呆症，以及提供课程作业和来自人口学、心理学和 临床心理学。这项培训还将使PI开始独立的研究生涯，并 在教职岗位上提交一份成功的R01提案。

PROJECT SUMMARY The purpose of the proposed research is to describe and cross-nationally compare the life-course pathways affecting cognition, cognitive impairment, dementia, and cognitive decline in the United States and Mexico. The PI, Dr. Joseph Saenz, received his Ph.D. in Population Health Science at the University of Texas Medical Branch where he received training in epidemiology and epidemiologic methods. Dr. Saenz has extensive experience studying health disparities in Mexico and the Mexican origin population in the United States. Joseph is currently a postdoctoral fellow at the Davis School of Gerontology at the University of Southern California (USC) where he has begun to study cognition in these populations. The proposed training will enhance the PI’s understanding of the measurement of cognition, and expose him to the approaches to cognitive aging used across various academic disciplines including demography, psychology, neuropsychology, and biology. Education is a strong predictor of cognitive function, cognitive impairment without dementia (CIND), and dementia in late life. Education may affect the clinical manifestation of cognitive functioning directly by impacting the strength and structure of brain structures and by providing greater cognitive reserve to compensate for pathological changes in the brain. However, education may also affect cognition via indirect pathways including occupation, income, wealth, healthcare access, and chronic conditions. Understanding these pathways is highly significant given the aging of the U.S. and Mexican populations and the social and economic costs of cognitive impairment. Because aging is a life-course process that occurs within larger contexts, it is important to consider how larger demographic, economic, and political contexts across countries influence cognitive development and decline throughout the life-course. Further, by acknowledging these differing contexts, future work may design and implement cognitive interventions that are more precisely catered to the context in which they are applied. These results also shed light on differences in cognitive aging across developing and developed countries. While studies of aging in Mexico (Mexican Health and Aging Study) and the U.S. (Health and Retirement Study) have used differing measures of cognitive functioning and methods for measuring and classifying normal cognition, CIND, and dementia, the proposed research makes use of newly collected harmonized assessments of cognitive functioning to develop comparable measures of cognition and definitions of CIND and dementia. I will investigate the direct and indirect pathways throughout the life-course through which education affects cognitive functioning, CIND, dementia, and cognitive decline in late life using multinomial probit regression models, growth curve models, and linear regression models to model CIND and dementia, cognitive decline, and cognitive function as a function of variables spanning the life-course. USC is an ideal location to receive the training necessary for the proposal given the multidisciplinary nature of the gerontology center, global study of aging, focus on cognition and dementia, and availability of coursework and mentorship from leaders in demography, psychology, and clinical psychology. This training will also position the PI to begin an independent research career and to submit a successful R01 proposal in a faculty position.