Biopsychosocial Reserves and Dementia: Identifying Protective Factors

项目概述：痴呆症的生物心理社会储备

PROJECT SUMMARY: Biopsychosocial Reserves of Dementia Dementia is a devastating neurocognitive disorder that negatively impacts independence and significantly contributes to the global mortality rate. Alzheimer’s disease, the most prevalent form of dementia, is the fifth- leading cause of death for individuals 65 years of age and older. Instances of Alzheimer’s disease and related dementias (ADRD) increase exponentially in later life and behavioral cues emerge decades prior to formal diagnosis. Greater levels of cognitive variability and accelerated cognitive decline are precursors for ADRD. Intra-individual changes in cognitive performance vary across the lifespan and by cognitive dimension. For example, crystallized abilities (culture and semantic-based abilities; i.e., verbal, procedural memory) tend to be maintained in later life whereas fluid abilities (innate aspects; i.e., response time, working memory) peak earlier in life. Building biopsychosocial reserves (i.e., physical robustness, healthy diet, social engagement, genetic factors, adequate sleep, personality) earlier in life are protective against cognitive decline. This predoctoral fellowship proposal aims to investigate the relationship between biopsychosocial reserves and ADRD through the mediating role of cognitive abilities in a longitudinal manner using data from the Honolulu- Asia Aging Study. The Honolulu-Asia Aging Study provides rich longitudinal biological and psychosocial data on 8,006 participants who were assessed for more than 45 years; participants were 45-64 years of age at baseline. Specifically, this study will determine the relationship between biopsychosocial reserves and changes in cognitive abilities. The study will also investigate the association of profiles of change in cognitive abilities and ADRD. Finally, it will establish the overall relationship between biopsychosocial reserves and ADRD through the mediating role of cognitive ability profiles over time. Each of the research aims will be evaluated through quantitative methods employing latent variable and structural equation modeling techniques. This research also serves as a mechanism to further advance the fellow’s expertise in areas of epidemiology of dementia, biological underpinnings of cognitive dysfunction, and advanced statistical methodology. This project supports the NIA’s mission and Alzheimer’s disease initiatives to understand diseases and conditions associated with growing older in order to extend healthy active years of life by employing comprehensive and longitudinal models to study cognitive health using uniquely long-lived individuals. This approach will effectively identify lifespan behaviorally-based cognitive protective factors, thus enhancing health and cognition among older adults. Results of the proposed study will contribute to the understanding of biopsychosocial reserves to promote cognitive health in later life as well as implications for developing interventions and preventions for cognitive decline.