Leveraging Longitudinal Data and Informatics Technology to Understand the Role of Bilingualism in Cognitive Resilience, Aging and Dementia

项目摘要 阿尔茨海默病和相关痴呆（ADRD）沿着其他年龄相关的 神经退行性疾病导致老年人口的显著发病率和成本 国际吧这一领域的进展已经发现，双语是一种保护因素， 延迟ADRD的发作，并可能增强认知储备。尽管如此，人们对 双语对认知储备和ADRD进展的直接影响;多重，纠缠 混杂的变量，如生活方式和心理弹性，使关系复杂化 双语和认知之间的关系，值得进一步研究。其他主要缺点 在以前的研究中，包括样本量小，缺乏人口多样性和数据不足， 相关协变量。我们的目标是通过以下具体目标来解决这些关键差距。 在目标1中，我们将利用先进的信息学和纵向电子健康记录（EHR） 来自三个地理上和人口统计学上不同的地点的数百万患者（即，MGB [Boston，MA]、UTHealth [Houston，TX]和UC Davis [萨克拉门托，CA]）。我们将大力发展 算法来识别潜在的单语和双语群体及其表型。我们将 传播可复制的信息学方法，以支持跨机构的研究。 在目标2中，我们将进行一项前瞻性队列研究，以评估动态认知变化 在单语和双语老年人中。我们将探索双语教育的潜在途径 随着时间的推移，使用综合工具和调查反复影响认知能力下降， 测量认知弹性，认知储备和相关因素，包括社会支持， 心理韧性和身体活动。 在目标3中，我们将开发和验证机器学习算法，以识别与年龄相关的发病率。 认知能力下降和痴呆症。我们将应用经过验证的语言分类器 为所有参与EHR系统，以检查双语关系的进展的作用， 认知能力下降和EHR数据中记录的其他因素的影响。 通过整合多学科探讨双语对认知储备的影响， 这一拟议设计将解决这一领域的主要差距和挑战。这样的研究有 有可能改变目前对神经和行为通路的理解， 语言、文化和环境。此外，获得的知识可以转化为 ADRD的现有干预措施和新治疗方法的改进。

Project Summary Alzheimer’s Disease and Related Dementias (ADRD) along with other age-related neurodegenerative diseases contribute to significant morbidity and costs for the aging population worldwide. Advances in this field have uncovered that bilingualism is a protective factor that delays onset of ADRD and may enhance cognitive reserve. Still, little is clearly known about the direct impact of bilingualism on cognitive reserve and ADRD progression; multiple, entangled confounding variables, such as lifestyle and psychological resilience, complicate the relationship between bilingualism and cognition and warrant further investigation. Other major shortcomings in previous studies include small sample size, lack of population diversity and insufficient data on relevant covariates. We aim to address these critical gaps via the following specific aims. In Aim 1, we will leverage advanced informatics and longitudinal electronic health records (EHRs) from millions of patients across three geographically and demographically diverse sites (i.e., MGB [Boston, MA], UTHealth [Houston, TX], and UC Davis [Sacramento, CA]). We will develop robust algorithms to identify potential monolingual and bilingual cohorts and their phenotypes. We will disseminate reproducible informatics methods to support research cross-institutionally. In Aim 2, we will conduct a prospective cohort study to evaluate the dynamic cognitive changes in monolingual and bilingual older adults. We will explore potential pathways by which bilingualism impacts cognitive decline over time using comprehensive instruments and surveys to repeatedly measure cognitive resilience, cognitive reserve, and related factors, including social support, psychological resilience, and physical activity. In Aim 3, we will develop and validate machine learning algorithms to identify onset of age-related cognitive decline and dementia using EHR data. We will apply the validated language classifier for all participating EHR systems to examine the role of bilingualism in relation to the progression of cognitive decline and the effect of other factors recorded in EHR data. By integrating multiple disciplines to explore the influence of bilingualism on cognitive reserve, this proposed design will address major gaps and challenges in this field. Such research has the potential to transform the current understanding of neural and behavioral pathways in relation to language, culture, and environment. Furthermore, the knowledge gained may translate to improvements in existing interventions and novel therapeutic approaches for ADRD.