Ongoing research in our center in Northern Manhattan has consistently shown that the prevalence and incidence of cognitive impairment and dementia are greater among older Caribbean Hispanics, predominantly from Dominican Republic, than among Caucasians. Despite the consistency of this observation, the causes for this health disparity remain elusive. Individuals from low and middle income countries, such as Dominican Republic, may be at increased risk because of the interacting influences of socioeconomic factors, unique genetic risk factors, and high representation of cerebrovascular disease. The proposed work, in response to PAR-11-031, Brain disorders in the developing world: Research across the lifespan, seeks ultimately to understand the sources of this disparity by building a collaboration with investigators in Santiago, Dominican Republic to integrate high resolution magnetic resonance imaging (MRI) into ongoing genetic studies of cognitive aging. Magnetic resonance imaging can be used to quantify small and large cerebrovascular disease (e.g., infarct, white matter hyperintensities, microbleeds) and to examine markers of neurodegeneration (e.g., hippocampus atrophy). The Estudio Familiar de Influencia Genetica de Alzheimer (EFIGA;NIH R37 AG015473 PI: R. Mayeux) [Family Study of the Genetic Influence of Alzheimer's Disease] is a large scale longitudinal genetic study of Alzheimer's disease (AD) comprising individuals with and without AD from families with and without strong histories of the disease;there are over 4,500 active older adult participants, over 2,700 of whom reside in in Santiago. Our proposed pilot study will collect MRI scans in Santiago on 70 active participants from EFIGA and integrate MRI data with clinical and genetic data collected as part of the parent project. We will explore the relationships of markers of cerebrovascular disease and neurodegeneration with demographic factors, cognitive function/diagnosis, and genetics. We will establish feasibility and pilot data for a prospective, large-scale MRI project of cognitive aging and genetics, carried out in Santiago. As part of the efforts proposed here, we will work towards establishing the local capacity to acquire standardized MRI data and carry out MRI analysis for research involving older adults. Finally, we aim to introduce formal and informal training opportunities on interdisciplinary cognitive aging research via clinical preceptorship, formal didactics, ongoing active collaboration, and a symposium. The proposed project will result in a strong collaboration poised to uncover sources of disparities of cognitive aging among Caribbean Hispanics.
Suboptimal cognitive aging is becoming a true pandemic, particularly in Latin America, where the prevalence of dementia is the highest globally. The proposed project will integrate magnetic resonance imaging into ongoing studies of cognitive aging in Santiago, Dominican Republic, with the ultimate goal of understanding what factors contribute to health disparities in cognitive impairment among Caribbean Hispanics. Integration of neuroimaging into studies of cognitive aging may improve cognitive outcomes in an aging population through the identification of novel and specific treatment targets for intervention and prevention.
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|Brickman, Adam M; Schupf, Nicole; Manly, Jennifer J et al. (2014) APOE ?4 and risk for Alzheimer's disease: do regionally distributed white matter hyperintensities play a role? Alzheimers Dement 10:619-29|
|Brickman, Adam M (2013) Contemplating Alzheimer's disease and the contribution of white matter hyperintensities. Curr Neurol Neurosci Rep 13:415|