Projections that 9 million people in the US will be diagnosed with AD by the year 2050 is staggering;even more daunting are estimates that China will have 34 million AD cases by the year 2025. The inextricable links between the U.S. and China ensure that what effects China will affect the US. With China still largely unaware of AD or other types of dementia as neurologic disorders, this lack of knowledge will prevent potential prevention/treatment strategies that can abate the costs that are certain to rise. The Framingham Heart Study (FHS) estimates that delaying the onset of disease by 5 years will reduce a person's risk of disease by 50%, but China is not sufficiently knowledgeable to take steps to reduce risk of disease. FHS has been conducting epidemiological study of mild cognitive impairment (MCI, a prodromal stage of AD) and AD and dementia for decades. The goal of this pilot grant entitled """"""""Epidemiology of Mild Cognitive Impairment and Dementia in China"""""""", is to model FHS'methods for studying prevalent and incident dementia in establishing a similar cohort study in China. We propose to implement the test protocol in both rural and urban areas of Guangzhou and Guangxi provinces in China. Methods include administering a health examination that will measure known and novel risk factors that have been previously linked to increase risk of MCI and AD, as well as a neuropsychological test battery to determine baseline cognitive status. Surveillance techniques for identifying prevalent dementia and tracking incident cases longitudinally will also be established. Current prevalence and incidence studies of dementia in China suggest that rates of AD/dementia are lower in China than in the US, but methodological variations limit generability of these findings. Further, with a rapidly growing elderly population in China, incidence rates of dementia have increased in recent years compared to the previous decade. Understanding the pattern of dementia among the Chinese and associated factors would help design effective intervention programs. Further, the long term implications of comparative studies will be opportunities to gain insight into the environmental x gene interactions that underlie a complex disease such as AD. The proposed study will lay the groundwork for a full-implementation study in China and may also help stimulate further Chinese research in AD and dementia.

Public Health Relevance

The proposed pilot study, Epidemiology of Mild Cognitive Impairment and Dementia in China, seeks to establish a cohort study to identify prevalent and incident cases of mild cognitive impairment (MCI) and Alzheimer's disease (AD) and other types of dementia in rural an urban regions of southern China. Modeled after the Framingham Heart Study's studies of preclinical and clinical dementia, the long-term aims are to determine risk factors and biomarkers linked to increased risk of MCI, AD and other dementia subtypes within the Chinese population. The establishment of this cohort study will greatly enhance the understanding of AD/dementia in China, as well as provide important comparative data for identifying the role that environment and genes play in development of dementing illnesses. .

National Institute of Health (NIH)
Fogarty International Center (FIC)
Exploratory/Developmental Grants (R21)
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Special Emphasis Panel (ZRG1-ICP2-B (51))
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Michels, Kathleen M
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Boston University
Schools of Medicine
United States
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