The project will develop foundations for investigating important questions on Alzheimer's Disease and Related Dementia (ADRD) in different context from current HRS International Sister Studies in various respects (e.g., aging, education, income) by expanding the existing Population Aging Research Center (PARC) P30 grant (that does not cover ADRD). It will expand the Latin American Network on Aging (LANA) in Core C on External Innovative Networks, to develop an ADRD-focus through building on long LANA relations and ~15 years of Chilean longitudinal data. LANA has engaged extensively with the Centro de Encuestas y Estudios Longitudinales (CEEL) de Universidad Catolica de Chile (Center of Surveys and Longitudinal Studies) on Chilean Social Protection Surveys (SPS). The SPS originated in 2002, with instruments based on the HRS and the Mexican MHAS, in collaboration with PARC/LANA and a PARC Associate's NIA RO1. The SPS is a stratified random national longitudinal sample of ~20,000 adults 18+ years old, with six follow-ups, and basic funding from the Chilean government and supplementary funding from a NIA R01 and the Inter-American Development Bank. Because of increasing interest in mental and physical health and other issues related to the rapidly-aging Chilean population, the Chilean government supported CEEL to undertake an additional survey on 2,523 SPS sample members 60+ years (SPS-60+) in 2017-18. This survey obtained broad information on mental and physical health and other sociodemographic variables, including reports on diagnoses of ADRD and other diseases associated with aging and Mini-Mental examination performance. These data can be linked to six previous SPS data rounds to permit rich characterization of life-cycle paths over ~15 years prior to the SPS-60+, and thus of precursors and predictors of mental and physical health reported in the SPS-60+. The Chilean government is committed to further longitudinal data collection, next being the 2019-20 SPS. The project has three specific aims: (SA1) To expand data from stratified random samples of the SPS-60+ for investigating ADRD in the SPS- 60+ by applying the Harmonized Cognitive Assessment Protocol (HCAP) and collecting saliva to permit identification of the ApoE4 gene that is associated with AD and to store for future analysis; (SA2) To validate HCAP with clinical assessments in a random subsample of SPS-60+ used in SA1; and (SA3) To link the SPS- 60+.data to the previous SPS rounds, and examine the precursors and correlates of ADRD diagnosis, Mini- Mental test performance, HCAP, and extent of validation of HCAP, as well as associations among these various measures. This project is a low-cost, high-scientific value for future comparative harmonized studies with HRS International Sister Studies for the unique Chilean population with its rapidly-aging and relatively-educated population and other distinct characteristics in comparison with other Latin American countries and the linkage to six rounds of SPS data since 2002. The international and interdisciplinary project team has considerable expertise on Chile, aging, ADRD, HCAP, biomarkers and population-level health and aging analyses.
FOR PUBLIC HEALTH: Alzheimer's Disease and Related Dementia (ADRD) are spreading rapidly and are a major public health concern. This project will lay the foundations for investigation of ADRD in a distinctive context, Chile, with its relatively high proportion of aging persons, particular policy concern about ADRD, and unusually rich longitudinal data over ~15 years so far and committed for the future ? which presents a rich and unique opportunity for extending the possible comparative harmonized analyses of the HRS International Sister Studies.
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