ANALYSIS CORE ABSTRACT American Indians/Alaska Natives (AI/ANs) and Native Hawaiians/Pacific Islanders (NHPIs) have a high prevalence of risk factors for Alzheimer?s disease and related dementias (ADRD), including vascular brain injury and other cognitive impairments. Yet we have limited data on ADRD in AI/ANs and NHPIs; even reliable prevalence estimates are lacking. One barrier to remediating this lack of knowledge is the fact that existing methods and measures for identifying, diagnosing, and evaluating ADRD are often inappropriate for use with these populations, which experience unique social, cultural, and environmental influences on ADRD. Most available studies on ADRD contain far too few members of these populations to permit meaningful analysis of distinct population subgroups. Therefore, we will conduct studies with AI/AN and NHPI cohorts and datasets using methods and instruments that yield accurate, reliable data on topics relevant to ADRD. The Native Alzheimer?s Disease-related Resource Center in Minority Aging Research (RCMAR) emphasizes health disparities and ADRD as the focus of Pilot Studies led by early- or mid-career investigators RCMAR Scientists that will provide the experience and mentorship they need to contribute to a rapid expansion of the scope and quality of ADRD research with AI/ANs and NHPIs. The goal of the Analysis Core is to optimize the quality of Pilot Studies conducted by RCMAR Scientists. We draw on 20 years of experience with the Native Elder Research Center RCMAR, which is jointly run by the University of Colorado and Washington State University. We also benefit from collaborative relationships with investigators from Alzheimer?s Disease Centers. This Core will ensure that Pilot Studies make efficient use of study resources, apply methods that optimize validity, and yield findings with clear and meaningful inference to the larger population of interest. We will integrate diverse methods from epidemiology, biostatistics, health economics, health services and policy, and health outcomes research, and we will augment our robust quantitative capacity with exceptional experience in qualitative methods specific to underrepresented minority communities. Thus, the Specific Aims of the Analysis Core are to: 1) Collaborate with the Research Education Component to develop and implement methods to optimize the validity, inference, and generalizability of Pilot Studies and future funding applications; 2) Provide structured support and formal didactic instruction to RCMAR Scientists; and 3) Develop and critically evaluate a catalog of datasets containing information on the health of AI/ANs and NHPIs that can used by RCMAR Scientists and future ADRD Investigators. If ADRD is as prevalent in these groups as in Whites, we would expect more than 78,800 elderly AI/ANs and 18,000 elderly NHPIs to be affected. The size of this at-risk population underscores the substantial public health importance of the program we propose. Therefore, the work of the Analysis Core will maximize scientific rigor while accommodating the logistical and methodological challenges that not infrequently arise in real-world research with underrepresented communities.
