Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin at Madison, School of Medicine and Public Health, Madison, WI, USA.
Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
J Alzheimers Dis. 2021;81(2):751-768. doi: 10.3233/JAD-201422.
There is growing consensus that non-genetic determinants of dementia can be linked to various risk- and resiliency-enhancing factors accumulating throughout the lifespan, including socioeconomic conditions, early life experiences, educational attainment, lifestyle behaviors, and physical/mental health. Yet, the causal impact of these diverse factors on dementia risk remain poorly understood due to few longitudinal studies prospectively characterizing these influences across the lifespan.
The Initial Lifespan's Impact on Alzheimer's Disease and Related Dementia (ILIAD) study aims to characterize dementia prevalence in the Wisconsin Longitudinal Study (WLS), a 60-year longitudinal study documenting life course trajectories of educational, family, occupational, psychological, cognitive, and health measures.
Participants are surveyed using the modified Telephone Interview for Cognitive Status (TICS-m) to identify dementia risk. Those scoring below cutoff undergo home-based neuropsychological, physical/neurological, and functional assessments. Dementia diagnosis is determined by consensus panel and merged with existing WLS data for combined analysis.
Preliminary findings demonstrate the initial success of the ILIAD protocol in detecting dementia prevalence in the WLS. Increasing age, hearing issues, lower IQ, male sex, APOE4 positivity, and a steeper annualized rate of memory decline assessed in the prior two study waves, all increased likelihood of falling below the TICS-m cutoff for dementia risk. TICS-m scores significantly correlated with standard neuropsychological performance and functional outcomes.
We provide an overview of the WLS study, describe existing key lifespan variables relevant to studies of dementia and cognitive aging, detail the current WLS-ILIAD study protocol, and provide a first glimpse of preliminary study findings.
越来越多的共识认为,痴呆症的非遗传决定因素可以与各种风险和增强弹性的因素联系起来,这些因素贯穿整个生命周期,包括社会经济状况、早期生活经历、教育程度、生活方式行为以及身心健康。然而,由于很少有前瞻性研究在整个生命周期内对这些影响进行特征描述,因此这些因素对痴呆症风险的因果影响仍知之甚少。
初始寿命对阿尔茨海默病和相关痴呆症的影响(ILIAD)研究旨在描述威斯康星纵向研究(WLS)中的痴呆症患病率,该研究是一项 60 年的纵向研究,记录了教育、家庭、职业、心理、认知和健康措施的生命历程轨迹。
使用改良的电话认知状态测试(TICS-m)对参与者进行调查,以确定痴呆症风险。得分低于截止值的人接受家庭为基础的神经心理、身体/神经和功能评估。痴呆症诊断由共识小组确定,并与现有的 WLS 数据合并进行综合分析。
初步研究结果表明,ILIAD 方案在 WLS 中检测痴呆症患病率的最初成功。年龄增长、听力问题、较低的智商、男性、APOE4 阳性、以及在前两个研究波中评估的记忆衰退年化率增加,所有这些都增加了低于 TICS-m 痴呆症风险截止值的可能性。TICS-m 得分与标准神经心理表现和功能结果显著相关。
我们提供了 WLS 研究的概述,描述了与痴呆症和认知老化研究相关的现有关键寿命变量,详细介绍了当前的 WLS-ILIAD 研究方案,并提供了初步研究结果的第一印象。