Alzheimer's Disease and Related Dementias (ADRD) in a Developing Country: Expanding the Sample to Give More Power for Collecting and Validating Harmonized Cognitive Assessment Protocol (HCAP) and Examining Its Precursors and Correlates

Aims: 

The proposed project will help establish foundations for investigating important questions on Alzheimer’s Disease and Related Dementia (ADRD) in Chile, a context different from the current Health and Retirement Study (HRS) International Sister Studies. The proposed project will supplement data being collected under an existing PARC Administrative Supplement (AS) for investigating ADRD in Chile. The proposed project will add 250 additional respondents to this data collection. The Centro de Encuestas y Estudios Longitudinales (CEEL) de Universidad Catolica de Chile has funds to cover another 700 and we are also seeking additional funds from multiple sources to reach a sample size of 2,523 (all those in SPS-60+, see below). The data will be collected from a subsample of the Chilean Social Protection Survey (SPS), which is a stratified random national longitudinal sample of ~20,000 adults 18+ years old originating in 2002, with six follow-ups. Moreover, the Chilean government is committed to further rounds of longitudinal data collection, the next being the 2019 SPS. In 2017-2018, the government funded an additional survey of 2,523 SPS respondents aged 60+ (SPS-60+). This survey obtained information on mental and physical health, including reported diagnoses of ADRD, other diseases associated with aging and the Mini-Mental examination as well as sociodemographic information. These data can be linked to 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+. PARC’s Latin American Network on Aging (LANA) has collaborated for over 15 years with CEEL (Director: Bravo) on the SPS. The SPS originated under the leadership of Bravo and facilitated by PARC Associates Behrman (LANA Head), Mitchell (co-PI on HRS), Soldo (then PI for PARC and MHAS), and Todd (PI on NIA Award to help develop and analyze earlier rounds of the SPS). In 2018, Elo (PI), Behrman and Bravo competed successfully for a P30 Administrative Supplement with the following 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); SA2) To validate HCAP with clinical assessments; 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. The proposed project is low-cost and has high-scientific value for future comparative harmonized studies with HRS International Sister Studies for the unique Chilean population. Next steps include developing a further AS to PARC to link the SPS with the harmonized HRS family of projects in the Gateway to Global Aging Data and to develop a NIA application for in-depth analysis of the SPS and HCAP.

Abstract: 

The project will expand data to be collected under an existing PARC Administrative Supplement (AS) for investigating Alzheimer’s Disease and Related Dementia (ADRD) in a context different from current HRS International Sister Studies. The PARC AS will cover adding the Harmonized Cognitive Assessment Protocol (HCAP) for 1000 respondents to the ongoing Chilean Social Protection Survey (SPS). The Quartet project will cover 250 additional respondents. The SPS is a stratified random national longitudinal sample of ~20,000 adults 18+ years old originating in 2002, with six follow-ups. Because of increasing interest in mental and physical health and impacts of pensions on the well-being of the rapidly-aging Chilean population, the government funded an additional survey of 2,523 SPS sample members 60+ years (SPS-60+) in 2017-8. This survey obtained broad information on mental and physical health and other sociodemographic variables, including reported diagnoses of ADRD and other diseases associated with aging and Mini-Mental test performance. These data can be linked to 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 government is committed to further longitudinal data collection, next the 2019 SPS. Our goal is to obtain funding to cover the 2,523 SPS-60+ sample members. The Centro de Encuestas y Estudios Longitudinales (CEEL) de Universidad Catolica de Chile has funds to cover another 700 and we are seeking additional funds from multiple sources to cover the rest. This overall project and reaching the full sample size has multiple benefits. First, it will expand the PARC Latin American Network on Aging (LANA) by developing an ADRD-focus through building on long LANA relations with CEEL and ~17 years of longitudinal data. Second, the larger sample will allow for more detailed analyses of the determinants of cognition and comparison with the Mexican Health and Aging Study (MHAS) and other surveys using the HCAP. Third, a successful implementation of the HCAP will help facilitate the integration of the SPS to the Gateway to Global Aging Data (GGAD), which is a public resource designed to facilitate cross-national and longitudinal studies on aging using HRS-like studies around the world. The overall combined project has three specific aims: (SA1) To expand data from the SPS-60+ for investigating ADRD by applying HCAP; (SA2) To validate HCAP by comparison with clinical assessments; and (SA3) To link the SPS-60+.data to the SPS rounds, and examine the precursors and correlates of ADRD diagnosis, Mini-Mental test performance, and HCAP, as well as associations among these measures. This project is a low-cost, highscientific value for future comparative harmonized studies with HRS International Sister Studies for the unique Chilean population. Next steps will include developing a further AS to PARC to link the SPS with the harmonized HRS family of projects in the GGDA and to develop a NIA application for in-depth analysis of the SPS and HCAP.

Funded By: 
Boettner
Award Dates: 
August 1, 2019 - June 30, 2020