Understanding racial/ethnic impact in the difference in cognitive performance
between NACC and a community-based cohort 
   Lead Investigator:    Cuiling Wang
   Institution      :    Albert Einstein College of Medicine
   E-Mail           :    cuiling.wang@einsteinmed.org
   Proposal ID      :    1270



   Proposal Description:
   Despite the fact that Alzheimer?s disease (AD) and dementia are a crisis facing the diverse aging population in US and the world, our understanding of the impact of ethnic and racial factors on AD and cognitive decline, the most important clinical signs of AD and dementia, remains limited. The majority of aging studies are either clinic or community based, and it is known that these two kinds of populations are different in many aspects. The Uniform Data Set (UDS) have been collected from over 30 US Alzheimer???s Disease Centers (ADC) by the University of Washington?s National Alzheimer?s Coordinating Center (NACC) since 2005. Many community-based aging studies also collected UDS data, including the Einstein Aging Study (EAS). In preliminary studies, we observed significant differences in some cognitive tests included in the UDS between the NACC and EAS samples. The EAS cohort is a diverse sample in term of race/ethnicity, with higher proportions of African Americans and Hispanics than the NACC. We are requesting the complete NACC UDS data to primarily investigate the role of race/ethnicity in the differential performance in UDS between the NACC and EAS cohorts. The effect of race/ethnicity in the association between pre-mordem cognitive performance and post-mordem neuropathology will also be investigated. Findings from this  project will help improve the understanding of the role of race/ethnicity in cognitive performance in both clinic and community-based cohorts, and have the potential of informing public health practice and policy making.                                                        Specific Aims:    Aim 1:  To evaluate the UDS cognitive performance measures at baseline and cognitive trajectory during follow-up in association with race/ethnicity in the NACC database and in the Einstein Aging Study (EAS), a community based cohort study, adjusting for age, education, sex, depression, ApoE genotype and other covariates.    Hypothesis 1.1. There are diffe