08/11-07/16
Type: 1R01AG039330-01
Principal Investigator: J. Verghese
Agency: National Institute on Aging, Fogarty International Center
Abstract
The goal of the Kerala Einstein study is to foster collaborative research to study risk factors for cognitive decline among older adults living in the southern Indian state of Kerala. Our research sites are the cities of Kozhikode and Thiruvananthapuram in Kerala state. The proposal will be directed by Dr Verghese, a neurologist at the Albert Einstein College of Medicine and a native of Kerala in collaboration with Dr. Mathuranath, Director, Division of Behavioral Neurology at the Sri Chitra Tirunal Institute, Thiruvananthapuram, one of India’s premier postgraduate medical institutes.
Sociodemographic changes in Kerala in recent decades have created major lifestyle changes that have resulted in a cardiovascular disease epidemic as well as increased risk for dementia. We propose to examine the role of three potentially modifiable healthy lifestyle variables (diet, physical activity, and social networks) of high relevance to India that may prevent cognitive decline via their effects on cardiovascular, stress, inflammation, and other pathways in 1700 older adults participating in our longitudinal cohort study in Thiruvananthapuram over a two-year follow-up period (Aim 1). Cardiovascular disease causes both macrovascular (strokes) and microvascular brain damage that may contribute to cognitive decline. However, the role of microvascular disease (microbleeds, lacunar infarctions and leukoariaosis) in dementia is not well defined. Hence, we also propose to conduct a neuroimaging substudy to identify the behavioral correlates of microvascular disease in 75 subjects with amnestic Mid Cognitive Impairment syndrome and 150 healthy controls (Aim 2).
Defining role of healthy lifestyle factors and microvascular disease in Kerala may also help in understanding the parallel epidemic of cardiovascular disease and dementia in immigrant and minority populations who comprise a third of the US population.
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