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Lenore J. Launer, Ph.D., Senior Investigator Chief, Neuroepidemiology Section Laboratory of Epidemiology, Demography, and Biometry E-mail: launerl@nia.nih.gov |
Biography: Dr. Launer received her Ph.D. in epidemiology and nutrition from Cornell University. From 1990 to 1999 she held academic appointments in the Netherlands (Erasmus University Medical School, Free University, National Institute for Public Health) where she collaborated in many epidemiologic studies of neurologic diseases including dementia and migraine headache. Dr. Launer joined NIA as Chief of the Neuroepidemiology Section in February 1999. |
Research Overview: Studies in the Neuroepidemiology Section focus on understanding the contribution of genetic, inflammatory, metabolic, vascular, and hormonal factors to sub-clinical and clinical outcomes in brain disease and investigating the links between brain disease and other common diseases of old age. Research is conducted using large epidemiologic studies, which allow us to test in the general population, hypotheses on risk/protective factors and mechanisms identified at a more basic science level. |
Vascular Factors and AD: Main research interests have focused on the role of vascular factors in brain disease. Genetic epidemiologic studies suggest the known mutations in amyloid processing, tau genes and alpha synucleins hypothesized to play a role in neurodegenerative processes, do not explain the great majority of dementia cases in the general population. These dementias are likely the result of an interaction between environmental factors and multiple genes that make small contributions to processes leading to neurodegeneration. The contribution of modifiable and genetic vascular factors to these dementias is not known. Vascular factors can contribute to neurodegeneration or lead to co-morbidity that increases the severity of dementia. Vascular factors may influence different stages of the dementing process. To this end, several studies have been conducted to examine the relation of vascular factors to different anatomical and functional markers of brain disease including: memory and executive domains of cognitive function; MRI measures of white matter lesions, (sub)-clinical stroke and regional (lobar and hippocampal) brain atrophy; clinical dementia and sub-types (AD and vascular dementia); and neuropathologic markers of AD. Studies are published or in progress to examine blood pressure, diabetes, smoking and lipids. The Honolulu Asia Aging Study (HAAS) has provided the basis for much of the research conducted on vascular factors and dementia. The HAAS is a prospective population-based study of Japanese American men that was initiated in 1965 as a part of the Honolulu Heart Program (HHP). The original cohort consisted of 8,006 Japanese-American men living on Oahu and born 1900 through 1919. When the HAAS was initiated in 1991-1993 there were 4,426 survivors, and 3,734 (80 percent) completed the total examination. |
Metabolic Risk Factors for Dementia: Steroidal hormones are hypothesized to modulate (improve) cognitive and affective behavior. There are few population-based studies of the association of steroidal hormones to these behaviors and they are mainly on women. We recently investigated the association of length of reproductive years (as a measure of exposure to endogeneous estrogen) and the risk for incident dementia in a large population-based cohort of women. We found, contrary to expectation, that a longer reproductive period was associated with an increased risk for incident dementia. This raises questions about the role of endogenous steroidal hormones. Investigations into the association of steroidal hormones and incident cognitive impairment and dementia are underway in the HAAS Japanese-American men. |
As a further test of the hypothesis that vascular risk factors may contribute to brain disease in old age, we have initiated a sub-study to the NHLBI randomized ACCORD (Action to Control Cardiovascular Risk in Diabetes) Trial. This trial includes a large sample of type 2 diabetics over 55 years of age. It is designed to compare the effects on cardiovascular disease of standard versus intensive treatment of risk factors in diabetics. The trial design allows us to compare the effects of standard versus intensive treatment of hyperglycemia, hypertension, and dyslipidemia on cognitive function and brain structure as measured by magnetic resonance imaging. |
Genetic Epidemiology of AD: Alzheimer's disease is a complex genetic disease meaning many genes contribute each with a small contribution. Studies are in progress to identify accurate phenotypes to let us better identify genes that regulate pathology in the pathways leading to dementia. We are also investigating the association of identified candidate genes and the risk for AD. This research is conducted in the context of the HAAS study and the newly initiated Age, Gene/Environment Susceptibility (AGES) study, which is conducted together with the Geriatric Epidemiology Section and in collaboration with the Icelandic Heart Association (IHA). The AGES examination is based on a well-defined cohort of 12,000 persons born between 1907-1935 that was established in 1967 by the IHA and followed by them as a part of the Reykjavik Study. |
The Neuroepidemiology Section has also carried out studies in the epidemiology of migraine headache, and is developing collaborations with laboratory scientists to bridge the gaps between our knowledge gained in epidemiologic studies with that gained through more basic research. |
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