SHS stroke II-SCE: Cognitive Impairment, Alzheimer's Disease and Vascular Brain Injury in American Indians

The objectives are: (1) To measure the impact that IAQ interventions for particulate matter, nitrogen dioxide, carbon monoxide, carbon dioxide, VOCs, and formaldehyde in tribal homes have on COPD symptoms and severity using objective measures for lung functioning, quality of life, and activities of daily living; (2) to measure the correlation between these IAQ hazards and COPD symptoms severity and gain a new understanding of the extent of the impact by using objective measures of lung functioning for the first time in this kind of study; (3) to gain a new understanding about the impact of known and suspected IAQ hazards on the daily activities of living and quality of life of people with COPD by using standardized tools for the first time in this kind of study; (4) to determine the impact of interventions to remediate mold on secondary fungal infections in residents with COPD; (5) to determine the feasibility of bringing effective and cost-effective IAQ intervention services to limited income, geographically isolated tribal populations with COPD; (6) to measure the impact of IAQ interventions on the health care utilization of individuals with COPD; and (7) to measure the additional impact of the IAQ interventions on children and other household members in terms of asthma, acute respiratory infections, other respiratory symptoms, acute bronchitis, and otitis media.