Direct and Indirect Effects of Socioeconomic Status and Discrimination on Subjective Cognitive Decline: A Longitudinal Study of African American Women.
Direct and Indirect Effects of Socioeconomic Status and Discrimination on Subjective Cognitive Decline: A Longitudinal Study of African American Women.
复制标题
社会经济地位和歧视对主观认知下降的直接和间接影响：非裔美国妇女的纵向研究。
DOI：
10.1093/geronb/gbad029
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Mielke,MichelleM
中科院分区：
文献类型：
--
作者：
Simons,RonaldL;Ong,MeiLing;Beach,StevenRH;Lei,Man-Kit;Philibert,Robert;Mielke,MichelleM
本研究建立在最近的研究结果表明，制度和人际种族主义的压力可能有助于非裔美国人的痴呆症的风险增加。我们调查了种族主义的两个后果--低社会经济地位（SES）和歧视--在多大程度上预测了19年后自我报告的认知能力下降（SCD）。此外，我们研究了可能将SES和歧视与认知能力下降联系起来的潜在中介途径。潜在的介质包括抑郁症，加速生物老化，和慢性疾病的发病。MethodsHypotheses进行了测试，使用的样本293名非洲裔美国妇女。使用日常认知量表评估SCD。结构方程模型被用来评估社会经济地位和种族歧视的影响，在2002年测量，在2021年报告的SCD。谈到中介，中年抑郁症在2002年进行了评估，加速老化在2019年，慢性病在2019年。年龄和前驱症状抑郁症作为协变量。ResultsThere有直接影响的SES和歧视SCD。此外，这两种应激源通过抑郁对SCD有显著的间接影响。最后，有证据表明，一个更复杂的途径，SES和歧视加速生物老化，加速老化，反过来导致慢性疾病，然后预测SCD。DiscussionResults本研究增加了越来越多的文献表明，生活在一个种族化的社会是一个核心因素，在解释高风险的痴呆症在美国黑人。未来的研究应继续强调在生命过程中暴露于种族主义影响认知的各种方式。
ObjectivesThe present study builds on recent findings suggesting that the stress of institutional and interpersonal racism may contribute to African Americans’ elevated risk for dementia. We investigated the extent to which 2 consequences of racism—low socioeconomic status (SES) and discrimination—predict self-reported cognitive decline (SCD) 19 years later. Further, we examined potential mediating pathways that might link SES and discrimination to cognitive decline. Potential mediators included depression, accelerated biological aging, and onset of chronic illnesses.MethodsHypotheses were tested using a sample of 293 African American women. SCD was assessed using the Everyday Cognition Scale. Structural equation modeling was used to assess the effects of SES and racial discrimination, both measured in 2002, on SCD reported in 2021. Turning to the mediators, midlife depression was assessed in 2002, accelerated aging in 2019, and chronic illness in 2019. Age and prodrome depression were included as covariates.ResultsThere were direct effects of SES and discrimination on SCD. In addition, these 2 stressors showed a significant indirect effect on SCD through depression. Finally, there was evidence for a more complex pathway where SES and discrimination accelerate biological aging, with accelerated aging, in turn leading to chronic illness, which then predicted SCD.DiscussionResults of the present study add to a growing literature indicating that living in a racialized society is a central factor in explaining the high risk for dementia among Black Americans. Future research should continue to emphasize the various ways that exposure to racism over the life course effects cognition.