Multilevel Biopsychosocial Stress Mechanisms Underlying Racial Disparities in ADRD Risk

项目总结

PROJECT SUMMARY The goal of this fellowship is to prepare the applicant, Emily Morris, for a career as an independent clinical researcher examining biopsychosocial stress mechanisms underlying racial disparities in Alzheimer's disease and related dementias (ADRD). The proposed project consists of a research project examining the roles of multilevel psychosocial stressors and biological risk factors in racial disparities in ADRD risk and a training plan consisting of formal coursework, mentorship, hands-on research, and professional development. Emily will be supported by a strong mentorship team with primary sponsors at the University of Michigan's Department of Psychology and Institute for Social Research and consultants from the School of Public Health and Columbia University. The mentorship team will provide expertise in ADRD disparities, neuropsychology, neuroimaging, epidemiology, and advanced statistical analyses. The training plan will help Emily develop expertise in 1) biopsychosocial determinants of racial disparities in ADRD, 2) biological risk factors and neuropathological processes of ADRD, 3) advanced longitudinal statistical analyses, including causal inference, and 4) disseminating findings and networking via manuscripts and conference presentations. Racial disparities in ADRD remain persistent. Without widely available treatment to modify the disease course of ADRD, better understanding of underlying biopsychosocial mechanisms is critical in designing interventions to alleviate these disparities. Stressors at multiple levels (i.e., interpersonal, community, societal) disproportionately affect non-Hispanic Black older adults and may increase risk for ADRD, ascertained through neuropsychological testing. Biological mechanisms through which these psychosocial stressors confer risk for ADRD (i.e., inflammation, cerebrovascular disease) may provide further insight for intervention targets. There is little consensus regarding how these mechanisms contribute to ADRD risk and disparities. Thus, the present study aims to examine whether 1) psychosocial stressors at multiple levels mediate racial disparities in ADRD risk, 2) biological risk factors mediate associations between psychosocial stressors and ADRD risk across Black and White older adults, and 3) similar associations can be identified in an independent, nationally representative dataset. These aims will be examined in the Michigan Cognitive Aging Project (MCAP), a racially balanced cohort of non-Hispanic Black and White older adults in Southeast Michigan, and the Health and Retirement Study (HRS), a nationally representative study of older adulthood in the US. The proposed study aims address both the NIA Strategic Directions for Research in Aging and the NIA Health Disparities Research Framework, which call for the consideration of biopsychosocial factors in examining racial disparities in ADRD. The findings could inform design and implementation of feasible interventions to alleviate racial disparities in ADRD.