The Epidemiology of Cognitive Decline in African Americans: Identifying Risk and Protective Factors

项目总结/摘要 到2060年，44%的美国老年人将是非西班牙裔白色人，而2020年这一比例为60%。认知下降 种族和族裔多样化的老年人口不断增加，是一个重大的公共卫生问题。黑人 不成比例地受到阿尔茨海默病和相关痴呆症（ADRD）的影响，并可能经历 认知能力下降的速度比其他群体更快。然而，很少有人知道这背后的机制 流行率上升。遗传机制并不能完全解释糖尿病患者中更高的衰退和ADRD风险。 老年黑人成年人，这表明其他因素可能解释这种变化。然而，大多数认知 老龄化研究来自于比较黑人和白人的研究， 健康状况、生物和心理社会风险以及可能导致 这些差异。这项研究的总体目标是阐明认知能力下降的风险和保护因素 （1）研究高血压与特定领域认知功能的关系 探讨严重生活事件和社会支持如何改变HBP-认知关联;（2） 探索炎症与认知能力下降之间的关系以及HBP如何介导 严重的生活事件和认知;（3）确定感知压力对 认知，并评估HBP和社会支持是否调节压力-认知关系。的 研究计划将利用两项全国公认的老年人研究的宝贵二手数据。 这个K 01奖申请将促进伯德博士的培训和专业发展， 职业生涯作为一个独立的调查员在老龄化，认知和ADRD领域。五年培训计划将 填补了（1）认知衰退和衰老研究以及（2）压力和应对理论的空白，同时建立在她的基础上。 方法优势包括（3）先进的纵向方法。伯德博士将完成拟议的 在亚利桑那州立大学（ASU）丰富的培训环境中进行研究， 大卫库恩博士，教授和老年心理学家（亚利桑那州立大学）和罗兰J.索普博士，健康教授， 行为与社会和少数民族老龄化专家（约翰霍普金斯大学）和国内和国际 Peter Lichtenberg，PhD（老年神经心理学家），基思惠特菲尔德，PhD （黑人认知专家），托尼·安东努奇博士（一生中的社会关系）和著名的 生物统计学家Wassim Tarraf博士该提案涉及国家执行局战略方向的目标B和F， 老龄化研究，这需要研究，以了解1）个人的影响，人际关系， 和社会因素对老龄化和2）老年人的健康差距。我们的研究有可能 影响个人的结果以及影响旨在改善认知健康的政策和计划， 人口老龄化，特别是对于认知能力下降和ADRD风险最大的美国黑人。

PROJECT SUMMARY/ABSTRACT By 2060, 44% of older U.S. adults will be non-Hispanic White compared with 60% in 2020. Cognitive decline in this growing racially and ethnically diverse older population is a major public health concern. Blacks are disproportionately affected by Alzheimer’s disease and related dementias (ADRD), and potentially experience a faster rate of cognitive decline than other groups. Yet, little is known is about the mechanisms underlying this increased prevalence. Genetic mechanisms do not account entirely for the higher risk of decline and ADRD in older Black adults, suggesting that other factors may explain this variation. However, the majority of cognitive aging research derives from studies that have compared Blacks to Whites versus exploring within-group variability in health conditions, biological, and psychosocial risk and protective factors that may account for these differences. This study's overall goal is to clarify risk and protective factors underlying cognitive decline in Blacks by: (1) Examining the relation between high blood pressure (HBP) and domain-specific cognitive decline and exploring how serious life events and social support modify the HBP-cognition association; (2) Exploring the relation between inflammation and cognitive decline and how HBP mediates the relation between serious life events and cognition; and (3) Identifying the consequence of perceived stress on changes in cognition and evaluating whether HBP and social support moderates the stress-cognition relationship. The research plan will leverage valuable secondary data from two nationally recognized studies of older adults. This K01 Award application will facilitate the training and professional development of Dr. Byrd to launch her career as an independent investigator in the field of aging, cognition, and ADRD. The five-year training plan will fill gaps in (1) cognitive decline and aging research and (2) stress and coping theories, while building on her methodological strengths to include (3) advanced longitudinal methods. Dr. Byrd will complete the proposed research in the rich training environment of Arizona State University (ASU), with co-primary mentorship from David Coon, PhD, Professor and geropsychologist (ASU) and Roland J. Thorpe, PhD, Professor of Health, Behavior and Society and minority aging expert (John Hopkin’s University) and nationally and internationally recognized secondary mentors Peter Lichtenberg, PhD (geriatric neuropsychologist), Keith Whitfield, PhD (expert on cognition among Blacks) ,Toni Antonucci, PhD (social relations across the lifespan) and renowned biostatistician Wassim Tarraf, PhD. The proposal addresses Goals B and F of the NIA Strategic Directions for Research on Aging, which calls for research that seeks to understand 1) the effects of personal, interpersonal, and societal factors on aging and 2) health disparities among older adults. Our research has the potential to influence individual outcomes as well as affect policies and programs aimed at improving cognitive health for the aging population, particularly for Black Americans who are at greatest risk for cognitive decline and ADRD.