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

项目摘要/摘要 到2060年，44%的美国老年人将是非西班牙裔白人，而2020年这一比例为60%。认知功能减退 这一不断增长的种族和民族多样化的老年人口是一个主要的公共卫生问题。黑人是 不成比例地受到阿尔茨海默病和相关痴呆(ADRD)的影响，并可能经历 认知衰退的速度比其他群体更快。然而，人们对这种现象背后的机制知之甚少。 患病率增加。遗传机制并不能完全解释更高的衰退和ADRD风险 年长的黑人成年人，这表明其他因素可能解释了这种差异。然而，大多数人的认知 老龄化研究源于比较黑人和白人与探索群体内的人的研究 健康状况、生物和心理社会风险和保护因素的变异性 这些差异。这项研究的总体目标是阐明认知能力下降背后的风险和保护因素 在黑人中：(1)研究高血压(HBP)和特定领域认知之间的关系 拒绝和探索严重生活事件和社会支持如何改变HBP-认知联想；(2) 探讨炎症与认知功能减退的关系及HBP如何调节炎症与认知功能衰退的关系 严重的生活事件和认知；以及(3)确定感知到的压力对生活中的变化的影响 认知和评估HBP和社会支持是否调节压力-认知关系。这个 研究计划将利用来自两项国家认可的老年人研究的有价值的辅助数据。 此K01奖项申请将促进伯德博士的培训和专业发展，以启动HER 作为一名在衰老、认知和ADRD领域的独立研究员。五年培训计划将 填补(1)认知衰退和衰老研究以及(2)压力和应对理论方面的空白，同时建立在她的基础上 方法论优势包括(3)先进的纵向方法。伯德博士将完成提议的 在亚利桑那州立大学(ASU)丰富的培训环境中进行研究，由来自 David Coon，博士，教授和老年心理学家(亚利桑那州立大学)和Roland J.Thorpe，博士，卫生学教授， 行为与社会和少数群体老龄化专家(约翰·霍普金大学)以及国内和国际 公认的二级导师Peter Lichtenberg博士(老年神经心理学家)，Keith Whitfield博士 (黑人认知专家)，Toni Antonucci，博士(终生社会关系)，著名 生物统计学家瓦西姆·塔拉夫博士。该提案涉及NIA战略方向的目标B和F 关于老龄化的研究，它要求进行研究，试图了解1)个人、人际、 以及影响老龄化的社会因素以及2)老年人之间的健康差距。我们的研究有可能 影响个人结果以及影响旨在改善以下方面认知健康的政策和计划 人口老龄化，特别是对美国黑人来说，他们认知能力下降和ADRD的风险最大。

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.