HANDLS Scan Substudy: Race, Socioeconomic status, and the Brain

HANDLS 扫描子研究：种族、社会经济地位和大脑

• 批准号: 8318673
• 负责人: Shari Waldstein
• 金额: $ 56.09万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE COUNTY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-15 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8318673
• 关键词: Address; African American; Age; Alcohols; Ancillary Study; Anger; Anisotropy; Baltimore; Behavioral; Biometry; Brain; Brain Pathology; Cardiovascular system; Cerebrovascular Disorders; Clinical Research; Cognitive; Communities; Comorbidity; Complex; Cross-Sectional Studies; Data; Data Collection; Dementia; Diet; Diffusion; Diffusion Magnetic Resonance Imaging; Elderly; Environmental Risk Factor; Epidemiology; Equation; Future; Geriatrics; Grant; Health; Health Services Accessibility; Impaired cognition; Incidence; Internal Medicine; Intramural Research Program; Investigation; Life; Link; Literature; Longevity; Magnetic Resonance Imaging; Maryland; Measures; Mediating; Mediation; Mediator of activation protein; Medical Research; Mental Depression; Modeling; National Institute on Aging; Neighborhoods; Nephrology; Outcome; Outcome Measure; Participant; Pathology; Pathway interactions; Physical Function; Physical activity; Population; Preventive Intervention; Psychological Factors; Psychology; Race; Race Relations; Radiology Specialty; Recruitment Activity; Research; Research Personnel; Resources; Risk; Scanning; Smoking; Social support; Socioeconomic Status; Spirituality; Stress; Stroke; Structure; Testing; Vascular Diseases; Woman; base; bioimaging; brain volume; cardiovascular risk factor; cerebral atrophy; cognitive function; deprivation; design; executive function; functional decline; functional disability; gray matter; health disparity; healthy aging; indexing; low socioeconomic status; member; morphometry; mortality; novel; physical conditioning; primary outcome; psychologic; racial discrimination; resilience; sex; social; socioeconomics; vigilance; white matter

DESCRIPTION (provided by applicant): Pronounced health disparities associated with race and socioeconomic status (SES) are noted for brain health endpoints including stroke (particularly at younger ages), dementia, brain structure on magnetic resonance imaging (MRI), cognitive decline, and functional disability. Efforts are needed to disentangle respective influences of race and SES on brain health, particularly early and subtle markers of pathology predictive of future stroke and dementia. MRI- assessed measures of gray matter (GM) and white matter (WM) volume and diffusion tensor imaging measures of WM microstructure offer such proven associations. Also critical is identification of multi-level mediators of the relations of race and SES to subtle brain pathology. Biomedical, behavioral, psychological, social and environmental factors have been implicated as potential mediators of the relations of race and SES to many physical health outcomes, but exceedingly little is known about these pathways with respect to brain health. MRI indices of subtle brain pathology may also mediate relations of race and SES to cognitive and physical function. Here we propose an interdisciplinary, ancillary study to the Healthy Aging In Neighborhoods of Diversity Across the Life Span (HANDLS). HANDLS study is a new 20-year epidemiological investigation conducted by the National Institute on Aging's Intramural Research Program focused on understanding health disparities among 4,000 socioeconomically diverse African-Americans (AA) and Whites living in Baltimore, MD. HANDLS is uniquely designed to disentangle the respective relations of race and SES to health outcomes. In HANDLS SCAN we propose to obtain quantitative MRI data from 500 (250 AA, 250 White; ages 30-64) stroke- and dementia-free HANDLS participants with a full range of SES to: (1) Examine race- and SES-related disparities in GM and WM volume, and WM microstructure (2) Examine multi-level mediators - biomedical, behavioral, psychological, social, and environmental - of the relations of race and SES to GM and WM; and (3) Examine whether GM and WM are proximal mediators of the relations of race and SES to cognitive and physical function. Structural equation modeling will be used to construct increasingly complex models to address these interrelated aims. PUBLIC HEALTH RELEVANCE: An understanding of multi-level mediators of the relations of race and SES to early and subtle markers of brain pathology, and the relation of brain pathology to cognitive and physical function, is needed to facilitate appropriate strategies in prevention and intervention critical to the reduction and ultimate elimination of health disparities in stroke, dementia, and cognitive and functional decline.

描述（由申请人提供）：在大脑健康终点中注意到与种族和社会经济地位（SES）相关的明显健康差异，包括中风（特别是在较年轻的年龄）、痴呆、磁共振成像（MRI）上的大脑结构、认知能力下降和功能障碍。需要努力阐明种族和社会经济地位对大脑健康的各自影响，特别是预测未来中风和痴呆的早期和微妙的病理标志物。 MRI 评估的灰质 (GM) 和白质 (WM) 体积测量以及 WM 微观结构的扩散张量成像测量提供了这种经过验证的关联。同样重要的是确定种族和社会经济地位与微妙的大脑病理学关系的多层次中介因素。生物医学、行为、心理、社会和环境因素被认为是种族和社会经济地位与许多身体健康结果关系的潜在中介因素，但人们对这些与大脑健康有关的途径知之甚少。微妙的大脑病理学的 MRI 指数也可能介导种族和社会经济地位与认知和身体功能的关系。在这里，我们提出了一项跨学科的辅助研究，以促进整个生命周期多样性社区的健康老龄化（HANDLS）。 HANDLS 研究是由国家老龄化研究所的校内研究计划进行的一项新的 20 年流行病学调查，重点了解居住在马里兰州巴尔的摩的 4,000 名社会经济多样化的非裔美国人 (AA) 和白人之间的健康差异。 HANDLS 的独特设计旨在理清种族和社会经济地位与健康结果的各自关系。在 HANDLS SCAN 中，我们建议从 500 名（250 AA，250 白人；年龄 30-64）无中风和痴呆的 HANDLS 参与者中获取定量 MRI 数据，这些参与者具有全方位的 SES：（1）检查 GM 和 WM 体积以及 WM 微观结构中与种族和 SES 相关的差异（2）检查多级调节因素 - 生物医学、行为、心理、社会和环境 - 种族和SES与GM和WM的关系； (3) 检查 GM 和 WM 是否是种族和 SES 与认知和身体功能关系的近端调节因素。结构方程模型将用于构建日益复杂的模型来解决这些相互关联的目标。公共健康相关性：需要了解种族和社会经济地位与大脑病理学早期和微妙标记之间关系的多层次中介因素，以及大脑病理学与认知和身体功能的关系，以促进采取适当的预防和干预策略，这对于减少和最终消除中风、痴呆以及认知和功能衰退方面的健康差异至关重要。