Mechanisms of inequalities in ADRD risk across race and place in the Michigan Cognitive Aging Project

密歇根认知老化项目中不同种族和地区 ADRD 风险不平等的机制

• 批准号: 10662077
• 负责人: Laura B Zahodne
• 金额: $ 106.81万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10662077
• 关键词: Adult; Affect; Aging; Alzheimer' s Disease; Alzheimer' s disease model; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Area; Attenuated; Behavioral; Black Populations; Black race; Brain; Censuses; Characteristics; Childhood; Cognitive; Cognitive aging; Communities; Control Locus; Country; Data; Diet; Disadvantaged; Discrimination; Disparity; Elderly; Ensure; Family; Goals; Growth; Health; Health Services; Health Services Accessibility; Health behavior; Hippocampus; Income; Individual; Inequality; Infrastructure; Internet; Interruption; Intervention; Knowledge; Leisure Activities; Life Cycle Stages; Link; Longitudinal Studies; Magnetic Resonance Imaging; Measures; Medical; Michigan; Modeling; Neighborhoods; Neuropsychology; Outcome; Participant; Pathway interactions; Physical activity; Policies; Population; Process; Race; Recording of previous events; Religion; Reporting; Research; Resources; Risk Factors; Self Perception; Social Work; Social support; Socioeconomic Status; Thick; Time; United States; White Matter Hyperintensity; apolipoprotein E-4; attenuation; cohort; comorbidity; critical period; data archive; dementia risk; depressive symptoms; educationally disadvantaged; experience; health disparity; longitudinal analysis; low socioeconomic status; middle age; mortality disparity; novel; psychologic; psychosocial; racial disparity; racial population; recruit; resilience factor; response; social; social cohesion; social group; theories

Risk of Alzheimer's disease and related dementias (ADRD) is higher for non-Latinx Black older adults than for non-Latinx White older adults. This disparity is not fully explained by commonly measured individual risk factors such as educational disadvantage, apolipoprotein E epsilon 4, or medical comorbidities. Thus, there is a critical need to identify additional modifiable targets at multiple levels to reduce ADRD inequalities in line with NIA's Strategic Directions for Research and the NIA Health Disparities Framework. The overall goal of this longitudinal study (N=700; 50% Black) is to identify new, modifiable pathways to reduce racial inequalities in ADRD by leveraging the community-based Michigan Cognitive Aging Project (MCAP), the National Neighborhood Data Archive (NaNDA), and recently released historical data from the 1950 census. Our strong preliminary data support concurrent neighborhood socioeconomic status (nSES) as a unique driver of cognitive inequalities that operates through modifiable environmental (e.g., public infrastructure), social (e.g., discrimination), psychological (e.g., depressive symptoms), and behavioral (e.g., diet) mechanisms. The current proposal will follow MCAP participants for a critical third time point to enable latent growth curve modeling of longitudinal cognitive trajectories, expand the cohort to ensure adequate power for between and within group longitudinal analyses in the presence of racial disparities in mortality, and collect structural magnetic resonance imaging (MRI) measures of brain integrity. In addition, this proposal will collect new data on residential histories to identify life course critical periods for neighborhood level interventions, develop a novel measure of neighborhood racial income inequality that could predict ADRD risk above and beyond nSES, and reveal resilience factors among Black older adults that could interrupt ADRD risk pathways. Recent studies have linked nSES to brain and cognitive outcomes, but the mechanisms, modifiers, and intersection with racial inequalities in ADRD are not yet understood. Grounded in the bioecological model and a life course model of ADRD inequalities, our overarching hypothesis is that eliminating racial inequalities in ADRD will require interventions at multiple levels of the exposome, and the current proposal will provide actionable knowledge to guide policies and interventions.

非LATINX黑人老年人患阿尔茨海默氏病和相关痴呆症（ADRD）的风险高于 非LATINX白人老年人。这种差异并未通过普遍测量的个人风险充分说明 教育劣势，载脂蛋白E Epsilon 4或医学合并症等因素。因此，有 在多个层面上确定其他可修改目标以减少ADRD不平等的临界需求 NIA的研究和NIA健康差异框架的战略方向。总体目标 纵向研究（n = 700; 50％黑色）是确定新的，可修改的途径，以减少种族不平等现象 通过利用社区的密歇根州认知老化项目（MCAP），美国国家 邻里数据存档（NANDA），最近发布了1950年人口普查的历史数据。我们的坚强 初步数据支持并发社区社会经济地位（NSE）作为认知的独特驱动力 通过可修改的环境（例如公共基础设施），社会（例如， 歧视），心理（例如抑郁症状）和行为（例如饮食）机制。这 当前的建议将跟随MCAP参与者的第三时间点，以实现潜在的增长曲线 纵向认知轨迹的建模，扩展队列，以确保在和之间 在群体纵向分析中，在死亡中存在种族差异的情况下，并收集结构 磁共振成像（MRI）的大脑完整性度量。此外，该建议将收集新数据 关于居住历史以确定邻里层面干预措施的关键时期，开发一个 邻里种族收入不平等的新型衡量标准，可以预测ADRD的风险 NSE，并揭示了黑人老年人的弹性因素，这些因素可能会中断ADRD风险途径。最近的 研究已将NSE与大脑和认知结果联系起来，但是机制，修饰符和相交 在ADRD中存在种族不平等现象。基于生物生物学模型和生活课程 ADRD不平等的模型，我们的总体假设是消除ADRD中的种族不平等现象 需要在多个杂志中进行干预，当前的提案将提供可行的 知识指导政策和干预措施。