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.

非拉丁裔黑人老年人患阿尔茨海默病和相关痴呆(ADRD)的风险高于 非拉丁裔白人老年人。这种差异不能用通常衡量的个人风险来完全解释。 受教育程度低、载脂蛋白E epsilon 4或医学合并症等因素。因此，有 迫切需要在多个层面确定更多可修改的目标，以减少ADRD不平等，以符合 NIA的研究战略方向和NIA健康差距框架。这个项目的总体目标是 纵向研究(N=700；50%黑人)是为了确定减少种族不平等的新的、可修改的途径 ADRD通过利用基于社区的密歇根州认知老龄化项目(MCAP)，国家 社区数据档案(Nanda)，最近发布了1950年人口普查的历史数据。我们的强者 初步数据支持同时存在的邻里社会经济地位(NSE)是认知的唯一驱动因素 通过可改变的环境(例如，公共基础设施)、社会(例如， 歧视)、心理(如抑郁症状)和行为(如饮食)机制。这个 目前的提案将跟踪MCAP参与者一个关键的第三个时间点，以实现潜在增长曲线 对纵向认知轨迹进行建模，扩大队列以确保在和之间有足够的能量 在组内纵向分析存在种族差异的死亡率，并收集结构性数据 磁共振成像(MRI)测量大脑的完整性。此外，这项提案将收集新的数据 关于住宅史，以确定社区一级干预的生命过程关键时期，制定 可以预测ADRD风险的邻里种族收入不平等的新衡量标准 NSE，并揭示了黑人老年人中可能中断ADRD风险途径的弹性因素。近期 研究已经将NSE与大脑和认知结果联系起来，但机制、修饰语和交集 在ADRD中存在种族不平等的情况目前还不清楚。植根于生物生态模型和生命过程 作为ADRD不平等的模型，我们的首要假设是消除ADRD中的种族不平等将 需要在曝光的多个层面上进行干预，目前的提案将提供可操作的 指导政策和干预措施的知识。