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症（ADRD）的风险高于非拉丁裔黑人老年人。 非拉丁裔白色老年人。通常测量的个体风险不能完全解释这种差异 如受教育程度低、载脂蛋白E β 4或内科合并症等因素。由此可见，有 迫切需要在多个层面确定其他可修改的目标，以减少ADRD不平等， NIA的研究战略方向和NIA健康差异框架。这个项目的总体目标是 纵向研究（N=700; 50%黑人）是为了确定新的，可修改的途径，以减少种族不平等， ADRD通过利用社区为基础的密歇根认知老化项目（MCAP），国家 邻里数据档案（NaNDA），以及最近发布的1950年人口普查的历史数据。我们强大 初步数据支持并发邻里社会经济地位（nSES）作为一个独特的驱动因素的认知 通过可改变的环境（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。的 目前的提案将在关键的第三个时间点跟踪MCAP参与者，以实现潜在增长曲线 纵向认知轨迹的建模，扩大队列，以确保足够的权力之间， 在死亡率存在种族差异的情况下进行组内纵向分析， 磁共振成像（MRI）测量大脑完整性。此外，该提案还将收集新的数据， 在居住历史上，确定邻里一级干预的生命过程关键时期，制定一个 邻里种族收入不平等的新衡量标准，可以预测ADRD风险 nSES，并揭示弹性因素中的黑人老年人，可能会中断ADRD的风险途径。最近 研究已经将nSES与大脑和认知结果联系起来，但机制，修饰符和交叉点 ADRD中的种族不平等还不清楚。基于生物生态模型和生命历程 ADRD不平等模型，我们的总体假设是，消除ADRD中的种族不平等将 需要在麻烦的多个层面进行干预，目前的提案将提供可操作的 指导政策和干预措施的知识。