Life-course social adversity, pesticide exposure, and cognitive outcomes among an ongoing cohort of mid-life Latina women in an under served agricultural region

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Latinos are expected to represent 21% of US adults over 65 years by 2060, up from 8% in 2015. Compared to non-Latino whites, US Latinos have a higher prevalence and earlier onset of Alzheimer’s disease and related dementias (ADRDs) and face a higher burden of related risk factors (e.g. cardio-metabolic conditions). Life- course circumstances including social adversity and environmental exposures may shape within-group variation in ADRDs and related risk factors among US Latinos. Understanding the unique and combined impacts of social and environmental factors on mid-life cognitive outcomes is critical for informing early ADRDs prevention efforts; these exposures represent actionable targets for multi-level interventions. Nevertheless, there is limited research on the impact of social adversity and pesticide exposure on ADRDs risk, including among mid-life Latinos living in underserved agricultural areas with high pesticide exposure. In particular, few studies have prospectively evaluated the impacts of social adversity, including culturally-specific (e.g. migration-related) adversity on ADRDs among Latinos; most studies of pesticides and ADRDs rely on crude exposure measures (e.g. recall of life-time occupation). We have a unique opportunity to evaluate social and pesticide exposure in association with ADRDs risk factors among an ongoing cohort of approximately 550 mid-life Latina women (average 47 years) living in an underserved agricultural region. The Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, initiated in 1998 as an NIEHS/EPA Children’s Center, is a well-established longitudinal birth cohort of low-income, Mexican American mother-child dyads living in a California agricultural community. Substantial information has been collected on mothers’ early and mid-life social adversity, mid-life cardio-metabolic health, and pesticide exposure captured via biomarkers and geographic information system-based residential proximity to pesticide applications. We aim to add two mid-life cognitive assessments, additional social adversity and pesticide exposure measures, and brain biomarker data collection (on a subset of 200). Informed by the life-course perspective and the exposure-stress-disease framework, which posits that social and environmental exposures may have unique and combined impacts on health, we propose to carry out the following Specific Aims: 1) To quantify associations between early and mid-life social adversity on cognitive performance among mid-life Latina women and the extent to which these associations are explained by cardio-metabolic and inflammatory mechanisms, 2) To estimate associations between agricultural pesticide exposure and cognitive performance and evaluate whether social adversity and pesticide exposure interact to produce poorer cognitive outcomes among mid-life Latina women, and 3) To evaluate relationships between life-course social adversity, pesticide exposure, and brain biomarkers among mid-life Latina women. Our overall goal is to inform early ADRDs prevention efforts among US Latinos -- the most rapidly growing aging minority group in the US.