Lifecourse Community Contexts and Health Behaviors as Drivers of Disparities in Risk of Alzheimer's Disease and Related Dementias

生命历程社区背景和健康行为是阿尔茨海默病和相关痴呆风险差异的驱动因素

• 批准号: 10679119
• 负责人: Rachel Lynne Peterson
• 金额: $ 24.9万
• 依托单位: UNIVERSITY OF MONTANA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10679119
• 关键词: Address; Adult; Affect; Age; Alzheimer' s Disease Pathway; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Amygdaloid structure; Amyloid; Amyloid beta-Protein; Area; Asian population; Atlases; Award; Behavior Therapy; Behavioral; Biological Factors; Birth History; Black Populations; Brain; California; Censuses; Childhood; Clinical Trials; Cognition; Cognitive; Communities; County; Data; Databases; Dementia; Diet; Disadvantaged; Dose; Economics; Elderly; Epidemiology; Ethnic Origin; Exposure to; Failure; Fibrinogen; Funding; Future; Gender; Geography; Goals; Green space; Health; Health Benefit; Health Promotion; Health behavior; Hippocampus (Brain); Impaired cognition; Individual; Influentials; International; Intervention; Latino Population; Libraries; Life Experience; Life Style; Link; Magnetic Resonance Imaging; Measures; Mediating; Mentorship; Methods; Modeling; Neighborhoods; Observational Study; Outcome; Participant; Pathway interactions; Physical activity; Play; Policies; Population; Positron-Emission Tomography; Public Health; Race; Research; Research Training; Risk Factors; Risk Reduction; Science; Shapes; Social Environment; Socioeconomic Status; Testing; Training; Translating; United States National Institutes of Health; Universities; Work; aging brain; brain health; built environment; cardiometabolism; career; cohort; community center; contextual factors; dementia risk; deprivation; farmers markets; health disparity; healthy aging; indexing; innovation; insight; modifiable risk; neuroimaging; neuroimaging marker; physical inactivity; population based; protective behavior; psychologic; response; social; social determinants; social epidemiology; social health determinants; socioeconomics; walkability

PROJECT SUMMARY/ABSTRACT Alzheimer's disease and related dementias (ADRD) are a pressing public health issue with substantial disparities. ADRD can only be addressed by minimizing the impact of modifiable risk factors – especially health behaviors. However, evidence suggests that health behaviors are shaped by the community contexts (i.e. built and social environments) in which we live, work, play, and age. Failure to understand and account for community- level contextual factors in ADRD risk reduction may minimize the impact of public health measures to reduce the risk of ADRD and worsen health disparities. Investigating pathways that connect community contextual factors, health behavior engagement, and disparities in ADRD risk is an untapped opportunity to advance the science ADRD risk reduction, and is aligned with NIA's strategic goals by “illuminat(ing) the pathways by which social, psychological, economic, and behavioral factors affect health,” and “understand(ing) environmental, social, cultural, behavioral, and biological factors that create and sustain health disparities.” This study leverages data from two innovative projects funded by the NIH (Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE); Neighborhood Atlas) and the PolicyMap database to identify when and how community contextual factors shape health behaviors and ADRD risk and disparities. This project will link KHANDLE participants' residential histories from birth to late-life with the validated Area Deprivation Indices available via the Neighborhood Atlast from 1910 to present, and geocoded measures of the built environment available via PolicyMap. This proposal seeks to define: 1) how the timing or duration of exposure to community contexts is associated with late-life cognitive/brain health; 2) if individual health behaviors mediate relationships between community contexts and cognitive/brain health; 3) if these pathways differ by race/ethnicity or gender. This research is complimented by a detailed training plan at the University of California Davis guided by a mentorship team comprised of nationally and internationally recognized scholars. The training will build upon the applicant's background in social epidemiology, health promotion, and healthy brain aging research to incorporate new training in causal inference methods, geospatial analysis, modeling neuroimaging biomarkers, and translational epidemiology. The combined research and training will prepare the applicant for a successful independent research career focused on understanding and addressing modifiable pathways for ADRD disparities. Findings from the proposed research are critical for advancing population based ADRD risk reduction strategies that eliminate, rather than exacerbate, health disparities.

项目摘要/摘要 阿尔茨海默氏病和相关痴呆症（ADRD）是一个紧迫的公共卫生问题 差异。 ADRD只能通过最大程度地减少可修改风险因素的影响来解决ADRD，尤其是健康 行为。但是，有证据表明，健康行为是由社区环境塑造的（即建造的 和社交环境）我们的生活，工作，游戏和年龄。无法理解和解释社区 - ADRD降低风险中的级别上下文因素可能会最大程度地减少公共卫生措施的影响以减少 ADRD的风险和健康分布较差的风险。调查连接社区背景因素的途径， 健康行为参与和ADRD风险的差异是推进科学的尚未开发的机会 ADRD的风险降低，并通过“ Inluminat（Inluminat）社会，社会， 心理，经济和行为因素会影响健康，”和“了解（ING）环境，社会， 造成和维持健康差异的文化，行为和生物学因素。” 这项研究利用了NIH资助的两个创新项目（Kaiser Healthy Seving and Diversey）的数据 生活经验（Khandle）；社区地图集）和策略成员数据库，以识别何时以及如何 社区背景因素塑造了健康行为以及ADRD风险和差异。这个项目将链接 Khandle参与者的居民历史从出生到晚年，并具有经过验证的地区剥夺指数 从1910年到现在，可通过附近的地打入街区，并采用了建筑环境的地理编码措施 可通过策略合成。该提案试图定义：1）如何接触社区的时间或时间 环境与晚期认知/大脑健康有关； 2）如果个人健康行为调解了关系 在社区环境与认知/大脑健康之间； 3）如果这些途径​​因种族/种族或性别而有所不同。 加州大学戴维斯分校的详细培训计划表示赞赏 指导团队完成了国内和国际认可的学者。培训将基于 申请人在社会流行病学，健康促进和健康的大脑衰老研究中的背景 因果推断方法，地理空间分析，神经影像学生物标志物的新培训和 翻译流行病学。合并的研究和培训将为申请人做好准备 独立研究职业专注于理解和解决ADRD的可修改途径 差异。拟议研究的发现对于促进基于人群的ADRD风险降低至关重要 消除而不是加剧健康差异的策略。