Aging Research Characterizing Health Equity via Social determinants (ARCHES)

通过社会决定因素表征健康公平的老龄化研究 (ARCCHES)

• 批准号: 10689089
• 负责人: Ganesh M Babulal
• 金额: $ 74.77万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10689089
• 关键词: Adult; Affect; Aging; Alzheimer disease prevention; Alzheimer' s Disease; Alzheimer' s disease pathology; Alzheimer' s disease risk; Alzheimer’s disease biomarker; Amyloid Proteins; Awareness; Behavioral; Biological; Biological Markers; Biological Models; Biostatistical Methods; Black American; Black Populations; Black race; Blood; Cerebrospinal Fluid; Chronic stress; Clinical; Cognition; Cognitive; Collaborations; Communities; Complex; Coping Behavior; Data; Dementia; Detection; Development; Diagnosis; Discrimination; Economics; Education; Educational workshop; Elderly; Employment; Enrollment; Environmental Risk Factor; Exposure to; Genetic; Genomics; Goals; Health; Health Disparities Research; Heterogeneity; Hippocampus; Image; Impaired cognition; Inflammation; Inflammatory; Intervention; Knowledge; Life Cycle Stages; Life Style; Link; MRI Scans; Magnetic Resonance Imaging; Maps; Measures; Mediator; Mental Depression; Methods; Modeling; Molecular; National Institute on Aging; Neighborhoods; Nerve Degeneration; Neurologic; Neuropsychological Tests; Neuropsychology; Participant; Plasma; Population; Population Heterogeneity; Population Study; Prevalence; Recording of previous events; Research; Research Methodology; Resources; Risk; Risk Factors; Sample Size; Sampling; Socioeconomic Status; Stress; Symptoms; Testing; United States; Validation; Vascular Diseases; White Matter Hyperintensity; Work; brain health; cognitive function; cognitive testing; cohort; community based participatory research; dementia risk; depressive symptoms; dynamic system; epidemiology study; follow-up; health care availability; health care service utilization; health equity; healthy aging; high risk; human old age (65+); indexing; inflammatory marker; innovation; longitudinal, prospective study; multidisciplinary; neuroimaging; novel; participant retention; pre-clinical; psychosocial; recruit; screening; social; social culture; social determinants; social factors; social health determinants; socioeconomics; suburb; tau Proteins; theories; trustworthiness

PROJECT SUMMARY/ABSTRACT Our long-term goal is to employ innovative community based participatory research to establish a community advisory board, to collaborate with our community partners to recruit, enroll, and retain a cohort of Black participants and, then, to examine causal mechanisms that increase the risk of Alzheimer disease (AD) within the community cohort. The long preclinical stage of AD, as reflected in biomarkers among adults, is a key risk factor of symptomatic AD. However, despite Blacks having a higher risk of developing AD, recent studies suggest that they have less abnormal levels of biomarkers than Whites in cognitively normal samples. This study aims to examine other risk factors of cognitive decline and AD such as depression, stress, and social determinants of health (SDOH) in a representative sample of Black participants. This research is significant because there are nearly 46 million Black Americans, comprising 13% of the population in the United States. The Black older adult population is expected to increase, from 4.4 million older adults in 2016 to 12.1 million by 2060. Despite these demographic projections, Blacks are significantly underrepresented in AD research. An almost exclusive focus on Whites has created a knowledge gap in understanding how SDOH mechanisms affect diverse populations. Closing this knowledge gap soon is critical since epidemiological studies suggest that Blacks are at twice the risk of AD compared to Whites. Our Specific Aims will (1) Establish a cohort of middle-to-older age Black adults (N=300) using community- based participatory research to understand the unique social, environmental, and economic barriers related to AD risk, (2) Determine the impact of depression, stress, and a novel, theory-based SDOH composite index (CI) on cognitive functioning in participants who are cognitively normal with and without preclinical AD, and (3) Test the association between white matter hyperintensities (WMH) and hippocampal volume (HV) with the SDOH-CI in a subset of participants (N=150) with magnetic resonance imaging (MRI) data. To test our Aims, we have assembled a multidisciplinary team with expertise in AD, SDOH, community- based participatory research and system dynamics, community mobilization, stress and depression, plasma biomarkers, genetics, neuroimaging, neuropsychology, and biostatistical methods. Participants will undergo a one-time blood draw for AD biomarker profiling, cognitive assessment using a neuropsychological battery, and participate in one MRI scan session. Participants will also participate in workshops, complete a comprehensive battery of SDOH measures mapped onto the National Institute of Aging’s Health Research Disparities Framework, and clinical, neurological, and neuropsychological tests annually for up to five years. Once obtained, this knowledge of how within-group heterogeneity in cognitive functioning and AD risk is impacted by SDOH may better support effective AD intervention and treatment for Black Americans.

项目概要/摘要 我们的长期目标是采用基于社区的创新参与式研究来建立 社区咨询委员会，与我们的社区合作伙伴合作，招募、注册和留住一批 黑人参与者，然后检查增加阿尔茨海默病 (AD) 风险的因果机制 在社区群体内。正如成人生物标志物所反映的那样，AD 的长期临床前阶段是一个 有症状 AD 的关键危险因素。然而，尽管黑人患 AD 的风险较高，但最近 研究表明，在认知正常的样本中，他们的生物标志物异常水平低于白人。 本研究旨在检查认知能力下降和 AD 的其他危险因素，例如抑郁、压力和 黑人参与者代表性样本中的健康社会决定因素（SDOH）。 这项研究意义重大，因为美国有近 4600 万黑人，占美国黑人人口的 13% 美国的人口。黑人老年人口预计将从 440 万增加到 到 2060 年，成年人口将在 2016 年增加到 1210 万。尽管有这些人口预测，黑人人口仍显着增加。 AD 研究中代表性不足。几乎只关注白人造成了知识差距 了解 SDOH 机制如何影响不同人群。尽快缩小这一知识差距至关重要 因为流行病学研究表明，黑人患 AD 的风险是白人的两倍。 我们的具体目标将 (1) 利用社区建立一个中老年黑人成年人群体 (N=300) 基于参与性研究，以了解与相关的独特的社会、环境和经济障碍 AD 风险，(2) 确定抑郁、压力和新颖的基于理论的 SDOH 综合指数 (CI) 的影响 对患有或不患有临床前 AD 的认知正常的参与者的认知功能的影响，以及 (3) 测试 白质高信号 (WMH) 和海马体积 (HV) 与 SDOH-CI 之间的关联 在一组参与者 (N=150) 中使用磁共振成像 (MRI) 数据。 为了测试我们的目标，我们组建了一支多学科团队，拥有 AD、SDOH、社区方面的专业知识—— 基于参与性研究和系统动力学、社区动员、压力和抑郁、等离子 生物标志物、遗传学、神经影像学、神经心理学和生物统计方法。参与者将接受 一次性抽血进行 AD 生物标志物分析、使用神经心理学电池进行认知评估，以及 参加一次 MRI 扫描。参与者还将参加研讨会，完成全面的 一系列 SDOH 措施映射到国家老龄化研究所的健康研究差异 每年进行框架以及临床、神经学和神经心理学测试，持续长达五年。 一旦获得关于认知功能和 AD 风险的组内异质性的知识， 受 SDOH 影响可能会更好地支持对美国黑人进行有效的 AD 干预和治疗。

项目成果

Health Disparities in Dementia.

痴呆症的健康差异。

• DOI: 10.1212/con.0000000000001088
• 发表时间: 2022-06-01
• 期刊: Continuum (Minneapolis, Minn.)
• 作者: Balls-Berry, Joyce Joy E;Babulal, Ganesh M
• 通讯作者: Babulal, Ganesh M

Multidimensional poverty is associated with dementia among adults in Afghanistan.

• DOI: 10.1016/j.eclinm.2023.101906
• 发表时间: 2023-04
• 期刊: ECLINICALMEDICINE
• 影响因子: 15.1
• 作者: Trani, Jean-Francois;Zhu, Yiqi;Park, Soobin;Khuram, Dauod;Azami, Rahim;Fazal, Monib Rahim;Babulal, Ganesh M.
• 通讯作者: Babulal, Ganesh M.

Promoting Authentic Academic-Community Engagement to Advance Health Equity.

• DOI: 10.3390/ijerph20042874
• 发表时间: 2023-02-07
• 期刊: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
• 作者: Hudson, Darrell;Gilbert, Keon;Goodman, Melody
• 通讯作者: Goodman, Melody

Attitudinal adjustment about dementia awareness and assessment: finetuning inclusion, diversity, and measurement of behavioral and psychological symptoms.

关于痴呆症认知和评估的态度调整：微调包容性、多样性以及行为和心理症状的测量。

• DOI: 10.1017/s1041610222000886
• 发表时间: 2023
• 期刊: International psychogeriatrics
• 影响因子: 7
• 作者: Ismail,Zahinoor;Babulal,GaneshM
• 通讯作者: Babulal,GaneshM