Perceived Discrimination Trajectories and Cognitive Functioning Among Older Black Adults

老年黑人的感知歧视轨迹和认知功能

• 批准号: 9808361
• 负责人: Kellee White Whilby
• 金额: $ 7.73万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-15 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9808361
• 关键词: Accounting; Address; Adult; Age; Aging; Alzheimer' s disease related dementia; Attention; Behavioral; Birth; Censuses; Characteristics; Chronic; Clinical; Cognitive; Cox Models; Dementia; Development; Discrimination; Disease; Elderly; Episodic memory; Exposure to; Foundations; Frequencies; Genetic Risk; Growth; Health; Health and Retirement Study; Heterogeneity; Impaired cognition; Intervention; Life; Linear Regressions; Link; Literature; Longitudinal Studies; Masks; Measurement; Measures; Mental Health; Modeling; Modification; Nature; Outcome; Pathway interactions; Pattern; Physiological; Premature aging syndrome; Process; Psychosocial Stress; Race; Reporting; Research; Research Design; Risk; Sampling; Selection Bias; Social support; Structure; Testing; Time; Vascular Diseases; Work; base; cognitive function; cognitive impairment no dementia; cognitive performance; coping; design; disability; experience; hazard; health data; improved; insight; low socioeconomic status; middle age; mortality; physical conditioning; psychologic; racial disparity; recruit; resilience; response; sex; social; sociodemographics; stressor

PROJECT SUMMARY / ABSTRACT The primary objective of this proposal is to investigate the association between perceived discrimination trajectories and cognitive functioning outcomes among middle-aged and older black adults. Psychosocial stress related to perceived discrimination has received less attention in the literature as a social exposure that may in part reflect racialized experiences for middle-aged and older black adults. While there are limited studies demonstrating an inverse association between higher levels of perceived discrimination and lower cognitive performance, even fewer have found a null association. The mixed results may be a function of differences in study design, attribution of discrimination, differential recruitment, selection, or survival bias. Prior work largely measured perceived discrimination at one-time point to predict cognitive health at a second time point. Moreover, a one-time cross-sectional assessment may mask significant heterogeneity in dynamic nature of repeated exposure to perceived discrimination. Further, the absence of studies accounting for frequency and variability in reported perceived discrimination may underestimate its impact on health. It is possible that patterns of cumulative exposure to perceived discrimination – perceived discrimination trajectories – may provide further insight on cognitive health risk and resilience. Yet, the identification of perceived discrimination trajectories and whether trajectories are associated with cognitive health outcome variability is unknown and merits systematic consideration. To address these gaps in the literature, we will investigate the association between perceived discrimination trajectories and cognitive health outcomes among a sample of middle-aged and older black adults using data from the Health and Retirement Study (2004 – 2016) to: 1) identify perceived discrimination trajectories and predictors of trajectory membership; 2) examine the relationship between perceived discrimination trajectories and episodic memory; 3) examine the relationship between perceived discrimination trajectories and risk of cognitive impairment and dementia. This project has relevance for research and clinical settings and presents an opportunity to: improve measurement of perceived discrimination in the aging process and allow for greater precision in estimating the cognitive health consequences of cumulative exposure to perceived discrimination. If perceived discrimination trajectories differentially predict poor cognitive health, this project will lay the foundation for distinguishing key pathways linking cumulative experiences of psychosocial stress to physiological aging and inform the design of culturally-relevant interventions to delay the development and progression of cognitive impairment among middle-aged and older black adults.

项目总结/摘要 本提案的主要目的是调查感知到的歧视 轨迹和认知功能的结果在中年和老年黑人成年人。心理社会 在文献中，与感知到的歧视有关的压力作为一种社会暴露， 可能部分反映了中年和老年黑人的种族化经历。虽然有限 研究表明，较高程度的歧视与较低程度的歧视之间存在负相关关系。 认知表现，甚至更少的人发现了零关联。混合的结果可能是一个函数， 研究设计差异、歧视归因、差异招募、选择或生存偏倚。 之前的工作主要是在一个时间点测量感知歧视，以预测第二个时间点的认知健康 时间点。此外，一次性的横断面评估可能掩盖动态的显著异质性。 重复暴露于感知歧视的性质。此外，由于缺乏研究， 报告的感知歧视的频率和可变性可能低估了其对健康的影响。是 可能的是，累积暴露于感知歧视的模式-感知歧视 轨迹-可以提供关于认知健康风险和弹性的进一步见解。然而， 感知歧视轨迹以及轨迹是否与认知健康结果相关 变异性是未知的，值得系统考虑。为了解决文献中的这些空白，我们将 调查感知的歧视轨迹与认知健康结果之间的关联 一个中年和老年黑人成年人的样本使用的数据来自健康和退休研究（2004 - 2016年）：1）确定感知歧视轨迹和轨迹成员的预测因素; 2）检查 知觉辨别轨迹与情景记忆之间的关系; 3）检验 感知歧视轨迹与认知障碍和痴呆风险之间的关系。这 该项目与研究和临床环境相关，并提供了一个机会：改善测量 在衰老过程中感知的歧视，并允许更精确地估计认知 累积暴露于感知歧视的健康后果。如果歧视 轨迹差异预测认知健康状况不佳，该项目将奠定基础，区分关键 将心理社会压力的累积经验与生理衰老联系起来的途径，并为设计提供信息， 文化相关的干预措施，以延缓认知障碍的发展和进展， 中年和老年黑人。