Contribution of Longitudinal Neighborhood Determinants to Cognitive Health and Dementia Disparities within a Multi-Ethnic Cohort

纵向邻里决定因素对多种族群体中认知健康和痴呆症差异的贡献

• 批准号: 10403516
• 负责人: Jana Ariel Hirsch
• 金额: $ 102.19万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-15 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10403516
• 关键词: Address; Affect; African American; Age; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Biological Markers; Buffers; Cerebrovascular Disorders; Characteristics; Clinical; Code; Cognition; Cognitive; Collection; Communities; Data; Data Set; Dementia; Diabetes Mellitus; Digit structure; Education; Elderly; Environment; Ethnic Origin; Ethnic group; Face; Food; Gender; Goals; Health; Hispanic Populations; Impaired cognition; Individual; Inequality; Intervention; Link; Longitudinal cohort; Low income; Maintenance; Measures; Minority; Multi-Ethnic Study of Atherosclerosis; Neighborhoods; Nerve Degeneration; Obesity; Outcome; Pathology; Pathway interactions; Pattern; Physical activity; Physical environment; Play; Policies; Population; Population Heterogeneity; Prevalence; Process; Race; Recreation; Research; Research Personnel; Resources; Risk; Role; Safety; Sampling; Science; Short-Term Memory; Shoulder; Sleep; Social Environment; Socioeconomic Status; Surveys; Testing; Time; Work; abeta deposition; adjudicate; base; built environment; cardiovascular risk factor; clinically relevant; cognitive ability; cognitive performance; cohort; dementia risk; design; disparity reduction; executive function; experience; healthy aging; improved; instrument; mild cognitive impairment; multi-ethnic; neighborhood association; nutrition; processing speed; racial and ethnic; racial disparity; screening; social cohesion; social determinants; socioeconomic disparity; socioeconomics; stem; theories; walkability

PROJECT SUMMARY/ABSTRACT Beyond the role that individual factors (e.g. age, race, gender, and socioeconomic status) play in the progression of Alzheimer's Disease and related dementias (ADRD), neighborhood factors (e.g. social and built environments) may affect cognitive health. Critically, although African American and Hispanic individuals face the highest and most disproportionate risk for ADRD, research has traditionally excluded diverse populations. Given historic and current patterning of healthy neighborhood factors by racial and socioeconomic characteristics, these features may partially explain observed disparities in ADRD risk. To date there has been no research on the role of neighborhood environments in disparities in ADRD risk. In this study, we propose to leverage and extend extensive longitudinal data from the Multi-Ethnic Study of Atherosclerosis (MESA) to address major gaps in research on neighborhoods and disparities in ADRD. We propose to undertake large-scale collection, processing, and distribution of new neighborhood data within MESA. Our main objective is to identify unique patterns of neighborhood change related to the causes of prevalence and disparities in cognitive decline and dementia. We will attain our main objective by (Aim 1) characterizing dynamic, longitudinal neighborhood social and built environment variables (survey-based and GIS-derived) relevant to cognition for residential addresses of a MESA; (Aim 2) examining associations of neighborhood environmental characteristics with cognition and clinically relevant ADRD outcomes; (Aim 3) investigate determinants of disparities in ADRD outcomes by socioeconomic position and race/ethnicity and assess the contribution of neighborhood environments. This project is poised to provide robust new evidence about pathways and links between neighborhood environments and cognitive outcomes, with important implications for built environment science, ADRD progression research, and policies to support healthy aging. Aim 1 will create the most comprehensive longitudinal neighborhood dataset on a diverse sample with detailed cognitive and ADRD outcomes for widespread dissemination to a network of researchers. Analyses in Aim 2 will contribute to developing substantive theory on the role of neighborhoods in ADRD progression and provide guidance for urban planners to design neighborhoods that support healthy aging. Aim 3 examines component contributions to racial disparities in cognition and ADRD. Through this, we expect to identify actionable, community and clinical interventions to address and remediate racial and socioeconomic inequalities derived from the unequal distribution of environmental supports for healthy aging. We expect this evidence to support and amplify efforts to reduce disparities.

项目总结/摘要 除了个人因素（如年龄，种族，性别和社会经济地位）在其中发挥的作用之外， 阿尔茨海默病和相关痴呆（ADRD）的进展，邻里因素（例如社会和建筑） 环境）可能会影响认知健康。关键是，尽管非洲裔美国人和西班牙裔人面临着 ADRD的风险最高和最不成比例，研究传统上排除了不同的人群。 考虑到种族和社会经济因素对健康邻里因素的历史和当前模式 这些特征可以部分解释ADRD风险中观察到的差异。迄今为止， 没有研究社区环境在ADRD风险差异中的作用。 在这项研究中，我们建议利用和扩展来自多民族研究的广泛的纵向数据， 运动疗法（梅萨），以解决在ADRD的邻里和差距研究的主要差距。我们 建议进行大规模的收集，处理和分发新的邻里数据， 梅萨。我们的主要目标是确定与以下原因相关的邻里变化的独特模式： 认知能力下降和痴呆症的患病率和差异。我们将通过（目标1）实现我们的主要目标 表征动态，纵向邻里社会和建成环境变量（基于调查和 GIS衍生）与梅萨的居住地址认知相关;（目标2）检查 具有认知和临床相关ADRD结局的社区环境特征;（目标3） 调查按社会经济地位和种族/民族划分的ADRD结局差异的决定因素， 评估邻里环境的贡献。 这个项目准备提供强有力的新证据，说明邻里之间的道路和联系。 环境和认知结果，对建筑环境科学，ADRD具有重要意义 发展研究和支持健康老龄化的政策。目标1将创建最全面的 不同样本的纵向邻域数据集，具有详细的认知和ADRD结果， 广泛传播到研究人员网络。目标2中的分析将有助于发展 对社区在ADRD进程中的作用提出了实质性的理论，并为城市规划者提供了指导 来设计支持健康老龄化的社区。目标3审查了对种族歧视的组成部分贡献 认知和ADRD的差异。通过这一点，我们希望确定可操作的，社区和临床 采取干预措施，解决和纠正因不平等而产生的种族和社会经济不平等 为健康老龄化提供环境支持。我们希望这些证据能够支持和扩大努力 减少不平等。