Uncovering Mechanisms of Racial Inequalities in ADRD: Psychosocial Risk and Resilience Factors for White Matter Integrity

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PROJECT SUMMARY The goal of this fellowship is to prepare the applicant, Jordan Palms, for a career as an independent clinical researcher elucidating disparities in brain health and Alzheimer’s disease and related dementias (ADRD). The proposed project consists of a research study examining the impact of racially patterned social stressors on white matter integrity within and across racial groups in two cohort studies, as well as a training plan consisting of hands-on research, mentorship, coursework, and professional development. Jordan will be supported by a strong mentorship team with primary sponsors within the University of Michigan’s Department of Psychology and consultants from Columbia University. The mentorship team will provide expertise in ADRD disparities, neuroimaging, neuropsychology, and advanced statistical analyses. The training plan will help Jordan develop expertise in 1) biopsychosocial mechanisms underlying racial disparities in ADRD, 2) processing of MRI images to characterize ADRD risk, 3) advanced statistical analyses, including moderation and causal mediation, and 4) disseminating findings and collaborating via manuscripts and conference presentations. Stark racial disparities exist within cognitive aging and ADRD. With limited treatments, identifying potential modifiable factors that increase risk or resilience for ADRD is necessary to develop interventions aimed at reducing disparities. Racially patterned social stressors (e.g., discrimination) have been theorized to be a driving force for these inequalities through multiple pathways. On interpersonal and societal levels, these stressors disproportionately affect non-Hispanic Black older adults in their risk for ADRD. Identifying the brain mechanisms in which these psychosocial stressors impact ADRD risk (i.e., white matter integrity) can provide direction towards intervention targets and treatments. However, little is known about how psychosocial stress leads to ADRD disparities. Thus, the present study aims to examine whether 1) discrimination is associated with white matter integrity among non-Hispanic Black adults, 2) external perceived control mediates Black-White disparities in white matter integrity, and 3) neighborhood social cohesion serves as a protective factor for racial inequalities in white matter integrity. These aims will be examined in the Washington Heights-Inwood Columbia Aging Project (WHICAP), a racially and ethnically diverse cohort of older adults in northern Manhattan, and the Michigan Cognitive Aging Project (MCAP), a racially balanced cohort of non-Hispanic Black and White adults transitioning to late life in Southeast Michigan. The proposed study aims address both the NIA Strategic Directions for Research in Aging and the NIA Health Disparities Research Framework, which call for the consideration of biopsychosocial factors in examining racial disparities in ADRD. The findings could be useful in designing and implementing interventions to reduce racial disparities in brain aging and ADRD.