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

项目总结 该奖学金的目标是为申请者乔丹·帕尔姆斯的独立职业生涯做好准备 临床研究人员阐明了大脑健康与阿尔茨海默病和相关痴呆(ADRD)之间的差异。 拟议的项目包括一项研究，考察种族模式的社会压力源的影响。 在两项队列研究中关于种族群体内部和跨种族的白质完整性，以及一项包括 实践研究、指导、课程作业和专业发展。约旦将得到一个 密歇根大学心理学系拥有强大的导师团队和主要赞助商 以及来自哥伦比亚大学的顾问。指导团队将提供有关ADRD差异的专业知识， 神经成像、神经心理学和高级统计分析。训练计划将帮助乔丹 在1)ADRD中潜在的种族差异的生物-心理-社会机制方面培养专门知识，2)处理 MRI图像以表征ADRD风险，3)高级统计分析，包括适度和因果 调解，以及4)通过手稿和会议报告传播调查结果和合作。 在认知老化和ADRD中存在明显的种族差异。在有限的治疗下，识别潜在的 增加ADRD风险或恢复力的可修改因素对于制定旨在 缩小差距。种族模式的社会压力(例如，歧视)被理论上认为是一种驱动力 通过多条途径为这些不平等施加压力。在人际和社会层面上，这些压力源 不成比例地影响非西班牙裔黑人老年人患ADRD的风险。确定大脑机制 其中这些心理社会应激源影响ADRD风险(即，白质完整性)可以提供方向 干预目标和治疗。然而，人们对心理社会压力如何导致ADRD知之甚少。 差距。因此，本研究旨在研究1)歧视是否与脑白质有关 非西班牙裔黑人成年人的诚信，2)外部知觉控制在非西班牙裔黑人和白人之间的差异 白质完整性，以及3)社区社会凝聚力是种族不平等的保护因素 在白质完整性方面。这些目标将在华盛顿高地-因伍德哥伦比亚老龄计划中进行审查 项目(WHICAP)，一个由曼哈顿北部和密歇根州老年人组成的种族和民族多元化的队列 认知老龄化项目(MCAP)，一个种族平衡的非西班牙裔黑人和白人成年人队列 过渡到密歇根州东南部的晚年生活。 拟议的研究旨在解决NIA老龄化研究的战略方向和NIA 健康差距研究框架，呼吁考虑生物、心理和社会因素 审查ADRD的种族差异。这些发现可能对设计和实施有帮助 减少脑老化和ADRD方面的种族差异的干预措施。

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.