Multimorbidity Trajectories, Psychosocial Resilience and Stress, and Risk of Dementia and Poor Cognitive Functioning

多重发病轨迹、社会心理弹性和压力、痴呆症和认知功能不良的风险

• 批准号: 10684061
• 负责人: Kellee White Whilby
• 金额: $ 18.77万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10684061
• 关键词: Acceleration; Address; Adverse event; Affect; Aging; Alzheimer disease prevention; Alzheimer' s Disease; Alzheimer' s disease risk; Attenuated; Biological Aging; Black Populations; Buffers; Cause of Death; Chronic; Chronic Disease; Chronic stress; Clinical; Clinical Course of Disease; Cognition; Cognitive; Cox Models; Data; Dementia; Development; Discrimination; Disease; Disease Progression; Disparity; Elderly; Episodic memory; Foundations; Gender; Growth; Health; Health and Retirement Study; Heterogeneity; Impaired cognition; Inequality; Intervention; Investigation; Knowledge; Life Cycle Stages; Link; Literature; Methodology; Methods; Modeling; Nature; Outcome; Pattern; Population; Population Heterogeneity; Prevalence; Prevention strategy; Process; Prospective cohort; Psychosocial Factor; Psychosocial Stress; Race; Research; Risk; Risk Factors; Role; Scholarship; Self Efficacy; Short-Term Memory; Social isolation; Social support; Specific qualifier value; Stress; Therapeutic Intervention; Time; Treatment/Psychosocial Effects; Variant; Woman; Work; cognitive change; cognitive function; cognitive reserve; dementia risk; design; disease disparity; disorder risk; enhancing factor; gender difference; gender disparity; health data; healthy aging; improved; insight; mild cognitive impairment; mortality; multiple chronic conditions; novel; person centered; population based; psychosocial; racial difference; racial disparity; resilience; risk stratification; theories; therapy design; verbal

PROJECT SUMMARY / ABSTRACT Alzheimer’s Disease (AD), the sixth leading cause of death in the US, is the most common form of dementia in later life. Substantial heterogeneity in the course of disease progression, AD prevalence, and mortality exist by gender and race. Yet, variations in the distribution and the relative importance of risk factors, such as multimorbidity, that may inform gender and racial differences in AD risk and cognitive change over time are not well understood. Data-driven strategies capturing the dynamic nature of chronic disease accumulation may offer critical insight regarding differences in dementia risk and cognitive functioning by gender and race. Further, a robust literature hypothesizes linkages between psychosocial resilience and stress with dementia risk and cognitive functioning. However, the extent to which these factors enhance or attenuate dementia risk and poor cognitive functioning merits systematic investigation and is in alignment with new priorities for AD and aging research. To address these gaps the proposed work will investigate the association between multimorbidity trajectories, psychosocial resilience/stress, dementia risk and changes in cognitive functioning using data from the Health Retirement Study (2000-2018). We propose two aims: 1) assess the effect of psychosocial resilience (e.g., perceived social support, self-efficacy, and mastery) on the relationship between multimorbidity trajectories and change in cognitive functioning and incident dementia; and 2) assess the effect of psychosocial stress (e.g., discrimination, chronic stress, social isolation) on the relationship between multimorbidity trajectories and change in cognitive functioning and incident dementia. Specifying multimorbidity trajectory classes that differentially predict dementia risk and poor cognitive functioning represents a valuable contribution in: clarifying factors that propagate gender and racial disparities in late life progressive cognitive decline and dementia risk; informing the design of interventions and preventive strategies targeting psychosocial resilience and stress among populations at greatest risk; and improving precision in stratifying risk for poor cognitive function to delay the development and progression of AD.

项目摘要/摘要