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.

项目概要/摘要 阿尔茨海默病 (AD) 是美国第六大死因，是最常见的疾病 晚年痴呆。疾病进展过程、AD 患病率和 死亡率因性别和种族而异。然而，风险因素的分布和相对重要性的变化， 例如多发病，这可能会影响 AD 风险和认知变化方面的性别和种族差异 时间不太了解。数据驱动策略捕捉慢性病的动态本质 积累可能会提供有关痴呆风险和认知功能差异的重要见解 性别和种族。此外，大量文献假设社会心理弹性和压力之间存在联系 具有痴呆风险和认知功能。然而，这些因素增强或减弱的程度 痴呆症风险和认知功能不良值得系统研究，并且与新的研究相一致 AD 和衰老研究的优先事项。为了解决这些差距，拟议的工作将调查该协会 多发病轨迹、社会心理弹性/压力、痴呆风险和认知变化之间 使用健康退休研究（2000-2018）的数据发挥作用。我们提出两个目标：1）评估 社会心理弹性（例如，感知的社会支持、自我效能和掌控力）对关系的影响 多发病轨迹与认知功能变化和痴呆事件之间的关系； 2）评估 社会心理压力（例如歧视、慢性压力、社会孤立）对关系的影响 多病轨迹与认知功能变化和痴呆事件之间的关系。指定 差异预测痴呆风险和认知功能不良的多病轨迹类别 在以下方面做出了宝贵贡献： 澄清晚年传播性别和种族差异的因素 进行性认知能力下降和痴呆风险；为干预措施和预防策略的设计提供信息 针对风险最大的人群的社会心理复原力和压力；并提高精度 对认知功能不良的风险进行分层，以延缓 AD 的发生和进展。