Multilevel Biopsychosocial Stress Mechanisms Underlying Racial Disparities in ADRD Risk

项目摘要 这个奖学金的目标是准备申请人，艾米丽莫里斯，作为一个独立的职业生涯 一位临床研究人员研究了阿尔茨海默氏症种族差异背后的生物心理社会压力机制 疾病及相关痴呆（ADRD）。拟议的项目包括一个研究项目， 多层次心理社会压力源和生物危险因素在ADRD风险种族差异中的作用， 培训计划包括正式课程、指导、实践研究和专业发展。 艾米丽将得到一个强大的导师团队的支持，该团队的主要赞助商是密歇根大学的 心理学系和社会研究所以及公共卫生学院的顾问 和哥伦比亚大学。导师团队将提供ADRD差异，神经心理学， 神经影像学、流行病学和高级统计分析。培训计划将帮助艾米丽发展 在1）ADRD种族差异的生物心理社会决定因素，2）生物风险因素和 ADRD的神经病理学过程，3）高级纵向统计分析，包括因果关系 推理，以及4）通过手稿和会议演讲传播研究结果和网络。 ADRD中的种族差异仍然存在。如果没有广泛可用的治疗来改变疾病 在ADRD的过程中，更好地理解潜在的生物心理社会机制对于设计 采取措施，缓解这些差距。多层次的压力源（即，人际、社区、社会） 不成比例地影响非西班牙裔黑人老年人，并可能增加ADRD的风险，通过 神经心理学测试这些心理社会压力源通过生物学机制赋予风险， ADRD（即，炎症、脑血管疾病）可以为干预目标提供进一步的见解。那里 关于这些机制如何导致ADRD风险和差异的共识很少。因此本 本研究旨在探讨1）多个层面的心理社会压力因素是否会介导ADRD的种族差异 风险，2）生物风险因素介导心理社会应激源和ADRD风险之间的关联， 黑人和白色老年人，3）类似的协会可以在一个独立的，全国性的 代表性数据集。这些目标将在密歇根认知老化项目（MCAP）中进行研究， 密歇根州东南部非西班牙裔黑人和白色老年人的种族平衡队列， 退休研究（HRS），这是美国老年人的全国代表性研究。 拟议的研究旨在解决两个NIA老龄化研究的战略方向和NIA 健康差异研究框架，该框架要求在评估中考虑生物心理社会因素， 研究ADRD中的种族差异。研究结果可以为可行的 采取干预措施，以缓解ADRD中的种族差异。

PROJECT SUMMARY The goal of this fellowship is to prepare the applicant, Emily Morris, for a career as an independent clinical researcher examining biopsychosocial stress mechanisms underlying racial disparities in Alzheimer's disease and related dementias (ADRD). The proposed project consists of a research project examining the roles of multilevel psychosocial stressors and biological risk factors in racial disparities in ADRD risk and a training plan consisting of formal coursework, mentorship, hands-on research, and professional development. Emily will be supported by a strong mentorship team with primary sponsors at the University of Michigan's Department of Psychology and Institute for Social Research and consultants from the School of Public Health and Columbia University. The mentorship team will provide expertise in ADRD disparities, neuropsychology, neuroimaging, epidemiology, and advanced statistical analyses. The training plan will help Emily develop expertise in 1) biopsychosocial determinants of racial disparities in ADRD, 2) biological risk factors and neuropathological processes of ADRD, 3) advanced longitudinal statistical analyses, including causal inference, and 4) disseminating findings and networking via manuscripts and conference presentations. Racial disparities in ADRD remain persistent. Without widely available treatment to modify the disease course of ADRD, better understanding of underlying biopsychosocial mechanisms is critical in designing interventions to alleviate these disparities. Stressors at multiple levels (i.e., interpersonal, community, societal) disproportionately affect non-Hispanic Black older adults and may increase risk for ADRD, ascertained through neuropsychological testing. Biological mechanisms through which these psychosocial stressors confer risk for ADRD (i.e., inflammation, cerebrovascular disease) may provide further insight for intervention targets. There is little consensus regarding how these mechanisms contribute to ADRD risk and disparities. Thus, the present study aims to examine whether 1) psychosocial stressors at multiple levels mediate racial disparities in ADRD risk, 2) biological risk factors mediate associations between psychosocial stressors and ADRD risk across Black and White older adults, and 3) similar associations can be identified in an independent, nationally representative dataset. These aims will be examined in the Michigan Cognitive Aging Project (MCAP), a racially balanced cohort of non-Hispanic Black and White older adults in Southeast Michigan, and the Health and Retirement Study (HRS), a nationally representative study of older adulthood in the US. 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 inform design and implementation of feasible interventions to alleviate racial disparities in ADRD.