Associations of Adverse Childhood Experiences with Midlife Neighborhood Deprivation and Cognitive Trajectories and Dementia Outcomes in Later Life

不良童年经历与中年邻里剥夺以及晚年认知轨迹和痴呆症结果的关联

• 批准号: 10730126
• 负责人: Adrienne R.S. Lee
• 金额: $ 4.19万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-18 至 2025-09-17
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10730126
• 关键词: Acceleration; Address; Adult; Affect; Age; Aging; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; Area; Black race; Buffers; Censuses; Childhood; Cognitive; Cognitive aging; Communities; Complex; Data; Dementia; Disparity; Early identification; Elderly; Environment; Environmental Risk Factor; Epigenetic Process; Equity; Ethnic Origin; Ethnic Population; Factor Analysis; Family; Family Study; Health; Health and Retirement Study; Health behavior and outcomes; Heterogeneity; Hispanic; Individual; Institution; International; Intervention; Latino; Latinx; Life; Life Cycle Stages; Link; Literature; Measures; Mediation; National Institute on Aging; Neighborhoods; Outcome; Paper; Pathway interactions; Phase; Physical Function; Play; Policies; Population; Postdoctoral Fellow; Prevention strategy; Psychometrics; Race; Research; Research Project Grants; Research Proposals; Residential Mobility; Retirement; Risk; Risk Reduction; Role; Sampling Studies; Socioeconomic Status; Surveys; United States; Universities; Wisconsin; Work; adverse childhood events; childhood adversity; cognitive function; cohort; dementia risk; deprivation; design; ethnic difference; experience; health equity; health inequalities; healthspan; human old age (65+); improved; indexing; insight; middle age; novel; prevent; protective factors; racial difference; racial population; resilience factor; risk mitigation; social; social determinants; stressor; structural health determinants; vulnerable community

Project Summary The burden of Alzheimer’s Disease and Related Dementias (ADRD) is projected to increase by 150% by the year 2060 to affect 14 million Americans, with four- and seven-fold increases anticipated among Black and Hispanic/Latino older adults. To better understand the accumulation of risk throughout the life course and the disparities that exist in ADRD, studying social and structural determinants of health and employing a life course perspective have been emphasized. Research on the role of early life stressors and adversity on ADRD is emerging, but still limited. Older adults who experienced more childhood adversities had greater likelihood of incident dementia in three international aging cohorts; U.S.-based studies have been largely cross-sectional in design, mixed results have been observed, and only one examined racial/ethnic differences. However, greater understanding of the role these factors play is imperative if we aim to mitigate the risk of ADRD with a health equity lens. Identifying early life risk factors for ADRD and the primary pathways through which childhood adversity is operating will allow for more targeted interventions to reduce risk of ADRD in later life for the most vulnerable in our population. In addition, the role of neighborhood deprivation in these relationships remains understudied, despite known ramifications of environmental factors on health behaviors and outcomes. Understanding structural determinants of health and how they impact risk of ADRD will provide valuable insight for identifying the most vulnerable communities for targeting effective prevention strategies and motive for structural changes and policies that aim to improve these environments and the overall health of those individuals at greatest risk. To have the greatest impact on reducing the risk of ADRD, the role of the environment must be considered. In the F99-phase of this proposed research, Adrienne Lee will conduct three novel studies of these complex associations. Specifically, Adrienne will use the Health and Retirement Study to evaluate the associations of childhood adversity with neighborhood deprivation, cognitive trajectories, and dementia outcomes within racial/ethnic subgroups. She will link the study sample to the area deprivation index in midlife to further understand the role of environment and structural determinants of health on these associations, and to identify population-specific mechanisms by which we can tailor interventions throughout the life course. In the K00-phase of this proposed research, Adrienne will build off her dissertation research to identify early life resilience factors that promote healthy cognitive aging and that may counteract ACE exposure, and she will examine the associations of ACE exposure, in combination with neighborhood deprivation in relation to other hallmarks of aging. This research will inform equitable interventions.

项目摘要 阿尔茨海默氏病和相关痴呆症（ADRD）的伯恩预计将在2060年增加150％ 影响1400万美国人，黑人和西班牙裔/拉丁美洲裔中预计会增加四倍和七倍 成年人。为了更好地了解整个生命过程中风险的积累以及ADRD中存在的分布， 强调了研究健康的社会和结构决定者并采用生活课程的观点。 关于早期生活压力源和广告在ADRD的作用的研究正在出现，但仍然有限。老年人 经历了更多的童年逆境，在三个国际衰老队列中发生痴呆症发生痴呆症的可能性更大。 基于美国的研究在很大程度上是设计的横断面，已经观察到混合的结果，只有一个 研究了种族/种族差异。但是，对这些因素所扮演的作用的更多了解是必须的 旨在通过健康权益镜头来减轻ADRD的风险。确定ADRD的早期生活危险因素和主要的生命危险因素 童年广告运行的途径将允许采取更多针对性的干预措施，以降低 在后来的生活中，我们人口中最脆弱的人。 此外，邻里剥夺在这些关系中的作用仍然被理解为目的地已知 环境因素对健康行为和结果的影响。了解结构决定者 健康以及它们如何影响ADRD的风险将为确定最脆弱的社区提供宝贵的见解 针对有效的预防策略以及旨在改善这些变化的结构性变化和政策的动机 环境和那些处于最大风险的人的整体健康状况。对减少的影响最大 ADRD的风险，必须考虑环境的作用。 在这项提出的研究的F99阶段中，Adrienne Lee将对这些复杂关联进行三项新的研究。 特别是，艾德丽安（Adrienne）将使用健康和退休研究来评估儿童广告与 种族/族裔亚组中的社区剥夺，认知轨迹和痴呆症结果。她会链接 研究样本到中年剥夺指数，以进一步了解环境和结构的作用 这些关联的健康决定因素，并确定我们可以量身定制的人群特定机制 在整个生活过程中进行干预。 在这项拟议的研究的K00阶段中，艾德丽安（Adrienne）将建立她的论文研究以识别早期生活 促进健康认知衰老并可能抵消ACE暴露的弹性因素，她将检查 ACE暴露的关联，与其他衰老标志有关的邻里剥夺。这 研究将为公平的干预提供信息。