Chronic Pain Severity, Biomarkers of Dementia, and Ethnic/Race Group Differences: Predicting Alzheimer's Disease Vulnerabilities

项目摘要/摘要 与非西班牙裔黑人(NHB)相比，非西班牙裔美国人患阿尔茨海默病的风险大大增加 非西班牙裔美国白人(Nhw)。与健康相关的脆弱性与生物心理社会压力有关， 这对NHB人群的影响不成比例。生活在慢性疼痛中是有压力的。骨关节炎(OA)是一种 高度普遍和衰弱的慢性疼痛状况，对NHB成年人的影响比NHW更严重 成年人。慢性疼痛与全身炎症增加和痴呆症风险增加有关，两者都 这对美国国民健康保险的影响是不成比例的。此外，NHB美国人的基因和 痴呆的生物标志物，但这些生物标志物与痴呆之间的关系较弱 NHB高于NHW种群。有证据表明，NHB成年人的淀粉样阳性大脑似乎比 预期中。这可能是由于种族/种族群体在环境、社会文化和健康方面的差异- 相关的压力暴露。终生累积暴露可能会减少大脑储备并导致 对生物系统造成损害，从而易患痴呆症。这暗示了生活体验因素， 包括慢性疼痛，可能在神经退化过程中发挥作用。因此，种族/种族，与 考虑到社会人口和心理社会因素，结合疼痛严重程度，可能会作为一种 阿尔茨海默氏症的关键易感性。目前尚不清楚的是：1)NHB和NHW是否伴有慢性膝关节 疼痛在炎症和痴呆的生物标志物上是不同的，如果2)疼痛严重程度高的NHB相对 与nhw同龄人相比，这些生物标志物和全球认知随着时间的推移发生了更大的变化。我们将使用 来自现有R01的数据，用于处理血浆生物标志物和新的脑部MRI炎症生物标志物和 痴呆症。我们有120名成年人的全面生物心理社会、核磁共振和一般认知数据 两年内有慢性疼痛的证据(60nhb，60nhw)。我们的发现将1)有助于 更好地理解慢性疼痛、民族/种族和痴呆症风险之间的动态关系；以及2) 促进识别对应激相关暴露敏感的新的脑MRI生物标志物 痴呆症风险。

Project Summary/Abstract Non-Hispanic black (NHB) Americans experience greatly increased risk of Alzheimer’s disease compared to non-Hispanic white (NHW) Americans. Health-related vulnerabilities are linked with biopsychosocial stress, which disproportionately affects NHB populations. Living with chronic pain is stressful. Osteoarthritis (OA) is a highly prevalent and debilitating chronic pain condition that affects NHB adults more severely than NHW adults. Chronic pain is associated with elevated systemic inflammation and increased risk of dementia, both of which disproportionately affect NHB Americans. Additionally, NHB Americans also have elevated genetic and biological markers of dementia but there are weaker relationships between those biomarkers and dementia in NHB than NHW populations. Evidence suggests the amyloid-positive brains of NHB adults appear older than expected. This might be due to ethnic/race groups differences in environmental, sociocultural, and health- related stress exposures. Cumulative exposure across the lifespan might reduce brain reserve and induce vulnerabilities to dementia by taking a toll on the biological system. This suggests life experience factors, including chronic pain, might play a role in neurodegenerative processes. Therefore, ethnicity/race, with consideration for sociodemographic and psychosocial factors, combined with pain severity might serve as a key vulnerability for Alzheimer’s disease. What is not known is whether: 1) NHB and NHW with chronic knee pain differ in biomarkers of inflammation and dementia, and if 2) NHB with high pain severity have relatively greater changes in those biomarkers and global cognition over time compared to their NHW peers. We will use data from an existing R01 to process plasma biomarkers and novel brain MRI biomarkers of inflammation and dementia. We have comprehensive biopsychosocial, MRI, and general cognitive data for 120 adults with evidence of chronic pain (60 NHB, 60 NHW) across a two-year period. Our findings will 1) contribute to an improved understanding of the dynamics between chronic pain, ethnicity/race, and dementia risk; and 2) promote the identification of novel brain MRI biological markers sensitive to stress-related exposure and dementia risk.