Contribution of Longitudinal Neighborhood Determinants to Cognitive Health and Dementia Disparities within a Multi-Ethnic Cohort

纵向邻里决定因素对多种族群体中认知健康和痴呆症差异的贡献

• 批准号: 10578800
• 负责人: Jana Ariel Hirsch
• 金额: $ 78.69万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-15 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10578800
• 关键词: Address; Affect; African American; Age; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Biological Markers; Buffers; Cerebrovascular Disorders; Characteristics; Clinical; Code; Cognition; Cognitive; Collection; Communities; Data; Data Set; Dementia; Diabetes Mellitus; Digit structure; Disparity; Education; Elderly; Environment; Ethnic Origin; Ethnic Population; Exclusion; Face; Food; Gender; Goals; Health; Hispanic Populations; Impaired cognition; Individual; Inequality; Intervention; Link; Longitudinal cohort; Low income; Maintenance; Measures; Multi-Ethnic Study of Atherosclerosis; Neighborhoods; Nerve Degeneration; Obesity; Outcome; Pathology; Pathway interactions; Pattern; Physical activity; Physical environment; Play; Policies; Population; Population Heterogeneity; Prevalence; Process; Race; Recreation; Research; Research Personnel; Resources; Risk; Role; Safety; Sampling; Science; Short-Term Memory; Shoulder; Sleep; Social Environment; Socioeconomic Status; Surveys; Testing; Time; Work; abeta deposition; adjudication; built environment; cardiovascular risk factor; clinically relevant; cognitive ability; cognitive performance; cohort; coping; dementia risk; design; disparity reduction; executive function; experience; healthy aging; improved; instrument; mild cognitive impairment; multi-ethnic; neighborhood association; nutrition; processing speed; racial disparity; racial minority; racial population; remediation; screening; social cohesion; social determinants; socioeconomic disparity; socioeconomics; stem; theories; walkability

PROJECT SUMMARY/ABSTRACT Beyond the role that individual factors (e.g. age, race, gender, and socioeconomic status) play in the progression of Alzheimer's Disease and related dementias (ADRD), neighborhood factors (e.g. social and built environments) may affect cognitive health. Critically, although African American and Hispanic individuals face the highest and most disproportionate risk for ADRD, research has traditionally excluded diverse populations. Given historic and current patterning of healthy neighborhood factors by racial and socioeconomic characteristics, these features may partially explain observed disparities in ADRD risk. To date there has been no research on the role of neighborhood environments in disparities in ADRD risk. In this study, we propose to leverage and extend extensive longitudinal data from the Multi-Ethnic Study of Atherosclerosis (MESA) to address major gaps in research on neighborhoods and disparities in ADRD. We propose to undertake large-scale collection, processing, and distribution of new neighborhood data within MESA. Our main objective is to identify unique patterns of neighborhood change related to the causes of prevalence and disparities in cognitive decline and dementia. We will attain our main objective by (Aim 1) characterizing dynamic, longitudinal neighborhood social and built environment variables (survey-based and GIS-derived) relevant to cognition for residential addresses of a MESA; (Aim 2) examining associations of neighborhood environmental characteristics with cognition and clinically relevant ADRD outcomes; (Aim 3) investigate determinants of disparities in ADRD outcomes by socioeconomic position and race/ethnicity and assess the contribution of neighborhood environments. This project is poised to provide robust new evidence about pathways and links between neighborhood environments and cognitive outcomes, with important implications for built environment science, ADRD progression research, and policies to support healthy aging. Aim 1 will create the most comprehensive longitudinal neighborhood dataset on a diverse sample with detailed cognitive and ADRD outcomes for widespread dissemination to a network of researchers. Analyses in Aim 2 will contribute to developing substantive theory on the role of neighborhoods in ADRD progression and provide guidance for urban planners to design neighborhoods that support healthy aging. Aim 3 examines component contributions to racial disparities in cognition and ADRD. Through this, we expect to identify actionable, community and clinical interventions to address and remediate racial and socioeconomic inequalities derived from the unequal distribution of environmental supports for healthy aging. We expect this evidence to support and amplify efforts to reduce disparities.

项目总结/文摘