Racial Disparities in Alzheimer's Disease and Related Dementias: The Role of School Segregation and Experiences of Discrimination

阿尔茨海默病和相关痴呆症的种族差异：学校隔离的作用和歧视经历

• 批准号: 10606362
• 负责人: Sirena Celeste Gutierrez
• 金额: $ 4.72万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10606362
• 关键词: Address; Adult; Affect; African American population; Age; Aging; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Black Populations; Black race; Chronic; Cognitive; Cognitive aging; Competence; Dementia; Desegregation; Discrimination; Disparity; Education; Elderly; Employment Opportunities; Environment; Epidemiologic Methods; Epidemiologist; Ethnic Population; Event; Exposure to; Funding; Future; Goals; Health; Hypertension; Impaired cognition; Income; Individual; Inequity; Intervention; Life; Life Cycle Stages; Life Experience; Link; Longitudinal cohort; Measures; Mediator; Mentorship; Methodology; Methods; Neighborhoods; Not Hispanic or Latino; Occupational; Outcome; Participant; Pathway interactions; Patient Self-Report; Physiological; Policies; Population; Population Heterogeneity; Population Intervention; Public Health; Race; Racial Segregation; Records; Research; Research Personnel; Research Support; Risk; Risk Factors; Role; Schools; Scientist; Shapes; Social Environment; Socioeconomic Status; Structural Racism; System; Time; Training; United States; Work; aged; aging brain; biological adaptation to stress; brain health; cardiovascular risk factor; career; cognitive function; cohort; dementia risk; early childhood; educational atmosphere; experience; first grade; health care availability; health inequalities; healthy aging; high risk; improved; insight; middle age; mild cognitive impairment; ninth grade; perceived discrimination; poor health outcome; prevent; racial difference; racial disparity; racial population; racism; residential segregation; school environment; segregation; sixth grade; skills; social factors; socioeconomics; stressor; twelfth grade

PROJECT SUMMARY Alzheimer’s disease and related dementias (ADRDs) are a major public health burden and disproportionately affect Black individuals. Although socioeconomic and cardiovascular risk factors partially account for this, experiences of structural (e.g. school segregation) and interpersonal racism (e.g. discrimination) could be important drivers of cognitive inequities. The racialized experience of school segregation can have pervasive effects on sustained discriminatory events and poor health outcomes because of stress-response activation, in addition to decreased socioeconomic opportunities, which may contribute to increased ADRDs risk. Limited studies on the impact of school segregation on late-life cognitive outcomes have produced mixed findings and did not consider incident dementia risk. Additionally, prior studies have not considered mid or late-life mediators of the association between school segregation or quantified the timing of school segregation. Thus, the rationale for the proposed research is to delineate the association of school segregation and resulting experiences of interpersonal discrimination on ADRDs risk to explain why Black individuals have a higher ADRDs burden than other racial and ethnic groups and to identify potential strategies to prevent ADRDs and reduce ADRDs disparities (e.g. organization and occupational policies to reduce racism). The analysis will leverage the Study of Healthy Aging in African Americans and Kaiser Healthy Aging and Diverse Life Experiences, NIA-funded longitudinal cohorts of older adult populations in the United States. The overall objective of this application is to examine the effect of school segregation on ADRDs inequities among older Black and White adults (ages 50-89). This project will also address how experiences of discrimination across the lifecourse impact cognitive trajectories and ADRDs risk. Specifically, this study will evaluate the association between attendance at a racially segregated school on cognitive decline and ADRDs risk among Black individuals (Aim 1) and evaluate the role of everyday and major life discrimination as mediators of this association (Aim 2). Finally, the proposed study will estimate the extent to which racial differences in cognitive decline and ADRDs risk are contributed by differential exposure to school segregation, everyday discrimination, and major life discrimination among Black and White individuals (Aim 3). Examining the roles of sociocontextual factors on ADRDs risk in a large, diverse cohort of Black and White individuals will provide valuable insight into the sustained effects of structural and interpersonal racism on ADRDs risk and will inform population interventions to reduce ADRDs inequities including the targeting of intermediate or proximal mechanisms (e.g. improving neighborhood and educational quality, enhancing access to additional income and employment opportunities). The proposed training, guided by an exemplary mentorship team, will enhance the applicant’s methodological skills, research competency, and content expertise needed for her career as a future independent researcher in ADRDs focused on strategies to reduce racial inequities.

项目总结