Study of Healthy Aging in African Americans

非裔美国人健康老龄化研究

• 批准号: 10739238
• 负责人: Paola Gilsanz
• 金额: $ 464.62万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-01-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10739238
• 关键词: Address; Adolescence; Adult; African; African American; African American population; African American student; Age; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; Amyloid; Amyloid beta-Protein; Atrophic; Back; Behavioral; Biological Markers; Birth; Black Populations; Black race; Blood; Blood Vessels; Brain; California; Caring; Cerebrovascular Disorders; Cerebrovascular Trauma; Childhood; Clinical; Clinical Data; Cognition; Cognitive aging; Cohort Studies; Collection; Communities; Community Health; Consent; Data; Dementia; Desegregation; Discrimination; Disparity; Education; Elderly; Enrollment; Exposure to; Family member; Female; Glial Fibrillary Acidic Protein; Goals; Health; Hyperlipidemia; Hypertension; Image; Impaired cognition; Incidence; Individual; Infrastructure; Institutional Racism; Investigation; Life; Life Cycle Stages; Life Experience; Life Style; Light; Longitudinal cohort study; Magnetic Resonance Imaging; Measures; Medical; Medical Records; Mothers; Nerve Degeneration; Neuropsychology; Not Hispanic or Latino; Obesity; Occupations; Outcome Study; Participant; Personal Satisfaction; Population; Positioning Attribute; Positron-Emission Tomography; Psychosocial Factor; Public Health; Reporting; Research; Risk Factors; Risk Reduction; Schools; Socioeconomic Status; Stress; Stroke Belt; Surveys; United States; Visit; Vulnerable Populations; Woman; aging brain; blood-based biomarker; brain health; brain magnetic resonance imaging; cardiovascular risk factor; cognitive function; cognitive performance; cohort; college; comorbidity; depressive symptoms; differences in access; experience; health disparity; healthy aging; high risk; high school; imaging biomarker; improved; interest; member; men; middle age; neurofilament; neuroimaging marker; neuropathology; programs; prospective; protective factors; recruit; resilience; resilience factor; segregation; sex; tau Proteins; vascular injury; vascular risk factor; young adult

PROJECT SUMMARY Black/African Americans have the highest rate of Alzheimer's disease and related dementias (ADRD) in the United States but evidence on risk and resiliency factors for ADRD is based almost exclusively on non-Hispanic Whites. The Study of Healthy Aging in African Americans (STAR) was initiated in 2017 (RF1AG050782) as a lifecourse cohort study of cognitive ageing in middle aged and elderly Black individuals who are long-term members of Kaiser Permanente Northern California. Recently established, STAR is one of the largest all Black cohort studies with prospective clinical, lifestyle, and behavioral data from 1960s - present. Cycle 1of STAR accomplished key goals including commencement of the cohort and enrollment of 764 Black individuals (mean age 69, range 53-95; 66% female) with 3 research visits approximately 15 months apart. All waves included an extensive neuropsychology battery along with survey collection of psychosocial factors, stress, discrimination, occupation, and an array of health, behavioral and functional measures, 233 participants had a brain MRI. STAR Cycle 1 has contributed key findings about cognitive aging in the Black population and set up an unprecedented infrastructure enabling linkage of early-life data and medical records to investigate predictors of cognitive decline, neurodegeneration and vascular injury. STAR participants display a wide array of life experiences and resiliency: 47% attended college, 80% reporting everyday discrimination, 57% with mothers < high school education, 28% financial problems in childhood while 4% in adulthood, 39% attended segregated schools, and 36% had >1 cardiovascular risk factor in young adulthood. Key findings from Cycle 1 include: 1) school segregation and timing of desegregation is associated with differences in late-life cognition; 2) hypertension, obesity, and hyperlipidemia in adolescence, young adulthood, and midlife are associated with poorer cognitive performance and more vascular brain injury; 3) birth in a stroke-belt state is associated with poorer cognitive function; 4) parental education and childhood socioeconomic status are associated with cognitive performance; and 5) attending a school with mostly Black students is associated with lower depressive symptoms in later life. The establishment of STAR in Cycle 1 sets the infrastructure for an unprecedented continuing study of the transition to ADRD and identification of lifetime factors that can reduce risk of cognitive impairment in Black older adults. In this completive renewal for Cycle 2 of STAR our aims are: Aim 1a: Enroll an additional 400 individuals into STAR to determine age and sex-specific incident ADRD and domain specific cognitive decline in a cohort of Black individuals. Aim1b: Evaluate lifecourse risk and protective factors of ADRD and cognitive decline in this cohort. Aim 2: Collect blood-based biomarkers consistent with the ATN framework (Aβ 42/40, total Tau and phosphoTau-181, neurofilament light [NfL], glial fibrillary acidic protein [GFAP]) and evaluate their contribution to ADRD and cognitive decline in a cohort of Black individuals. Aim 3a: Determine the contribution of lifecourse risk and protective factors on neuroimaging markers of neurodegeneration, atrophy, and vascular injury change in 300 Black individuals. Aim 3b: Determine the contribution of neuroimaging markers of neurodegeneration, atrophy, and vascular injury change on cognitive decline and ADRD in a Black cohort. Aim 4a: Initiate a brain donation program in STAR and characterize the spectrum of neuropathology in a cohort of Black participants. Aim 4b. Evaluate predictors of interest, consent, and participation in the brain donation program.

项目摘要 在美国，黑人/非洲裔美国人的阿尔茨海默病和相关痴呆症（ADRD）发病率最高 但ADRD的风险和弹性因素的证据几乎完全基于非西班牙裔白人。研究 非裔美国人的健康老龄化（星星）于2017年启动（RF 1AG 050782），作为一项生命过程队列研究， Kaiser Permanente长期会员中老年黑人的认知老化 北方加州。最近成立的星星是最大的全黑人队列研究之一，具有前瞻性临床， 生活方式和20世纪60年代至今的行为数据。星星的第1周期完成了关键目标，包括 队列和入组764名黑人个体（平均年龄69岁，范围53-95岁; 66%为女性），进行3次研究访视 大约相隔15个月所有波都包括一个广泛的神经心理学电池沿着的调查收集， 心理社会因素，压力，歧视，职业，以及一系列健康，行为和功能措施，233 参与者接受了脑部MRI检查。星星周期1贡献了关于黑人人口认知老化的关键发现 并建立了一个前所未有的基础设施，使早期生命数据和医疗记录的联系，以调查预测因素 认知能力下降神经退化和血管损伤星星参与者展示了广泛的生活经历 和弹性：47%上过大学，80%报告每天受到歧视，57%的母亲<高中教育， 28%的儿童有经济问题，4%的成年人有经济问题，39%的人上过隔离学校，36%的人有>1 心血管危险因素。第一周期的主要研究结果包括：1）学校隔离和 种族隔离与晚年认知的差异有关; 2）高血压，肥胖和高脂血症， 青春期、青年期和中年与认知能力较差和大脑血管较多有关 损伤; 3）在中风带状态下出生与认知功能较差有关; 4）父母教育和童年 社会经济地位与认知表现有关; 5）就读于黑人学生居多的学校， 与晚年较低的抑郁症状有关。在第一周期建立了星星， 一项前所未有的关于向ADRD过渡的持续研究，并确定了可以降低ADRD风险的终身因素。 黑人老年人的认知障碍在星星第2周期的全面更新中，我们的目标是：目标1a：注册 另外400名个体进入星星，以确定年龄和性别特异性事件ADRD和领域特异性认知 一群黑人的衰落。目标1b：评估ADRD和认知的生命过程风险和保护因素 在这个群体中下降。目的2：收集与ATN框架一致的血液生物标志物（Aβ 42/40，总Tau 和磷酸化Tau-181，神经丝轻[NfL]，胶质细胞酸性蛋白[GFAP]），并评估它们对 一组黑人个体的ADRD和认知下降。目标3a：确定生命周期风险的贡献， 300例黑人神经退行性变、萎缩和血管损伤变化的神经影像学标志物的保护因素 个体目的3b：确定神经退行性变、萎缩和血管病变的神经影像学标志物的作用 黑人队列中认知下降和ADRD的损伤变化。目标4a：在星星启动一项大脑捐赠计划， 描述一组黑人参与者的神经病理学谱。目标4 b。评估感兴趣的预测因子， 同意，并参与大脑捐赠计划。

项目成果

What is the association between adverse childhood experiences and late-life cognitive decline? Study of Healthy Aging in African Americans (STAR) cohort study.

• DOI: 10.1136/bmjopen-2023-072961
• 发表时间: 2023-11-02
• 期刊: BMJ OPEN
• 影响因子: 2.9
• 作者: Lor, Yi;George, Kristen M.;Gilsanz, Paola;Meunier, Claire C.;Peterson, Rachel L.;Hayes-Larson, Eleanor;Barnes, Lisa L.;Mungas, Dan;Whitmer, Rachel A.
• 通讯作者: Whitmer, Rachel A.

Evaluating interpersonal discrimination and depressive symptoms as partial mediators of the effects of education on cognition: Evidence from the Study of Healthy Aging in African Americans (STAR).

评估人际歧视和抑郁症状作为教育对认知影响的部分中介：来自非裔美国人健康老龄化研究（STAR）的证据。

• DOI: 10.1002/alz.12957
• 发表时间: 2023
• 期刊: Alzheimer's & dementia : the journal of the Alzheimer's Association
• 作者: Cintron,DakotaW;Calmasini,Camilla;Barnes,LisaL;Mungas,DanM;Whitmer,RachelA;Eng,ChloeW;Gilsanz,Paola;George,KristenM;Peterson,RachelL;Glymour,MMaria
• 通讯作者: Glymour,MMaria

Association of Timing of School Desegregation in the United States With Late-Life Cognition in the Study of Healthy Aging in African Americans (STAR) Cohort.

• DOI: 10.1001/jamanetworkopen.2021.29052
• 发表时间: 2021-10-01
• 期刊: JAMA network open
• 影响因子: 13.8
• 作者: Peterson RL;George KM;Barnes LL;Gilsanz P;Mayeda ER;Glymour MM;Mungas DM;Whitmer RA
• 通讯作者: Whitmer RA