Longitudinal Examination of Neighborhood Disadvantage, Cognitive Aging, and Alzheimer's Disease Risk in Disinvested, African American Neighborhoods

项目摘要 非裔美国人(AA)阿尔茨海默病的发病率和发病时间都不成比例地高，而且 与美国白人相关的痴呆(ADRD)。尽管先前的研究已经取得了显著的进展 尽管我们对ADRD中的种族差异的理解有所贡献，但我们仍然缺乏对 个人作为AA的生活经历，包括累积暴露于结构性种族主义，对 增加的ADRD风险以及这些风险背后的潜在机制。在现有的基础上， 由我们团队以前资助的研究开发的基于社区的研究基础设施，我们将遵循 居住在两个历史上被撤资的、以AA为主的社区的居民队列(n=1133)，以了解 生命周期中动态的社区社会经济状况如何影响认知结果 中老年成年人。这项提议的前提是，社区隔离和随后的 撤资通过以下因素导致AA认知结果较差：a)较少获得 教育机会和b)更多地接触与种族和社会经济有关的压力源，包括 歧视、创伤和不良童年事件。反过来，这些累积的暴露会滋生心理 居民的警觉，导致心脏代谢失调和睡眠中断，这可能是 邻里劣势与不良反应风险之间的关联。我们还将检查潜在的保护措施 可能促进认知健康的因素，包括社区社会凝聚力、安全性和满意度。 拟议的研究将利用我们现有的关于风险和保护因素、生物行为的纵向数据 中介者和基线认知评估，并将包括：1)三波认知评估 50岁的全部参与者(35-49岁的参与者将有两个 对50岁的受试者进行ADRD的评估和临床判定(n=906)，2)附加 对血压和客观睡眠的评估，3)对生活和居住的综合评估 使用健康和退休研究(HRS)的问卷调查历史；以及4)深入定性 访谈揭示AA在实现最佳认知方面所经历的人生机遇和障碍 晚年的健康。了解结构性种族主义如何影响AA的生活体验，包括 随着时间的推移，邻里条件的动态变化对于多层次干预和政策的制定至关重要 努力减少消除种族歧视中普遍存在的种族和社会经济差距。

Project Summary African Americans (AAs) have disproportionately higher rates and earlier onset of Alzheimer’s disease and related dementias (ADRD) relative to White Americans. Although prior research has made significant contributions to our understanding of racial disparities in ADRD, we still lack a comprehensive understanding of how the individual lived experience of being AA, including cumulative exposure to structural racism, contributes to elevated ADRD risk and the potential mechanisms underlying those risks. Building on the existing, community-based research infrastructure developed by our team’s previously funded studies, we will follow a cohort of residents (n=1133) living in two historically disinvested, predominantly AA communities to understand how dynamic neighborhood socioeconomic conditions across the lifecourse contribute to cognitive outcomes in mid- and late-life adults. This proposal rests on the premise that neighborhood segregation and subsequent disinvestment contributes to poor cognitive outcomes for AAs via factors including a) lower access to educational opportunities and b) higher exposure to race- and socioeconomically-relevant stressors, including discrimination, trauma, and adverse childhood events. In turn, these cumulative exposures foster psychological vigilance in residents, leading to cardiometabolic dysregulation and sleep disruption, which may mediate associations between neighborhood disadvantage and ADRD risk. We also will examine potential protective factors that may promote cognitive health, including neighborhood social cohesion, safety, and satisfaction. The proposed study will leverage our existing longitudinal data on risk and protective factors, biobehavioral mediators, and baseline cognitive assessments, and will include: 1) three waves of cognitive assessments in the full cohort of participants who are 50 years+ (participants who are aged 35-49 years will have two assessments) and clinical adjudication of ADRD in participants who are 50+ (n=906), 2) additional assessments of blood pressure and objective sleep, 3) a comprehensive assessment of life and residential history using the questionnaire from the Health and Retirement Study (HRS); and 4) in-depth qualitative interviews to reveal lifecourse opportunities and barriers experienced by AAs in achieving optimal cognitive health in late life. Understanding how structural racism has influenced the lived experience of AAs including dynamic changes in neighborhood conditions over time is critical to inform multi-level intervention and policy efforts to reduce pervasive racial and socioeconomic disparities in ADRD.