HANDLS Scan Substudy: Race, Socioeconomic status, and the Brain

描述(由申请人提供)：与种族和社会经济地位(SES)相关的显著健康差异在大脑健康终点中被注意到，包括中风(特别是在较年轻的年龄)、痴呆症、磁共振成像(MRI)的大脑结构、认知能力下降和功能残疾。需要努力理清种族和SES对大脑健康的各自影响，特别是预测未来中风和痴呆症的早期和微妙的病理学标志。MRI评估的灰质(GM)和白质(WM)体积的测量以及WM微观结构的扩散张量成像测量提供了这种被证实的关联。同样关键的是确定种族和SES与微妙的大脑病理的关系的多个水平的中介。生物医学、行为、心理、社会和环境因素已被认为是种族和SES与许多身体健康结果之间的潜在中介因素，但对这些途径与脑健康的关系知之甚少。微妙的脑病理的MRI指标也可能调节种族和SES与认知和身体功能的关系。在这里，我们提出了一项跨学科的辅助研究，以期对不同社区的健康老龄化进行研究。HANDLS研究是一项新的为期20年的流行病学调查，由国家老龄研究所的墙内研究计划进行，重点是了解居住在马里兰州巴尔的摩的4000名社会经济不同的非裔美国人(AA)和白人的健康差距。HANDLS的独特设计是为了理清种族和SES与健康结果的各自关系。在HANDLS扫描中，我们建议从500名(250名AA，250名怀特；30岁-)无中风和痴呆的具有全方位SES的HANDLS参与者中获得定量MRI数据，以：(1)检查种族和SES相关的GM和WM体积以及WM微观结构；(2)检查种族和SES与GM和WM关系的多水平中介；以及(3)GM和WM是否是种族和SES与认知和身体功能关系的近端中介。结构方程模型将被用来构建越来越复杂的模型，以解决这些相互关联的目标。公共卫生相关性：需要了解种族和自闭症与早期和微妙的脑病理标记物的关系，以及脑病理与认知和身体功能的关系，以促进适当的预防和干预策略，这对减少和最终消除中风、痴呆症以及认知和功能衰退的健康差距至关重要。

DESCRIPTION (provided by applicant): Pronounced health disparities associated with race and socioeconomic status (SES) are noted for brain health endpoints including stroke (particularly at younger ages), dementia, brain structure on magnetic resonance imaging (MRI), cognitive decline, and functional disability. Efforts are needed to disentangle respective influences of race and SES on brain health, particularly early and subtle markers of pathology predictive of future stroke and dementia. MRI- assessed measures of gray matter (GM) and white matter (WM) volume and diffusion tensor imaging measures of WM microstructure offer such proven associations. Also critical is identification of multi-level mediators of the relations of race and SES to subtle brain pathology. Biomedical, behavioral, psychological, social and environmental factors have been implicated as potential mediators of the relations of race and SES to many physical health outcomes, but exceedingly little is known about these pathways with respect to brain health. MRI indices of subtle brain pathology may also mediate relations of race and SES to cognitive and physical function. Here we propose an interdisciplinary, ancillary study to the Healthy Aging In Neighborhoods of Diversity Across the Life Span (HANDLS). HANDLS study is a new 20-year epidemiological investigation conducted by the National Institute on Aging's Intramural Research Program focused on understanding health disparities among 4,000 socioeconomically diverse African-Americans (AA) and Whites living in Baltimore, MD. HANDLS is uniquely designed to disentangle the respective relations of race and SES to health outcomes. In HANDLS SCAN we propose to obtain quantitative MRI data from 500 (250 AA, 250 White; ages 30-64) stroke- and dementia-free HANDLS participants with a full range of SES to: (1) Examine race- and SES-related disparities in GM and WM volume, and WM microstructure (2) Examine multi-level mediators - biomedical, behavioral, psychological, social, and environmental - of the relations of race and SES to GM and WM; and (3) Examine whether GM and WM are proximal mediators of the relations of race and SES to cognitive and physical function. Structural equation modeling will be used to construct increasingly complex models to address these interrelated aims. PUBLIC HEALTH RELEVANCE: An understanding of multi-level mediators of the relations of race and SES to early and subtle markers of brain pathology, and the relation of brain pathology to cognitive and physical function, is needed to facilitate appropriate strategies in prevention and intervention critical to the reduction and ultimate elimination of health disparities in stroke, dementia, and cognitive and functional decline.