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）有不成比例的更高的比率和更早的阿尔茨海默病发作， 相关性痴呆（ADRD）相对于白色美国人。尽管先前的研究已经取得了重大进展， 尽管我们对ADRD中的种族差异的理解做出了贡献，但我们仍然缺乏对ADRD中种族差异的全面理解。 如何个人生活的经验，是AA，包括累积暴露于结构性种族主义，有助于 ADRD风险升高以及这些风险的潜在机制。在现有基础上， 基于社区的研究基础设施，由我们的团队以前资助的研究开发，我们将遵循 一组居民（n=1133）生活在两个历史上被剥夺投资的，主要是AA社区，以了解 在整个生命过程中，动态的社区社会经济条件如何有助于认知结果， 中年和老年人。这一建议的前提是，邻里隔离和随后的 撤资通过以下因素导致AA的认知结果不佳，包括a）较低的获得 教育机会和B）更高的种族和社会经济相关的压力，包括 歧视、创伤和不良童年事件。反过来，这些累积的暴露会促进心理上的 居民的警惕性，导致心脏代谢失调和睡眠中断，这可能介导 邻里劣势与ADRD风险之间的关联。我们还将检查潜在的保护性 可能促进认知健康的因素，包括邻里社会凝聚力，安全和满意度。 拟议的研究将利用我们现有的风险和保护因素，生物行为， 介质和基线认知评估，并将包括：1）三波认知评估， 年龄在50岁以上的参与者（35-49岁的参与者将有两个 50岁以上受试者（n=906）的ADRD临床裁定，2）额外 血压和客观睡眠的评估，3）生活和住宅的综合评估 使用健康与退休研究（HRS）的问卷调查历史;以及4）深入定性 访谈，以揭示AAs在实现最佳认知能力方面所经历的生命过程机会和障碍 晚年的健康了解结构性种族主义如何影响AA的生活经历，包括 邻里状况随时间的动态变化对于多层次干预和政策的制定至关重要 努力减少民主与复兴运动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.