Social Mechanisms of Cognitive Aging Disparities in Rural and Urban Older Populations

拟议项目的目标是了解认知老化的城乡差异，以及社会环境如何影响老年痴呆症和相关痴呆症（ADRD）在晚年的发展。我们建议收集两波的调查和生态瞬时评估，以表征个人社交网络，面对面的互动，活动空间和ADRD的认知症状之间的关系在城市和农村地区的老年人的机制。与城市地区的老年人相比，农村地区老年人的ADRD发病率高得不成比例。干预的一个关键点是社会环境，它有可能通过提供认知刺激的机会来减少这些地理差异。例如，刺激社会互动和活动（例如，网络朋友的数量、社会接触的频率和社会活动的参与）已被确定为有希望的干预途径，以发展对ADRD的复原力。然而，现有的文献依赖于有限的和一维的社会环境的措施。我们采用多方法的方法来确定哪些方面的社会环境最好地解释城乡认知老化的差距。我们的具体目标如下：目标1是描述农村和城市地区老年人的日常社会互动和活动。目的2是评估个人网络，社会互动和活动空间的组合如何介导或调节与ADRD相关的地理居住和衰老相关的认知障碍之间的关系。目的3是探索社会环境的变化与农村和城市老年人与年龄相关的认知障碍之间的纵向关系。通过结合社会科学的前沿方法，包括社会网络分析和生态瞬时评估，该项目旨在确定新的评估和干预目标，以减少认知老化对个人，家庭和城乡医疗保健系统的负担。这些知识对于确定有效的社会干预目标以减少农村和城市地区ADRD的风险至关重要。

The goal of the proposed project is to understand rural-urban disparities in cognitive aging and how the social environment influences development of Alzheimer’s disease and related dementias (ADRD) in later life. We propose to gather two waves of surveys and ecological momentary assessments to characterize the mechanisms underlying relationships between personal social networks, face-to-face interactions, activity spaces, and cognitive symptoms of ADRD in older adults living in urban and rural areas. Rates of ADRD are disproportionately high among older adults in rural areas compared to those in urban areas. A critical point of intervention is the social environment, which has the potential to reduce these geographic disparities by offering opportunities for cognitive stimulation. For instance, stimulating social interactions and activities (e.g., number of network friends, frequency of social contact, and participation in social events) have been identified as promising avenues for interventions to develop resilience against ADRD. However, the existing literature relies on limited and unidimensional measures of the social environment. We adopt a multi-method approach to identify which aspects of the social environment best explain rural-urban cognitive aging disparities. Our specific aims are as follows: Aim 1 is characterize the daily social interactions and activities of older adults in rural and urban areas. Aim 2 is to assess how a combination of personal networks, social interactions, and activity spaces either mediate or moderate the relationship between geographic residence and aging-related cognitive impairments linked to ADRD. Aim 3 is to explore longitudinal relationships between changes in the social environment and aging-related cognitive impairments among rural and urban older adults. By combining leading-edge methods from the social sciences—including social network analysis and ecological momentary assessments—this project seeks to identify novel targets for assessment and intervention to reduce the burden of cognitive aging on individuals, families, and the health care system across rural and urban areas. This knowledge is critical for identifying effective social intervention targets for reducing risk of ADRD in rural and urban areas.