Culturally relevant contributors to cognitive and MRI changes in older Latinos

项目摘要/摘要 拉美裔是美国增长最快的少数民族人口之一，他们的比例是美国的1.5倍 像年长的非拉丁裔白人一样患上阿尔茨海默氏症。与文化相关的因素，如文化适应， 拉美人适应美国并可能采用美国的价值观和做法的过程，可能有助于 拉丁美洲人脑老化和阿尔茨海默氏症的健康差异。虽然文化适应的程度一直是 与拉美人的许多健康结果相关的是，在认知和大脑老化方面所做的工作较少。更新的 文化适应理论认为，文化适应不是一个静态的、线性的过程，而是拉美裔和西班牙人之间的动态交流 从更广泛的社会环境决定因素中脱颖而出并得到其加强的其他社会成员 对现在被称为“语境中的文化适应”(AIC)的过程至关重要。因此，除了传统的文化适应因素外， (例如，美国的语言偏好和/或年限)、个人层面(例如，感知到的歧视、家庭 和/或文化压力源)和社区水平(例如犯罪率)社会环境决定因素需要 融入对年长的拉丁裔人的研究。我们将结合地理空间信息学的进步来量化 AIC的邻域水平决定因素、纵向多模式神经成像和数字捕获 对60岁及以上拉丁裔人群的行为进行最全面的AIC研究 因为它与拉美人的大脑老化有关。到2030年，65岁及以上的拉丁裔人口将增长约225% 与非拉丁裔白人65%的增幅相比，阿尔茨海默氏症的发病率也将不成比例 为年长的拉丁裔增加。这个R01，它的重点是AIC和拉丁美洲人的脑老化，可能会提供更多 全面了解这一不成比例增长的原因。 为了达到研究的总体目标--调查AIC与认知和认知功能改变的关系 老年拉丁美洲人的脑MRI指数并确定这些因素是否会影响有充分证据的 其他危险因素与认知或脑MRI指标变化之间的关系-我们将进行 全面评估AIC框架，包括对邻里因素进行地理编码，重复 多模式核磁共振，以及对350名拉丁裔老年人行为的数字捕捉。我们将利用 拉什阿尔茨海默病中心的两项队列研究纳入了正在进行的纵向数据采集 将认知和其他风险因素引入这一R01。当组合在一起时，这些信息将允许我们检查 老年拉丁裔AIC与认知改变(Aim 1)和脑MRI指数(Aim 2)的关系 确定AIC水平是否改变了心血管疾病危险因素概况与 同一人群中的认知或脑MRI指数(目标3)。鉴于阿尔茨海默氏症的发病率是 不成比例地增加了在美国的拉美裔美国人，了解这种健康的可改变的贡献者 这一群体特有的差异是至关重要的。

PROJECT SUMMARY/ABSTRACT Latinos are one of the fastest growing minority populations in the US, and they are 1.5 times as likely to develop Alzheimer’s dementia as older non-Latino Whites. Culturally relevant factors such as acculturation, the process by which Latinos adapt to the US and potentially adopt its values and practices, may contribute to health disparities in brain aging and Alzheimer’s dementia in Latinos. While levels of acculturation have been linked to a number of health outcomes in Latinos, less work has been done in cognition and brain aging. Newer theories of acculturation suggest it is not a static, linear process but a dynamic exchange between Latinos and other members of society that emerges from and is reinforced by broader socioenvironmental determinants vital to a process now called ‘acculturation in context’ (AIC). Thus, in addition to traditional acculturation factors (e.g., language preference and/or years in the US), individual-level (e.g., perceived discrimination, family and/or cultural stressors) and neighborhood-level (e.g., crime rates) socioenvironmental determinants need to be integrated into research in older Latinos. We will incorporate advances in geospatial informatics to quantify neighborhood-level determinants of AIC, longitudinal multi-modal neuroimaging, and the digital capture of behavior in a well-characterized cohort of Latinos 60 years and older for the most comprehensive study of AIC as it relates to brain aging in Latinos. By 2030, the Latino population 65 and older will increase by ~225% compared to a 65% increase in non-Latino Whites; rates for Alzheimer’s dementias will also disproportionately increase for older Latinos. This R01, with its focus on AIC and brain aging in Latinos, may provide a more comprehensive understanding of the reasons for this disproportionate increase. To achieve the overall goal of the study – to investigate the relationship of AIC to changes in cognition and brain MRI indices in older Latinos and determine whether these factors affect the well-documented relationships between other risk factors and changes in cognition or brain MRI indices – we will conduct a comprehensive assessment of the AIC framework including the geocoding of neighborhood factors, repeat multi-modal MRI, and the digital capture of behavior in 350 older Latinos. We will leverage the infrastructure of two cohort studies at the Rush Alzheimer’s Disease Center to incorporate ongoing longitudinal data acquisition of cognition and other risk factors into this R01. When combined, this information will allow us to examine the relationship of AIC to change in cognition (Aim 1) and brain MRI indices (Aim 2) in older Latinos, and determine if levels of AIC modify the relationship of cardiovascular disease risk factor profiles to changes in cognition or brain MRI indices in this same population (Aim 3). Given that rates of Alzheimer’s dementia are disproportionately increasing for Latinos in the US, understanding modifiable contributors to this health disparity that may be specific to this population is critical.