Lifecourse Community Contexts and Health Behaviors as Drivers of Disparities in Risk of Alzheimer's Disease and Related Dementias

项目总结/摘要 阿尔茨海默病和相关痴呆症（ADRD）是一个紧迫的公共卫生问题， 差距。ADRD只能通过最大限度地减少可改变的风险因素（尤其是健康）的影响来解决 行为。然而，有证据表明，健康行为是由社区环境塑造的（即建立 和社会环境），我们生活，工作，娱乐和年龄。不理解和不负责社区- ADRD风险降低中的水平背景因素可能会最大限度地减少公共卫生措施的影响， ADRD的风险和恶化的健康差距。调查连接社区背景因素的途径， 健康行为参与和ADRD风险的差异是推进科学的一个尚未开发的机会 ADRD风险降低，并通过“照亮社会， 心理，经济和行为因素影响健康，”和“了解环境，社会， 文化，行为和生物因素，创造和维持健康差距。 这项研究利用了由NIH资助的两个创新项目（Kaiser Healthy Aging和Diverse）的数据。 生活经验（KHANDLE）;邻里地图集）和PolicyMap数据库，以确定何时以及如何 社区环境因素塑造健康行为和ADRD风险和差异。该项目将连接 KHANDLE参与者从出生到晚年的居住史与经验证的区域延迟指数 从1910年至今，通过邻里Atlast提供，并对建筑环境进行地理编码 通过PolicyMap。这项建议旨在界定：（1）接触社区的时间或持续时间 环境与晚年认知/大脑健康相关; 2）如果个人健康行为介导关系 社区环境和认知/大脑健康之间的关系; 3）这些途径是否因种族/民族或性别而异。 这项研究得到了加州戴维斯大学详细培训计划的补充， 导师团队由国内和国际知名学者组成。培训将建立在 申请人在社会流行病学、健康促进和健康大脑老化研究方面的背景， 在因果推理方法，地理空间分析，建模神经成像生物标志物， 转化流行病学结合研究和培训将准备申请人成功 独立的研究生涯，专注于了解和解决ADRD的可修改途径 差距。拟议研究的结果对于推进基于人群的ADRD风险降低至关重要 消除而不是加剧健康差距的战略。

PROJECT SUMMARY/ABSTRACT Alzheimer's disease and related dementias (ADRD) are a pressing public health issue with substantial disparities. ADRD can only be addressed by minimizing the impact of modifiable risk factors – especially health behaviors. However, evidence suggests that health behaviors are shaped by the community contexts (i.e. built and social environments) in which we live, work, play, and age. Failure to understand and account for community- level contextual factors in ADRD risk reduction may minimize the impact of public health measures to reduce the risk of ADRD and worsen health disparities. Investigating pathways that connect community contextual factors, health behavior engagement, and disparities in ADRD risk is an untapped opportunity to advance the science ADRD risk reduction, and is aligned with NIA's strategic goals by “illuminat(ing) the pathways by which social, psychological, economic, and behavioral factors affect health,” and “understand(ing) environmental, social, cultural, behavioral, and biological factors that create and sustain health disparities.” This study leverages data from two innovative projects funded by the NIH (Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE); Neighborhood Atlas) and the PolicyMap database to identify when and how community contextual factors shape health behaviors and ADRD risk and disparities. This project will link KHANDLE participants' residential histories from birth to late-life with the validated Area Deprivation Indices available via the Neighborhood Atlast from 1910 to present, and geocoded measures of the built environment available via PolicyMap. This proposal seeks to define: 1) how the timing or duration of exposure to community contexts is associated with late-life cognitive/brain health; 2) if individual health behaviors mediate relationships between community contexts and cognitive/brain health; 3) if these pathways differ by race/ethnicity or gender. This research is complimented by a detailed training plan at the University of California Davis guided by a mentorship team comprised of nationally and internationally recognized scholars. The training will build upon the applicant's background in social epidemiology, health promotion, and healthy brain aging research to incorporate new training in causal inference methods, geospatial analysis, modeling neuroimaging biomarkers, and translational epidemiology. The combined research and training will prepare the applicant for a successful independent research career focused on understanding and addressing modifiable pathways for ADRD disparities. Findings from the proposed research are critical for advancing population based ADRD risk reduction strategies that eliminate, rather than exacerbate, health disparities.