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

项目摘要/摘要 阿尔茨海默病和相关痴呆(ADRD)是一个紧迫的公共卫生问题，有大量的 差距。ADRD只能通过将可改变的风险因素的影响降至最低来解决--尤其是健康 行为。然而，有证据表明，健康行为是由社区环境塑造的(即 和社会环境)，我们生活、工作、娱乐和变老。未能理解和解释社区- 减少ADRD风险的水平背景因素可能会将公共卫生措施的影响降至最低 有患ADRD的风险，并加剧健康差距。调查连接社区背景因素的路径， 健康行为参与和ADRD风险差异是推动科学发展的一个尚未开发的机会 ADRD降低风险，并与NIA的战略目标保持一致，通过“照亮”社会、 心理、经济和行为因素影响健康，“理解”环境、社会、 造成和维持健康差距的文化、行为和生物因素。 这项研究利用了由美国国立卫生研究院资助的两个创新项目(凯撒健康老龄化和多元化)的数据 生活体验(KhandLe)；邻里地图集)和政策地图数据库，以确定时间和方式 社区背景因素塑造健康行为以及ADRD风险和差异。该项目将链接 Khandle参与者从出生到晚年的居住史与验证的面积剥夺指数 从1910年到现在，可通过邻居获得，并对建成环境进行地理编码测量 可通过PolicyMap获得。这项提议试图定义：1)接触社区的时间或持续时间 背景与晚年认知/大脑健康有关；2)个人健康行为是否会调节人际关系 社区背景和认知/大脑健康之间的关系；3)这些途径是否因种族/民族或性别而不同。 这项研究得到了加州大学戴维斯分校详细的培训计划的赞扬，该计划由一名 由国内和国际公认的学者组成的导师团队。培训将建立在 申请人在社会流行病学、健康促进和健康脑老化研究方面的背景 在因果推理方法、地理空间分析、神经成像生物标记物建模以及 翻译流行病学。研究和培训的结合将使申请者为成功的 独立研究生涯专注于理解和解决ADRD的可修改途径 差距。拟议研究的结果对于推进以人群为基础的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.