Factors of Resilience to Alzheimers Disease and Related Dementias among Latinx: The Role of Bilingualism

项目摘要/摘要 随着人口老龄化，拉丁裔社区、家庭和医疗保健系统将面临 阿尔茨海默病和相关痴呆症(ADRD)危机日益严重。确定增强韧性的因素 在老龄化的拉丁裔社区中开展ADRD，对于成功地缩小差距至关重要。一些人 研究发现，与单语者相比，双语者患AD的风险更低，但其他研究没有发现 双语优势的证据。双语者之间的群体内部差异几乎没有受到关注， 如第二语言(L2)习得年龄、熟练程度和语言使用频率，以及这些因素如何 差异1)与老年人的认知功能有关，2)如果它们缓冲了神经病理对 认知衰退，以及3)AD认知衰退如何影响双语者的语言使用。 确定双语能力对阿尔茨海默病的复原力可能导致新的干预措施 缓解认知老化和ADRD差异。这个项目的总体目标是确定方面是否 掌握双语的程度，包括习得年龄、语言使用和熟练程度，可以缓冲神经成像的影响 认知和认知衰退的病理标记物(如AD生物标记物和脑血管疾病) 在中老年拉丁裔成年人中。这项研究的K99阶段显示，较早的获得年龄， 更高的二语熟练程度和更多的日常双语使用，但没有增加语码转换 与情节记忆、语言能力和执行功能的各方面呈正相关， 不受令人困惑的社会文化因素(即教育、社会经济地位、移民)的影响。在 R00阶段，将评估双语能力与认知衰退的影像指标之间的关系 (目标1)我们将评估认知状态的变化是否与 双语能力(目标2)。这项拟议的研究将协调目前在三个州注册的拉丁裔成年人的数据 有可用的淀粉样蛋白和tau PET、MRI和认知评估的纵向队列：子代研究 以及哥伦比亚大学华盛顿高地-因伍德哥伦比亚老龄化项目，以及哥伦比亚大学 加州-戴维斯多样性老龄化队列。为了实现这些目标，申请者在 文化神经心理学、健康差异和统计方法，通过在 K99阶段集中于1)扩展认知神经科学和心理语言学的知识 双语能力；2)神经影像数据建模；3)复原力的可操作性和测量 拉丁裔人口老龄化；以及4)加强统计方法，侧重于数据协调，随意 推理方法和潜变量建模。这份R00提案为独立的 研究生涯主要集中在认知老化中双语保护因素的潜在机制。

Project Summary/Abstract As the population ages, Latinx communities, families, and healthcare systems will be confronted by the growing crisis of Alzheimer’s disease and related dementias (ADRD). Identifying factors that confer resilience to ADRD among aging Latinx communities is of critical importance to successfully reduce disparities. Some studies find that bilinguals are at reduced AD risk compared to monolinguals, but other studies do not find evidence of a bilingual advantage. Little attention has been given to within-group differences among bilinguals, such as age of second language (L2) acquisition, proficiency, and frequency of language use, and how these differences 1) are related to cognitive function in older age, 2) if they buffer the effects of neuropathology on cognitive decline, and 3) how cognitive decline in AD can influence language use among bilinguals. Determination of the aspects of bilingualism that confer resilience to AD could lead to novel interventions to mitigate cognitive aging and ADRD disparities. The overall aim of this project is to determine whether aspects of bilingualism, including age of acquisition, language use, and proficiency, buffer the effects of neuroimaging markers of pathology (i.e., AD biomarkers and cerebrovascular disease) on cognition and cognitive decline within middle- and older-aged Latinx adults. The K99 phase of this study showed that earlier age of acquisition, greater L2 proficiency, and greater daily bilingual language use, but not increased code-switching, were positively associated with episodic memory, language abilities, and aspects of executive functioning, independent of confounding sociocultural factors (i.e., education, socioeconomic status, immigration). In the R00 phase, the relationship between bilingualism and imaging markers on cognitive decline will be evaluated (Aim 1) and we will evaluate whether change in cognitive status is associated with longitudinal changes in bilingualism (Aim 2). The proposed study will harmonize data from Latinx adults currently enrolled in three longitudinal cohorts with available amyloid and tau PET, MRI, and cognitive assessments: the Offspring study and the Washington Heights-Inwood Columbia Aging Project at Columbia University, and the University of California-Davis Diversity Aging Cohort. To accomplish these goals, the applicant has built on his strengths in cultural neuropsychology, health disparities, and statistical methods through the training obtained during the K99 phase focused on 1) expanding knowledge of the cognitive neuroscience and psycholinguistics of bilingualism; 2) modeling neuroimaging data; 3) the operationalization and measurement of resilience among aging Latinx populations; and 4) enhancing statistical methods focused on data harmonization, casual inference methods and latent variable modeling. This R00 proposal lays the foundation for an independent research career focused on mechanisms underlying the protective factors of bilingualism in cognitive aging.