Uncovering Mechanisms of Racial Inequalities in ADRD: Psychosocial Risk and Resilience Factors for White Matter Integrity

项目摘要 该奖学金的目标是准备申请人，约旦棕榈，作为一个独立的职业生涯， 临床研究员阐明大脑健康和阿尔茨海默病及相关痴呆症（ADRD）的差异。 拟议的项目包括一项研究，探讨种族模式的社会压力的影响 在两项队列研究中，对种族群体内部和跨种族群体的白色物质完整性进行了研究，并制定了一项培训计划， 实践研究、指导、课程和专业发展。约旦将得到一个 强大的导师团队与密歇根大学心理学系的主要赞助商 以及来自哥伦比亚大学的顾问。导师团队将提供ADRD差异方面的专业知识， 神经影像学、神经心理学和高级统计分析。训练计划将帮助约旦 发展以下方面的专门知识：1）ADRD中种族差异的生物心理社会机制，2） 表征ADRD风险的MRI图像，3）高级统计分析，包括适度和因果关系 调解，以及4）传播研究结果，并通过手稿和会议演示文稿进行合作。 认知老化和ADRD中存在明显的种族差异。在有限的治疗下， 增加ADRD风险或复原力的可改变因素对于制定针对ADRD的干预措施是必要的 减少差距。种族模式的社会压力源（例如，歧视）理论上被认为是一种驱动力， 这些不平等现象是通过多种途径造成的。在人际和社会层面，这些压力源 不成比例地影响非西班牙裔黑人老年人患ADRD的风险。识别大脑机制 其中这些心理社会应激源影响ADRD风险（即，白色物质完整性）可以提供朝向 干预目标和治疗方法。然而，很少有人知道心理社会压力如何导致ADRD 差距。因此，本研究的目的是检验1）歧视是否与白色物质有关 完整性在非西班牙裔黑人成年人，2）外部感知控制介导的黑白差异， 白色物质的完整性，3）邻里社会凝聚力是种族不平等的保护因素 白色物质的完整性。这些目标将在华盛顿海茨-因伍德哥伦比亚老龄化研究中得到检验 项目（WHICAP），一个在北方曼哈顿和密歇根州的种族和民族多样化的老年人队列。 认知老化项目（MCAP），非西班牙裔黑人和白色成年人的种族平衡队列 在密歇根州东南部度过晚年 拟议的研究旨在解决两个NIA老龄化研究的战略方向和NIA 健康差异研究框架，该框架要求在评估中考虑生物心理社会因素， 研究ADRD中的种族差异。研究结果可能有助于设计和实施 干预措施，以减少大脑老化和ADRD的种族差异。

PROJECT SUMMARY The goal of this fellowship is to prepare the applicant, Jordan Palms, for a career as an independent clinical researcher elucidating disparities in brain health and Alzheimer’s disease and related dementias (ADRD). The proposed project consists of a research study examining the impact of racially patterned social stressors on white matter integrity within and across racial groups in two cohort studies, as well as a training plan consisting of hands-on research, mentorship, coursework, and professional development. Jordan will be supported by a strong mentorship team with primary sponsors within the University of Michigan’s Department of Psychology and consultants from Columbia University. The mentorship team will provide expertise in ADRD disparities, neuroimaging, neuropsychology, and advanced statistical analyses. The training plan will help Jordan develop expertise in 1) biopsychosocial mechanisms underlying racial disparities in ADRD, 2) processing of MRI images to characterize ADRD risk, 3) advanced statistical analyses, including moderation and causal mediation, and 4) disseminating findings and collaborating via manuscripts and conference presentations. Stark racial disparities exist within cognitive aging and ADRD. With limited treatments, identifying potential modifiable factors that increase risk or resilience for ADRD is necessary to develop interventions aimed at reducing disparities. Racially patterned social stressors (e.g., discrimination) have been theorized to be a driving force for these inequalities through multiple pathways. On interpersonal and societal levels, these stressors disproportionately affect non-Hispanic Black older adults in their risk for ADRD. Identifying the brain mechanisms in which these psychosocial stressors impact ADRD risk (i.e., white matter integrity) can provide direction towards intervention targets and treatments. However, little is known about how psychosocial stress leads to ADRD disparities. Thus, the present study aims to examine whether 1) discrimination is associated with white matter integrity among non-Hispanic Black adults, 2) external perceived control mediates Black-White disparities in white matter integrity, and 3) neighborhood social cohesion serves as a protective factor for racial inequalities in white matter integrity. These aims will be examined in the Washington Heights-Inwood Columbia Aging Project (WHICAP), a racially and ethnically diverse cohort of older adults in northern Manhattan, and the Michigan Cognitive Aging Project (MCAP), a racially balanced cohort of non-Hispanic Black and White adults transitioning to late life in Southeast Michigan. The proposed study aims address both the NIA Strategic Directions for Research in Aging and the NIA Health Disparities Research Framework, which call for the consideration of biopsychosocial factors in examining racial disparities in ADRD. The findings could be useful in designing and implementing interventions to reduce racial disparities in brain aging and ADRD.