Multilevel Biopsychosocial Stress Mechanisms Underlying Racial Disparities in ADRD Risk

项目总结 该奖学金的目标是为申请者艾米丽·莫里斯的独立职业生涯做好准备。 研究阿尔茨海默病种族差异的生物心理社会应激机制的临床研究人员 疾病及相关痴呆(ADRD)。拟议的项目包括一项研究项目，该项目研究 多水平心理社会应激源和生物危险因素在ADRD风险和年龄的种族差异中的作用 包括正式课程、指导、实践研究和专业发展的培训计划。 艾米丽将得到密歇根大学一个强大的导师团队的支持，该团队的主要赞助者是密歇根大学 公共卫生学院心理学系和社会研究所顾问 和哥伦比亚大学。指导团队将提供ADRD差异、神经心理学、 神经影像、流行病学和高级统计分析。培训计划将帮助艾米丽发展 1)ADRD中种族差异的生物、心理和社会决定因素方面的专门知识，2)生物风险因素和 ADRD的神经病理过程，3)高级纵向统计分析，包括病因 推论，以及4)通过手稿和会议报告传播调查结果和建立联系。 可持续发展中的种族差距依然存在。没有广泛可用的治疗方法来改变这种疾病 在ADRD的过程中，更好地理解潜在的生物-心理-社会机制在设计中至关重要 旨在缓解这些差距的干预措施。多个层面的压力源(即人际、社区、社会) 不成比例地影响非西班牙裔黑人老年人，并可能增加ADRD的风险，通过 神经心理测试。这些心理社会应激源产生风险的生物学机制 ADRD(即炎症、脑血管疾病)可能为干预目标提供进一步的洞察力。那里 关于这些机制如何导致ADRD风险和差异，几乎没有达成共识。因此，现在 这项研究旨在调查1)多个水平的心理社会应激源是否在ADRD中起到调节种族差异的作用 风险，2)生物风险因素在心理社会应激源和ADRD风险之间起中介作用 黑人和白人老年人，以及3)类似的协会可以在一个独立的，全国性的 代表性数据集。这些目标将在密歇根州认知老龄化项目(MCAP)中进行检验，这是一项 密歇根州东南部非西班牙裔黑人和白人老年人的种族平衡队列，以及健康 以及退休研究(HRS)，这是一项具有全国代表性的关于美国老年人的研究。 拟议的研究旨在解决NIA老龄化研究的战略方向和NIA 健康差距研究框架，呼吁考虑生物、心理和社会因素 审查ADRD的种族差异。这些研究结果可以为设计和实施可行的 采取干预措施，以缓解ADRD的种族差距。

PROJECT SUMMARY The goal of this fellowship is to prepare the applicant, Emily Morris, for a career as an independent clinical researcher examining biopsychosocial stress mechanisms underlying racial disparities in Alzheimer's disease and related dementias (ADRD). The proposed project consists of a research project examining the roles of multilevel psychosocial stressors and biological risk factors in racial disparities in ADRD risk and a training plan consisting of formal coursework, mentorship, hands-on research, and professional development. Emily will be supported by a strong mentorship team with primary sponsors at the University of Michigan's Department of Psychology and Institute for Social Research and consultants from the School of Public Health and Columbia University. The mentorship team will provide expertise in ADRD disparities, neuropsychology, neuroimaging, epidemiology, and advanced statistical analyses. The training plan will help Emily develop expertise in 1) biopsychosocial determinants of racial disparities in ADRD, 2) biological risk factors and neuropathological processes of ADRD, 3) advanced longitudinal statistical analyses, including causal inference, and 4) disseminating findings and networking via manuscripts and conference presentations. Racial disparities in ADRD remain persistent. Without widely available treatment to modify the disease course of ADRD, better understanding of underlying biopsychosocial mechanisms is critical in designing interventions to alleviate these disparities. Stressors at multiple levels (i.e., interpersonal, community, societal) disproportionately affect non-Hispanic Black older adults and may increase risk for ADRD, ascertained through neuropsychological testing. Biological mechanisms through which these psychosocial stressors confer risk for ADRD (i.e., inflammation, cerebrovascular disease) may provide further insight for intervention targets. There is little consensus regarding how these mechanisms contribute to ADRD risk and disparities. Thus, the present study aims to examine whether 1) psychosocial stressors at multiple levels mediate racial disparities in ADRD risk, 2) biological risk factors mediate associations between psychosocial stressors and ADRD risk across Black and White older adults, and 3) similar associations can be identified in an independent, nationally representative dataset. These aims will be examined in the Michigan Cognitive Aging Project (MCAP), a racially balanced cohort of non-Hispanic Black and White older adults in Southeast Michigan, and the Health and Retirement Study (HRS), a nationally representative study of older adulthood in the US. 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 inform design and implementation of feasible interventions to alleviate racial disparities in ADRD.