Contributions of educational quality and occupational complexity on racial and ethnic inequities in brain health and Alzheimer's disease and related dementia

教育质量和职业复杂性对大脑健康和阿尔茨海默病及相关痴呆症中种族和民族不平等的影响

• 批准号: 10642798
• 负责人: Paola Gilsanz
• 金额: $ 35.33万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-15 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10642798
• 关键词: Address; Adult; African American; African American population; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Asian population; California; Cerebrovascular Trauma; Characteristics; Cognition; Cognitive; Cognitive aging; Complex; Computerized Medical Record; Data; Data Sources; Dementia; Discrimination; Disease; Disparity; Education; Educational Status; Elderly; Epidemiology; Ethnic Population; Evaluation; Future; Goals; Health; Impaired cognition; Incidence; Individual; Intervention; Knowledge; Latino Population; Lead; Legal; Life Cycle Stages; Life Experience; Link; Location; Magnetic Resonance Imaging; Measures; Mediating; Minority; Minority Groups; Names; Nerve Degeneration; Neurology; Occupational; Occupations; Participant; Pathway interactions; Pattern; Persons; Phase; Physiological; Population; Population Heterogeneity; Positioning Attribute; Positron-Emission Tomography; Primary Schools; Public Health; Race; Recommendation; Reporting; Research; Risk Factors; Role; Schools; Science; Secondary Schools; Social Environment; Socioeconomic Status; Source; Stroke; Time; United States National Institutes of Health; Universities; aging brain; brain health; caucasian American; checkup examination; cognitive reserve; cohort; college; dementia risk; ethnic difference; ethnic disparity; ethnic diversity; experience; first grade; health disparity; healthy aging; high school; imaging biomarker; improved; junior high school; neuroimaging; ninth grade; prevent; protective factors; racial difference; racial discrimination; racial disparity; racial diversity; racial population; segregation; sixth grade; social; symposium; twelfth grade

ABSTRACT By 2050 nearly 14 million people will suffer from Alzheimer's disease and related dementias (ADRD) in the US and minorities will be disproportionally burdened. While it is known that certain racial/ethnic groups, such as African Americans, have higher rates of dementia, reasons for disparities are unknown. Though education and occupation are robustly associated with ADRD, research on education quality and occupational complexity has primarily included only Whites or, when examining racial/ethnic differences, focused on comparisons between Whites and African Americans. We propose to examine the role of educational quality and occupational complexity on cognitive decline, ADRD, and imaging markers of vascular brain injury and neurodegeneration in a cohort with unparalleled racial/ethnic diversity. The proposed study derives measures of education quality and occupational complexity, building upon the following rich data sources at Kaiser Permanente Northern California: detailed social and physical measures from a Multiphasic Health Checkup completed during the 1960s to 1990s; electronic medical records from 1996 onward; and detailed social, cognitive, and neuroimaging measures from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study assessments. KHANDLE collects the names and locations of schools attended at 1st, 6th, 9th, and 12th grades as well as college or university attended which will be linked to historical indicators of school quality. Comprehensive information collected regarding occupation enables delineation of occupational complexity in early-, mid-, and late-adulthood. Utilizing these comprehensive data sources, we are in a unique position to successfully complete the aims of the study, which are to: 1) Evaluate the roles of education quality on cognitive decline, ADRD incidence, and imaging markers of vascular brain injury and neurodegeneration in African American, White, Asian, and Latino individuals; 2) Examine the role of occupational complexity on cognitive decline, ADRD incidence, and imaging markers of vascular brain injury and neurodegeneration in this diverse cohort; 3) Delineate if patterns of educational quality and occupational complexity across the lifecourse mediate racial and ethnic disparities in ADRD, cognitive decline, and imaging markers of vascular brain injury and neurodegeneration. Utilizing a lifecourse approach, as recommended by the NIH State of the Science on Preventing Cognitive Decline, the proposed research will add vital information regarding the characteristics and timing of education quality and occupational complexity characteristics associated with ADRD and may inform future interventions aiming to improve cognition among elderly of all racial/ethnic groups. Given the marked disparities in ADRD rates by racial/ethnic groups there has never been a more critical time to understand how sociocontextual risk factors impact brain health in diverse populations.

抽象的 到 2050 年，美国将有近 1400 万人患有阿尔茨海默病和相关痴呆症 (ADRD) 少数族裔将承受不成比例的负担。虽然众所周知，某些种族/族裔群体，例如 非裔美国人的痴呆症发病率较高，造成差异的原因尚不清楚。虽然教育和 职业与 ADRD 密切相关，对教育质量和职业复杂性的研究表明 主要只包括白人，或者在检查种族/民族差异时，重点关注之间的比较 白人和非裔美国人。我们建议研究教育质量和职业的作用 认知能力下降、ADRD 以及血管性脑损伤和神经退行性变的影像学标志物的复杂性 一群具有无与伦比的种族/民族多样性的群体。拟议的研究得出了教育质量的衡量标准 和职业复杂性，基于 Kaiser Permanente Northern 的以下丰富数据源 加利福尼亚州：在多阶段健康检查期间完成的详细社会和身体措施 20 世纪 60 年代至 90 年代； 1996 年起的电子病历；以及详细的社交、认知和 凯撒健康老龄化和多样化生活经历 (KHANDLE) 研究的神经影像学测量 评估。 KHANDLE 收集一年级、六年级、九年级和十二年级就读学校的名称和位置 以及就读的学院或大学，这将与学校质量的历史指标联系起来。 收集的有关职业的综合信息可以描述职业的复杂性 成年早期、中期和晚期。利用这些全面的数据源，我们处于独特的地位 成功地完成了研究的目标，即： 1）评估教育质量对 认知能力下降、ADRD 发生率以及血管性脑损伤和神经退行性疾病的影像学标志物 非裔美国人、白人、亚洲人和拉丁美洲人； 2）考察职业复杂性对 认知能力下降、ADRD 发生率以及血管性脑损伤和神经退行性变的影像学标志物 多样化的群体； 3) 描述整个生命历程中的教育质量和职业复杂性模式 介导ADRD、认知能力下降和血管性脑损伤的影像学标志物中的种族和民族差异 和神经退行性变。根据 NIH 科学状况的建议，采用生命全程方法 为了预防认知能力下降，拟议的研究将添加有关特征和特征的重要信息 与 ADRD 相关的教育质量和职业复杂性特征的时间安排，可能会提供信息 未来的干预措施旨在提高所有种族/族裔群体老年人的认知能力。鉴于已标记 种族/族裔群体 ADRD 比率存在差异，现在正是了解如何解决这一问题的关键时刻 社会环境风险因素影响不同人群的大脑健康。