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1400万人患阿尔茨海默氏病和相关痴呆症（ADRD） 少数民族将负担不成比例的负担。众所周知，某些种族/种族群体，例如 非洲裔美国人的痴呆率较高，差异的原因是未知的。虽然教育和 职业与ADRD牢固相关，教育质量和职业复杂性的研究已有 主要包括白人，或者在检查种族/种族差异时，专注于比较 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和成像标记的复杂性是血管脑损伤和神经退行性的标记 具有无与伦比的种族/种族多样性的队列。拟议的研究得出了教育质量的度量 和职业复杂性，基于Kaiser Permanente Northern的以下丰富数据源 加利福尼亚：从多相健康检查中完成的详细社会和身体措施完成了 1960年代至1990年代；从1996年开始的电子病历；以及详细的社会，认知和 Kaiser健康衰老和多样化的生活经验（Khandle）研究的神经影像措施（Khandle）研究 评估。 Khandle收集了一名，6岁，9年级和12年级就读的学校的姓名和位置 以及大学或大学都将与学校质量的历史指标有关。 有关职业收集的全面信息，可以划定职业复杂性 早期，中期和后期。利用这些全面的数据源，我们处于独特的位置 成功完成研究的目的，该目的是：1）评估教育质量的作用 认知能力下降，ADRD发病率以及血管脑损伤和神经退行性的成像标记 非裔美国人，白人，亚洲和拉丁裔个人； 2）检查职业复杂性在 认知能力下降，ADRD发病率以及血管脑损伤和神经退行性的成像标记 多样的队列； 3）描述整个生命的教育质量和职业复杂性的模式 介导ADRD的种族和种族差异，认知能力下降以及血管脑损伤的成像标记 和神经变性。按照NIH科学状态的建议，利用生命力的方法 防止认知能力下降，拟议的研究将增加有关特征和 与ADRD相关的教育质量和职业复杂性特征的时机，可能会告知 未来的干预措施旨在改善所有种族/族裔群体的认知。给定标记 种族/族裔群体的ADRD差距差异从来没有更关键的时间来了解如何 社会上下文风险因素会影响不同人群的大脑健康。