Multimorbidity Trajectories, Psychosocial Resilience and Stress, and Risk of Dementia and Poor Cognitive Functioning

多重发病轨迹、社会心理弹性和压力、痴呆症和认知功能不良的风险

基本信息

批准号：
10524911
负责人：
Kellee White Whilby
金额：
$ 22.61万
依托单位：
UNIV OF MARYLAND, COLLEGE PARK
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-01 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10524911
关键词：
Address Affect Aging Alzheimer disease prevention Alzheimer&apos s Disease Alzheimer&apos s disease risk Attenuated Biological Aging Black Populations Buffers Cause of Death Chronic Chronic Disease Chronic stress Clinical Clinical Course of Disease Cognition Cognitive Cox Models Data Dementia Development Discrimination Disease Disease Progression Elderly Episodic memory Foundations Gender Growth Health Health and Retirement Study Heterogeneity Impaired cognition Inequality Intervention Investigation Knowledge Life Cycle Stages Link Literature Methodology Methods Modeling Nature Outcome Pattern Population Population Heterogeneity Prevalence Prevention strategy Process Prospective cohort Psychosocial Factor Psychosocial Stress Race Research Risk Risk Factors Role Scholarship Self Efficacy Short-Term Memory Social isolation Social support Specific qualifier value Stress Therapeutic Intervention Time To specify Treatment/Psychosocial Effects Variant Woman Work cognitive change cognitive function cognitive reserve dementia risk design disease disparity disorder risk enhancing factor gender difference gender disparity health data healthy aging improved insight mild cognitive impairment mortality multiple chronic conditions novel person centered population based psychosocial racial difference racial disparity resilience risk stratification stress resilience theories therapy design

项目摘要

PROJECT SUMMARY / ABSTRACT Alzheimer’s Disease (AD), the sixth leading cause of death in the US, is the most common form of dementia in later life. Substantial heterogeneity in the course of disease progression, AD prevalence, and mortality exist by gender and race. Yet, variations in the distribution and the relative importance of risk factors, such as multimorbidity, that may inform gender and racial differences in AD risk and cognitive change over time are not well understood. Data-driven strategies capturing the dynamic nature of chronic disease accumulation may offer critical insight regarding differences in dementia risk and cognitive functioning by gender and race. Further, a robust literature hypothesizes linkages between psychosocial resilience and stress with dementia risk and cognitive functioning. However, the extent to which these factors enhance or attenuate dementia risk and poor cognitive functioning merits systematic investigation and is in alignment with new priorities for AD and aging research. To address these gaps the proposed work will investigate the association between multimorbidity trajectories, psychosocial resilience/stress, dementia risk and changes in cognitive functioning using data from the Health Retirement Study (2000-2018). We propose two aims: 1) assess the effect of psychosocial resilience (e.g., perceived social support, self-efficacy, and mastery) on the relationship between multimorbidity trajectories and change in cognitive functioning and incident dementia; and 2) assess the effect of psychosocial stress (e.g., discrimination, chronic stress, social isolation) on the relationship between multimorbidity trajectories and change in cognitive functioning and incident dementia. Specifying multimorbidity trajectory classes that differentially predict dementia risk and poor cognitive functioning represents a valuable contribution in: clarifying factors that propagate gender and racial disparities in late life progressive cognitive decline and dementia risk; informing the design of interventions and preventive strategies targeting psychosocial resilience and stress among populations at greatest risk; and improving precision in stratifying risk for poor cognitive function to delay the development and progression of AD.

项目摘要 /摘要阿尔茨海默氏病（AD）是美国第六大死亡原因，是最常见的形式后来的痴呆症。在疾病进展，AD患病率和性别和种族存在死亡率。然而，风险因素的分布和相对重要性的变化，例如多种多发性，可能会导致广告风险和认知变化的性别和种族差异时间不太了解。数据驱动的策略捕获了慢性病的动态性质积累可能会提供有关痴呆风险和认知功能差异的关键见解性别和种族。此外，强大的文献假设心理社会韧性与压力之间的联系具有痴呆症风险和认知功能。但是，这些因素增强或减弱的程度痴呆症风险和认知功能不佳，值得系统投资，并且与新的一致广告和衰老研究的优先事项。为了解决这些差距，拟议的工作将调查协会在多发生轨迹，社会心理韧性/压力，痴呆症风险和认知变化之间使用健康退休研究（2000-2018）的数据运作。我们提出了两个目标：1）评估社会心理韧性（例如，感知的社会支持，自我有效和掌握）对关系的影响在多发经能轨迹和认知功能和入射痴呆症之间的变化之间； 2）评估社会心理压力（例如歧视，慢性压力，社会隔离）的影响在多发经能轨迹和认知功能和入射痴呆症之间的变化之间。指定差异预测痴呆症风险和认知功能差的多发性轨迹类别代表以下有价值的贡献：在后期传播性别和种族分布的澄清因素渐进的认知能力下降和痴呆症风险；告知干预措施和预防策略的设计针对人口中的心理社会韧性和压力最大；并提高精度分层认知功能差的风险延迟AD的发展和发展。