Perceived racism, cardiovascular disease risk, and neurocognitive aging

感知种族主义、心血管疾病风险和神经认知衰老

• 批准号: 10448789
• 负责人: Karin Schon
• 金额: $ 83.17万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10448789
• 关键词: Address; Adult; African American population; Age; Aging; Algorithms; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Ambulatory Blood Pressure Monitoring; Ambulatory Monitoring; American; American Heart Association; Amygdaloid structure; Atherosclerosis; Biological; Biological Markers; Biometry; Black American; Black race; Blood Pressure; Blood Tests; Brain; Cardiology; Chronic; Chronic stress; Cognitive; Data; Discrimination; Education; Elderly; Episodic memory; Equation; Exhibits; Family; Family history of; Fasting; Future; Genetic Risk; Goals; Head; Health; Health Policy; Hippocampus (Brain); Human; Hypersensitivity skin testing; Implicit Association Test; Institutional Racism; Interview; Knowledge; Left; Life; Life Stress; Link; Lipids; Magnetic Resonance Imaging; Measures; Medial; Mediating; Mediation; Mediator of activation protein; Memory; Memory Loss; Mental Depression; Mental Health; Methods; Modeling; Nerve Degeneration; Neurobiology; Neurocognitive; Neuropsychology; Outcome; Participant; Population Heterogeneity; Prefrontal Cortex; Proxy; Recording of previous events; Risk; Risk Factors; Social Discrimination; Societal Factors; Socioeconomic Status; Source; Sterile coverings; Structural Racism; Structure; System; Testing; Thick; Time; Tweens; White Matter Hyperintensity; aged; aging brain; base; biobehavior; black women; brain health; cardiovascular disorder risk; cardiovascular health; caucasian American; cognitive neuroscience; cognitive testing; college; community engagement; comorbidity; depressive symptoms; executive function; experience; geriatric mental health; health disparity; health inequalities; healthy aging; indexing; neuropathology; people of color; perceived discrimination; physical conditioning; predictive modeling; racism; recruit; relating to nervous system; residential segregation; sex; social; social factors; social interventions; social stress

There is increasing knowledge that racism makes us sick. Black Americans are twice as likely as White Ameri- cans to have Alzheimer’s disease (AD) independent of genetic risk. Despite this knowledge, little is known about whether and how chronic experiences of racism contribute to medial temporal hippocampal (MTH) and prefrontal-executive system integrity, systems that exhibit profound neurodegeneration in AD. Although comor- bid illnesses and socioeconomic status contribute to the AD health disparity, disparities remain. This highlights a critical unmet need for understanding social and societal contributors to disparities in brain health. A major contributor to health inequities in the U.S. is chronic stress due to the cumulative effects of racism over the life- time. Although the negative impact of chronic stress on the MTH and prefrontal systems is well known, less understood is the impact of chronic interpersonal and institutional/structural racism, unique and salient forms of chronic stress in Black Americans, on neurocognitive integrity of these brain systems. Since perceived racism contributes to health disparities in cardiovascular disease (CVD) risk factors, which are also risk factors for AD, perceived racism should have a significant impact also on the AD health disparity. In support of this, our pre- liminary data show that perceived racism in older Black women predicts future subjective memory decline, which was in part mediated by depressive symptoms, and that greater perceived social discrimination predicts poorer memory and lower amygdala and hippocampal head volumes in older adults. Despite this knowledge, the cumulative impact of racism on neurocognitive integrity in Black seniors remains unknown. The objective of this application is to investigate the impact of racism on neurocognitive MTH-memory and prefrontal-executive system integrity in Black seniors and to examine potentially underlying biological mechanisms. Our central hy- pothesis is that cognitively healthy Black seniors who have experienced higher levels of chronic racism will show greater CVD risk (Aim 1) and poorer MTH and prefrontal integrity (Aim 2) than those who have experi- enced fewer instances of racism over the lifetime. We further hypothesize that CVD risk and mental health will mediate (i.e., explain) the relationship between perceived racism and neurocognitive integrity (Exploratory Aim). Perceived interpersonal racism will be assessed with a structured interview and institutional/structural racism based on racial residential segregation. Ten-year CVD risk will be assessed using the 2013 Atheroscle- rotic CVD (ASCVD) risk algorithm, with lipid and other biomarkers obtained from a fasting blood test and blood pressure from ambulatory blood pressure monitoring. Neurocognitive MTH and prefrontal system integrity will be examined using a cognitive assessment of episodic memory and executive function, respectively, and struc- tural MRI. Further, we will use structural equation modeling to examine interrelationships between racism, CVD risk, mental health, and neurocognitive integrity. Addressing this knowledge gap is critical for developing new health policies and biobehavioral and social interventions for healthy aging.

人们越来越了解种族主义使我们生病。黑人美国人的可能性是白人的两倍 罐子患阿尔茨海默氏病（AD）独立于遗传风险。尽管有这些知识，但鲜为人知 关于种族主义的长期经历是否有助于内侧临时海马（MTH）和 前额叶 - 执行系统完整性，在AD中提取深刻神经变性的系统。虽然是 投标疾病和社会经济地位有助于AD健康差异，仍然存在差异。这突出了 对了解大脑健康差异的社会和社会贡献者的关键需​​求。专业 由于种族主义对生命的累积影响，美国对健康不平等的贡献是长期压力 时间。尽管慢性应激对MTH和前额叶系统的负面影响是众所周知的，但较少 了解是慢性人际交往和机构/结构种族主义的影响， 黑人美国人的慢性压力，这些大脑系统的神经认知完整性。自从认为种族主义 导致心血管疾病（CVD）危险因素的健康差异，这也是AD的危险因素， 感知的种族主义也应该对AD健康差异产生重大影响。为此，我们的 Limarinary Data表明，在老年黑人妇女中，人们认为种族主义预测未来的主观记忆下降， 这部分是由抑郁症状介导的，而更大的社会歧视预测​​了 老年人的记忆力较差，杏仁核下部和海马头体积。尽管有这些知识， 种族主义对黑人老年人的神经认知完整性的累积影响仍然未知。目的 该应用是为了调查种族主义对神经认知MTH-MEMORY和前额外的执行的影响 黑人老年人的系统完整性，并检查潜在的潜在生物学机制。我们的中央 pothesis是，经历了更高水平的慢性种族主义的认知健康的黑人老年人 与拥有经验的人相比，表现出更大的CVD风险（AIM 1）和较差的MTH和前额叶完整性（AIM 2）（AIM 2） 一生中，种族主义的实例更少。我们进一步假设CVD风险和心理健康将 调解（即解释）感知的种族主义与神经认知完整性之间的关系（探索性 目的）。将通过结构化的访谈和机构/结构性评估人际种族主义 种族主义基于种族居民种族隔离。十年CVD风险将使用2013年的Atheroscle进行评估 Rotic CVD（ASCVD）风险算法，脂质和其他生物标志物是从禁食血液测试和血液中获得的 卧床血压监测的压力。神经认知能力MTH和前额叶系统的完整性将 分别使用情节记忆和执行功能的认知评估以及结构 - Tural MRI。此外，我们将使用结构方程建模来检查种族主义之间的相互关系 风险，心理健康和神经认知完整性。解决这一知识差距对于开发新的知识至关重要 健康政策以及健康衰老的生物行为和社会干预措施。