Contribution of Longitudinal Neighborhood Determinants to Cognitive Health and Dementia Disparities within a Multi-Ethnic Cohort

纵向邻里决定因素对多种族群体中认知健康和痴呆症差异的贡献

• 批准号: 10403516
• 负责人: Jana Ariel Hirsch
• 金额: $ 102.19万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-15 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10403516
• 关键词: Address; Affect; African American; Age; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Biological Markers; Buffers; Cerebrovascular Disorders; Characteristics; Clinical; Code; Cognition; Cognitive; Collection; Communities; Data; Data Set; Dementia; Diabetes Mellitus; Digit structure; Education; Elderly; Environment; Ethnic Origin; Ethnic group; Face; Food; Gender; Goals; Health; Hispanic Populations; Impaired cognition; Individual; Inequality; Intervention; Link; Longitudinal cohort; Low income; Maintenance; Measures; Minority; Multi-Ethnic Study of Atherosclerosis; Neighborhoods; Nerve Degeneration; Obesity; Outcome; Pathology; Pathway interactions; Pattern; Physical activity; Physical environment; Play; Policies; Population; Population Heterogeneity; Prevalence; Process; Race; Recreation; Research; Research Personnel; Resources; Risk; Role; Safety; Sampling; Science; Short-Term Memory; Shoulder; Sleep; Social Environment; Socioeconomic Status; Surveys; Testing; Time; Work; abeta deposition; adjudicate; base; built environment; cardiovascular risk factor; clinically relevant; cognitive ability; cognitive performance; cohort; dementia risk; design; disparity reduction; executive function; experience; healthy aging; improved; instrument; mild cognitive impairment; multi-ethnic; neighborhood association; nutrition; processing speed; racial and ethnic; racial disparity; screening; social cohesion; social determinants; socioeconomic disparity; socioeconomics; stem; theories; walkability

PROJECT SUMMARY/ABSTRACT Beyond the role that individual factors (e.g. age, race, gender, and socioeconomic status) play in the progression of Alzheimer's Disease and related dementias (ADRD), neighborhood factors (e.g. social and built environments) may affect cognitive health. Critically, although African American and Hispanic individuals face the highest and most disproportionate risk for ADRD, research has traditionally excluded diverse populations. Given historic and current patterning of healthy neighborhood factors by racial and socioeconomic characteristics, these features may partially explain observed disparities in ADRD risk. To date there has been no research on the role of neighborhood environments in disparities in ADRD risk. In this study, we propose to leverage and extend extensive longitudinal data from the Multi-Ethnic Study of Atherosclerosis (MESA) to address major gaps in research on neighborhoods and disparities in ADRD. We propose to undertake large-scale collection, processing, and distribution of new neighborhood data within MESA. Our main objective is to identify unique patterns of neighborhood change related to the causes of prevalence and disparities in cognitive decline and dementia. We will attain our main objective by (Aim 1) characterizing dynamic, longitudinal neighborhood social and built environment variables (survey-based and GIS-derived) relevant to cognition for residential addresses of a MESA; (Aim 2) examining associations of neighborhood environmental characteristics with cognition and clinically relevant ADRD outcomes; (Aim 3) investigate determinants of disparities in ADRD outcomes by socioeconomic position and race/ethnicity and assess the contribution of neighborhood environments. This project is poised to provide robust new evidence about pathways and links between neighborhood environments and cognitive outcomes, with important implications for built environment science, ADRD progression research, and policies to support healthy aging. Aim 1 will create the most comprehensive longitudinal neighborhood dataset on a diverse sample with detailed cognitive and ADRD outcomes for widespread dissemination to a network of researchers. Analyses in Aim 2 will contribute to developing substantive theory on the role of neighborhoods in ADRD progression and provide guidance for urban planners to design neighborhoods that support healthy aging. Aim 3 examines component contributions to racial disparities in cognition and ADRD. Through this, we expect to identify actionable, community and clinical interventions to address and remediate racial and socioeconomic inequalities derived from the unequal distribution of environmental supports for healthy aging. We expect this evidence to support and amplify efforts to reduce disparities.

项目摘要/摘要 超越个人因素（例如年龄，种族，性别和社会经济地位）在 阿尔茨海默氏病和相关痴呆症（ADRD）的进展，邻里因素（例如社会和建造 环境）可能会影响认知健康。至关重要的是，尽管非裔美国人和西班牙裔人面对 传统上，研究是ADRD的最高和最不成比例的风险，被排除在不同的人群中。 鉴于种族和社会经济的历史性和当前对健康邻里因素的模式 特征，这些特征可能会部分解释ADRD风险中观察到的差异。到目前为止 没有关于邻里环境在ADRD风险中的差异中的作用的研究。 在这项研究中，我们建议利用和扩展从多民族研究的广泛纵向数据 动脉粥样硬化（MESA）解决了ADRD的社区和差异研究的主要差距。我们 建议在内部进行大规模收集，处理和分配新的邻里数据 台面。我们的主要目的是确定与与原因相关的邻里变化的独特模式 认知能力下降和痴呆症的患病率和差异。我们将通过（AIM 1）实现我们的主要目标 表征动态，纵向社区社交和建筑环境变量（基于调查和 GIS衍生的）与台面住宅地址的认知有关； （目标2）检查 具有认知和临床相关结果的邻里环境特征； （目标3） 通过社会经济地位和种族/种族和种族/种族和种族和种族的差异调查决定因素 评估邻里环境的贡献。 该项目有望提供有关途径和社区之间联系的强大新证据 环境和认知结果，对建筑环境科学具有重要意义 进展研究以及支持健康衰老的政策。 AIM 1将创造最全面的 在不同样本的纵向邻里数据集，具有详细的认知和ADRD结果 广泛传播到研究人员网络。 AIM 2中的分析将有助于发展 关于社区在ADRD进步中的作用的实质性理论，并为城市规划者提供指导 设计支持健康衰老的社区。 AIM 3检查对种族的组成贡献 认知和ADRD的差异。通过此，我们希望确定可操作的，社区和临床 解决和补救从不平等的种族和社会经济不平等的干预措施 环境支持的分配健康衰老。我们希望这些证据支持和扩大努力 减少差异。