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.

项目概要/摘要 除了个人因素（例如年龄、种族、性别和社会经济地位）在 阿尔茨海默病和相关痴呆症 (ADRD) 的进展、邻里因素（例如社会和建筑） 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临着 ADRD 风险最高且最不成比例，研究传统上排除了不同人群。 鉴于种族和社会经济因素对健康邻里因素的历史和当前模式 特征，这些特征可以部分解释观察到的 ADRD 风险差异。迄今为止已经有 没有关于邻里环境在 ADRD 风险差异中的作用的研究。 在这项研究中，我们建议利用和扩展来自多民族研究的广泛纵向数据 动脉粥样硬化 (MESA) 旨在解决 ADRD 社区研究和差异方面的主要差距。我们 建议在年内大规模收集、处理和分发新的社区数据 台面。我们的主要目标是确定与以下原因相关的社区变化的独特模式： 认知能力下降和痴呆的患病率和差异。我们将通过（目标 1）实现我们的主要目标 描述动态的、纵向的邻里社会和建筑环境变量（基于调查和 GIS 衍生）与 MESA 居住地址的认知相关； （目标 2）审查协会 具有认知和临床相关 ADRD 结果的邻里环境特征； （目标 3） 根据社会经济地位和种族/族裔调查 ADRD 结果差异的决定因素，以及 评估邻里环境的贡献。 该项目将为邻里之间的路径和联系提供强有力的新证据 环境和认知结果，对建筑环境科学、ADRD 具有重要影响 进展研究以及支持健康老龄化的政策。目标 1 将创建最全面的 不同样本的纵向邻里数据集，包含详细的认知和 ADRD 结果 广泛传播给研究人员网络。目标 2 中的分析将有助于开发 关于社区在 ADRD 进展中的作用的实质性理论，为城市规划者提供指导 设计支持健康老龄化的社区。目标 3 检查对种族的贡献 认知和 ADRD 方面的差异。通过这一点，我们期望确定可操作的、社区和临床的 采取干预措施解决和纠正因不平等而产生的种族和社会经济不平等 分配对健康老龄化的环境支持。我们期望这些证据能够支持和扩大努力 以减少差距。