The impact of segregation and the mediating effects of vascular risk on 10-year cognitive and functional outcomes in Black/African American older adults enrolled in the ACTIVE study

隔离的影响以及血管风险对参加 ACTIVE 研究的黑人/非裔美国老年人 10 年认知和功能结果的影响

• 批准号: 10791382
• 负责人: Alexandra Leigh Clark
• 金额: $ 32.91万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10791382
• 关键词: Acceleration; Address; African American; Aging; Alzheimer' s disease model; Alzheimer' s disease related dementia; Applications Grants; Attitude; Biological; Biological Factors; Black race; Blood Vessels; Cardiovascular Diseases; Censuses; Chronic; Cognition; Cognitive; Collaborations; Communities; Complex; Data; Data Linkages; Data Set; Diabetes Mellitus; Diagnosis; Dimensions; Discrimination; Disparity; Education; Elderly; Enrollment; Equity; Future; Glean; Goals; Health; Health behavior; Hyperlipidemia; Hypertension; Individual; Inequity; Intervention; Investigation; Laws; Link; Longevity; Longitudinal Studies; Longitudinal cohort study; Measurement; Measures; Mediating; National Institute on Aging; National Institute on Minority Health and Health Disparities; Nature; Neighborhoods; Neuropsychology; Not Hispanic or Latino; Obesity; Outcome; Participant; Pathologic; Pathway interactions; Performance; Physiological; Plasma; Play; Prevalence; Prevention; Prevention strategy; Research; Resources; Risk; Risk Factors; Risk Reduction; Role; Sampling; Smoking History; Social isolation; Structural Racism; Training; Vascular Diseases; Work; age related; arterial stiffness; cognitive function; cognitive performance; cognitive training; cohort; ethnic diversity; experience; functional outcomes; health care quality; health disparity; improved; indexing; neuroimaging; novel; pathological aging; performance based measurement; racial disparity; racial diversity; racial population; residential segregation; segregation; social; social health determinants; vascular risk factor

PROJECT SUMMARY/ABSTRACT Inequitable social and environmental contexts produced by structural racism and discrimination (SRD) have led to greater prevalence of Alzheimer’s disease and related dementias, as well as cardiovascular disease, among Black/African American older adults. The current proposal (1) explores the impact of segregation as a community-level driver of racial disparities in 10-year cognitive and functional aging trajectories, and (2) determines if vascular risk partially explains how segregation becomes biologically embedded and ultimately contributes to adverse aging outcomes among of Black older adults enrolled in Advanced Cognitive Training for Vital Elderly (ACTIVE) study. The study team builds upon previous census data linkage efforts to improve estimation of SRD by characterizing multiple indices of segregation (exposures, isolation, clustering); employs a multi-dimensional research approach by examining social (segregation) and biological (vascular risk) casual pathways of late-life declines in cognition and everyday functioning; and delineates the effects of segregation on subjective cognitive concerns, objective neuropsychological performance, and ecologically valid performance-based measures of everyday functioning. This work meets the direct goals of the NIA’s PAS-19- 391 by specifically clarifying important pathways that create and sustain AD disparities; taking a multi- dimensional approach to improve the estimation of environmental/built risk factors on longitudinal outcomes; and leveraging large scale existing datasets to enhance our understanding of factors underlying transitions from normal to pathological. Findings from this proposal are expected to advance research on modifiable intervention and prevention pathways that promote more equitable aging outcomes among Black older adults.

项目摘要/摘要 结构性种族主义和歧视（SRD）产生的不平等社会和环境环境已领导 在阿尔茨海默氏病和相关痴呆症以及心血管疾病的更大患病率中 黑人/非裔美国人老年人。当前的提案（1）探讨了种族隔离的影响 十年认知和功能性衰老轨迹中种族分布的社区级驱动力，以及（2） 确定血管风险是否部分解释了种族隔离是如何在生物学上嵌入的，最终是如何嵌入的 在接受高级认知训练的黑人老年人中导致不良衰老的结果 进行重要的老年人（活跃）研究。研究团队基于以前的人口普查数据链接以改进 通过表征多个隔离指数（暴露，隔离，聚类）来估计SRD；雇员 通过检查社会（种族隔离）和生物学（血管风险）休闲的多维研究方法 晚年的途径在认知和每天起作用；并描述种族隔离的影响 关于主观认知问题，客观的神经心理学表现和生态有效 每天运作的基于绩效的措施。这项工作符合NIA的PAS-19-- 391特别澄清创建和维持广告分布的重要途径；多 改善对纵向结果的环境/建筑风险因素的估计的维度方法； 并利用大规模现有数据集来增强我们对过渡基本因素的理解 从正常到病理。预计该建议的结果将推进对可修改的研究 干预和预防途径可以促进黑人老年人更公平的衰老结局。