The Role of Mid-life Psychosocial Stressors, Social Resources and Physiological Dysregulation in Understanding Race Differences in Cognitive Decline

中年社会心理压力源、社会资源和生理失调在理解认知衰退中的种族差异中的作用

• 批准号: 10057959
• 负责人: Uchechi Acholonu Mitchell
• 金额: $ 32.7万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10057959
• 关键词: Accounting; Acute; Address; Adult; Adverse effects; Affect; Age; Aging; Alzheimer' s disease related dementia; Biological Markers; Cardiovascular system; Childhood; Chronic; Cognition; Cognitive; Data; Decision Making; Dementia; Discrimination; Episodic memory; Event; Exposure to; Family; Financial Hardship; Friends; Goals; Health; Health and Retirement Study; Immune; Immune system; Impaired cognition; Impairment; Incidence; Individual; Inflammatory; Intercept; Intervention; Investigation; Joints; Lead; Learning; Life; Life Cycle Stages; Life Stress; Maintenance; Measures; Mediating; Mediation; Memory; Metabolic; Modeling; National Institute on Aging; Not Hispanic or Latino; Outcome; Pathway interactions; Physiological; Prevalence; Prevention; Process; Psyche structure; Race; Reporting; Research; Resources; Risk; Risk Factors; Role; Sampling; Sex Differences; Short-Term Memory; Social support; Socioeconomic Status; Strategic Planning; Stress; System; Testing; Time; Woman; Work; black/white disparity; cognitive function; disorder prevention; disparity reduction; ethnic diversity; ethnic minority population; experience; family support; gender difference; health data; improved; lifestyle factors; men; middle age; modifiable risk; processing speed; protective factors; psychosocial; racial difference; racial disparity; racial diversity; racial minority; sex; social; social engagement; social integration; stressor

ABSTRACT As individuals age, gradual changes in memory, learning and decision-making naturally occur; however, accelerated rates of cognitive decline may be signs of impending impairment and dementia. Racial and ethnic minorities carry a greater dementia burden than whites with a prevalence and incidence rate approximately 2-3 times higher among blacks than whites. These disparities are often attributed to differences in socioeconomic status, lifestyle factors, chronic conditions and childhood conditions. While accounting for these factors tends to reduce these disparities, the black-white difference often persists, warranting examination of other determinants of this inequity, particularly at earlier stages of the life course. Recent research suggest that cognitive decline among blacks begins during mid-life. This earlier rate of decline may be due to differential exposure to mid-life acute and chronic stressors. Older racial and ethnic minorities generally report greater exposure to stress compared to whites, which puts them at greater risk for poor health. These stressors can accelerate dysregulation of key physiological systems, including the cardiovascular, metabolic and immune systems, which are associated with cognitive outcomes. Thus, race differences in stress exposure that lead to differences in physiological functioning may be one pathway through which stressors differentially affect the cognitive function of blacks and whites. Additionally, social resources, such as social support, engagement and integration are associated with positive cognitive outcomes and may protect against the negative effects of acute and chronic stressors on change in cognitive function. The overarching goal of this proposal is to assess the role of acute and chronic stressors, social resources and physiological dysregulation on black-white differences in change in cognitive function. We will: determine whether acute and chronic stressors during mid- life are associated with cognitive decline and whether they explain black-white differences in cognitive decline (Aim 1); examine whether change in physiological dysregulation mediates the relationship between mid-life stress and cognitive decline (Aim 2); and, determine whether mid-life availability of social resources influences the relationship between stress and cognitive decline (Aim 3). Finally, we will test a conceptual model for cognitive decline that incorporates acute and chronic stressors, social resources and physiological dysregulation across race- and sex-specific groups (Aim 4). To achieve these aims, we will use data from the Health and Retirement Study and linear mixed effects models that include random intercepts and random slopes. The findings from this research will improve our understanding of mid-life factors that influence aging and disparities in cognitive function, thus aligning with Goal B and F of the National Institute on Aging’s Strategic Plan. This research will also help identify points of intervention and modifiable risk and protective factors for cognitive decline, which aligns with the objectives of PA-18-850.

抽象的 随着个人的年龄，自然发生记忆，学习和决策的年级变化；然而， 认知下降的加速率可能是即将损害和痴呆症的迹象。种族和种族 少数族裔比白人的痴呆症燃烧更大 黑人的倍数高于白人。这些差异通常归因于社会经济的差异 地位，生活方式因素，慢性病和儿童状况。在考虑这些因素的同时趋向于 为了减少这些分布，黑白差异通常会持续存在，警告其他 这种不平等的决定因素，特别是在生活课程的早期阶段。最近的研究表明 黑人的认知能力下降在中年开始。较早的下降速度可能是由于差异 暴露于中年急性和慢性应激源。年长的种族和少数民族通常报告更大 与白人相比，承受压力的暴露使他们面临更大的健康风险。这些压力源可以 关键生理系统的加速失调，包括心血管，代谢和免疫 系统，与认知结果有关。那是压力暴露的种族差异，导致 身体功能的差异可能是一种途径，压力源对此影响不同 黑人和白人的认知功能。此外，社会资源，例如社会支持，参与和 整合与积极的认知结果有关，并可以防止 急性和慢性应激源对认知功能的变化。该提案的总体目标是评估 急性和慢性压力源，社会资源和身体失调对黑白的作用 认知功能变化的差异。我们将：确定中急性和慢性应激源是否 生活与认知能力下降有关，以及它们是否解释了认知能力下降的黑白差异 （目标1）;检查身体失调的变化是否介导了中年的关系 压力和认知能力下降（目标2）；并且，确定社会资源的中年可用性是否影响 压力与认知能力下降之间的关系（目标3）。最后，我们将测试一个概念模型 认知能力下降，结合了急性和慢性压力，社会资源和生理 跨种族和性别特定组的失调（目标4）。为了实现这些目标，我们将使用来自 健康和退休研究以及线性混合效应模型，包括随机拦截和随机截距 插槽。这项研究的发现将改善我们对影响衰老的中年因素的理解 以及认知功能的差异，因此与国家老化研究所的目标B和F保持一致 战略计划。这项研究还将有助于确定干预点和可修改的风险和保护性 认知下降的因素，与PA-18-850的目标相吻合。