Epidemiology of racial differences in decision making among older adults

老年人决策中种族差异的流行病学

• 批准号: 10237350
• 负责人: PATRICIA A BOYLE
• 金额: $ 68.11万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-15 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10237350
• 关键词: African American; Aging; Alzheimer' s Disease; Alzheimer' s disease risk; Basic Science; Cognition; Cognitive; Complex; Data; Decision Making; Dementia; Discrimination; Elderly; Epidemiology; Fibrinogen; Fraud; Goals; Health; Impaired cognition; Internet; Intervention; Knowledge; Life; Link; Longevity; Mediating; Memory; Minority; Modeling; Outcome; Participant; Pathway interactions; Personal Satisfaction; Predisposition; Psychosocial Factor; Public Health; Race; Research; Resources; Risk; Socioeconomic Status; Testing; Translational Research; Trust; Victimization; Work; cognitive ability; cognitive function; contextual factors; demographics; disability; discounting; financial literacy; health disparity; health economics; health literacy; human old age (65+); mild cognitive impairment; mortality; novel strategies; novel therapeutic intervention; psychological distress; psychosocial; racial difference; rate of change; research study; response; sound

ABSTRACT Sound decision making is important for maintaining independence and well-being across the lifespan but is critical in old age, when some of life’s most complex and impactful decisions are made. Recent work from our group and others has shown that decision making requires cognitive, contextual and psychosocial resources and that many older persons—even those without cognitive impairment—are vulnerable to poor decision making in key domains such as finance and health and frequently become victims of fraud. Poor decision making in aging predicts several adverse health outcomes including Alzheimer’s disease, incident mild cognitive impairment and mortality and poses a major public health and economic challenge. Importantly, however, most of the research on decision making to date has involved White participants. Relatively little is known about decision making among African Americans, despite well documented racial differences in the cognitive, contextual (e.g., socioeconomic status) and psychosocial (e.g., psychological distress) resources that influence decision making. Building on our conceptual model of decision making in aging and compelling preliminary data that suggest racial differences, we hypothesize that racial differences in decision making contribute to disparities in health outcomes and that contextual and psychosocial factors account for these differences. The goal of the proposed study, submitted in response to PAR-16-448, is to elucidate the determinants and adverse health consequences of racial differences in decision making. This study will leverage the unique resources of an ongoing study of African Americans, the Minority Aging Research Study, to collect new longitudinal data on multiple aspects of decision making (i.e., financial and health decision making, temporal discounting, scam susceptibility, fraud victimization) and related contextual and psychosocial factors in 600 older African Americans without dementia. These newly collected data will be linked with identical longitudinal decision making data already available from an ongoing study of more than 1,100 Whites from the Memory and Aging Project to support analyses of: 1) racial differences in decision making among African Americans and Whites matched on demographics and cognition, 2) the contextual and psychosocial factors that drive them, and 3) the degree to which racial differences in decision making contribute to disparities in health. Thus, this study is uniquely poised to efficiently identify the determinants and public health impact of racial differences in decision making and will facilitate new therapeutic approaches to promote independence, health and well-being among diverse older persons.

抽象的 健全的决策对于维持整个生命周期的独立性和福祉很重要，但 在老年时期，至关重要的是，当生活中一些最复杂，最有影响力的决定时。我们最近的工作 小组和其他人表明，决策需要认知，上下文和社会心理资源 而且许多老年人（即使没有认知障碍的老年人）也容易受到决定不良的影响 在金融和健康等关键领域中建立并经常变得可怕。决定不当 在衰老预测中，包括阿尔茨海默氏病在内的几种不良健康结果，中期事件 认知障碍和死亡率，构成了重大的公共卫生和经济挑战。重要的是， 但是，迄今为止，大多数关于决策的研究都涉及白人参与者。相对较少 关于非裔美国人的决策，目的地有据可查的种族差异 认知，背景（例如社会经济地位）和心理社会（例如心理困扰）资源 这会影响决策。以我们在衰老和引人注目的决策概念模型为基础 提示种族差异的初步数据，我们假设决策中的种族差异 有助于健康成果的差异，而背景和社会心理因素为此解释了这些 差异。响应于16-448的拟议研究的目的是阐明 决策中种族差异的决定因素和不利的健康后果。这项研究会 利用正在进行的非洲裔美国人的独特资源，少数族裔老化研究， 收集有关决策多个方面的新纵向数据（即财务和健康决策 进行，临时打折，骗局易感性，欺诈性胜利）以及相关的背景和社会心理 600名没有痴呆症的非裔美国人的因素。这些新收集的数据将与 从正在进行的1,100多个白人的研究中已经获得了相同的纵向决策数据 从记忆和老化项目来支持：1）在决策中的种族差异 非裔美国人和白人与人口统计和认知相匹配，2）背景和社会心理 驱动它们的因素，以及3）决策做出贡献的种族差异的程度 健康差异。这是有效地确定确定者和公共卫生的独特中毒的独特中毒 种族差异在决策中的影响，并将促进新的治疗方法来促进 潜水员老年人的独立，健康和福祉。