The Contribution of Repetitive Head Impacts and Social Determinants of Health to Alzheimer's Disease and Related Dementia in Older Adult Black Men

重复性头部撞击和健康的社会决定因素对老年黑人阿尔茨海默病和相关痴呆症的影响

• 批准号: 10740485
• 负责人: Robert W. Turner
• 金额: $ 129.35万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10740485
• 关键词: Accelerometer; Adult; Affect; Age; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; Amyloid beta-Protein; Atrophic; Biological Assay; Biological Markers; Black American; Black Populations; Black race; Blood; Boston; Brain; Cerebrospinal Fluid; Childhood; Cognition; Cognitive; Collaborations; Data; Data Set; Detection; Diagnosis; Diffusion; Disease; Disparity; Dose; Economics; Education; Elderly; Enrollment; Environment; Equation; Exposure to; Face; Frequencies; Goals; Health; Hippocampus; Impaired cognition; Individual; Late Effects; Life; Light; Link; Magnetic Resonance Imaging; Manufactured football; Mediating; Modeling; Neighborhoods; Nerve Degeneration; Neurobehavioral Manifestations; Neurodegenerative Disorders; Neurologic; Neurological outcome; Outcome; Participant; Pathway interactions; PhenX Toolkit; Plasma; Play; Positioning Attribute; Poverty; Proteins; Publishing; Questionnaires; Research; Resistance; Risk; Risk Factors; Role; Severities; Surveys; Tauopathies; Testing; Traumatic Brain Injury; Underrepresented Populations; Universities; Washington; Wellness Program; White Matter Hyperintensity; adverse childhood events; black men; brain health; chronic traumatic encephalopathy; cognitive function; contact sports; dosage; education access; experience; head impact; health care availability; health care quality; indexing; instrument; men; nervous system disorder; neurofilament; neuropsychiatric symptom; neuropsychiatry; racial disparity; racial identity; recruit; resilience; response; social factors; social health determinants; tau-1; white matter

ABSTRACT. Black Americans face nearly double the risk of Alzheimer’s disease (AD) and related compared to Whites. Black American men may be at increased risk for late-life neurological disorders associated with exposure to repetitive head impacts (RHI) and traumatic brain injury (TBI) from contact sports participation and other risk factors. Exposure to RHI/TBI is linked with late-life cognitive impairment, neuropsychiatric disturbances, and structural brain changes. Black racial identity and exposure to RHI/TBI has been shown to have an additive effect on MRI metrics of atrophy and cerebrospinal fluid neurodegenerative disease proteins. These neurological disparities might be explained by social determinants of health (SDOH) (e.g., education access and quality, health care access and quality, neighborhood environment), which might affect resistance and resilience to other neurological disorders from RHI/TBI. SDOH factors might indeed contribute to neurological outcomes in adult Black men irrespective of RHI/TBI. Yet, there has been persistent under- representation of Blacks in biomedical and health research, including among studies of the late effects of RHI from American football play. The overarching goal of this study is to examine the impact of RHI/TBI from American football and the contribution of early-life SDOH to later-life cognitive function, neuropsychiatric symptoms, structural MRI features, and plasma biomarkers in Black male former American football athletes and non-RHI/TBI exposed Black men. We will recruit 100 Black male former American football athletes (across all levels of play and cognitive continuum, 50+ years) and 100 age-matched Black males without RHI/TBI. Participants will enroll to complete harmonized cognitive and neuropsychiatric tests, MRI, and blood draw to assess neurodegenerative disease proteins. A battery of questionnaires (e.g., Adverse Childhood Experiences, Childhood-Experiences Survey, SHARELIFE survey) will be administered to assess SDOH. In Aim 1, we will investigate the association between RHI/TBI and later-life cognitive and neuropsychiatric symptoms in Black male former American football athletes. Aim 2 will investigate the association between RHI/TBI and later-life biomarkers of Aß, p-tau, and neurodegeneration outcomes in Black male former American football athletes. Aim 3 will examine the contribution of SDOH to later-life cognitive and neuropsychiatric symptoms and later-life biomarkers of Aß, p-tau, and neurodegeneration outcomes. Our hypotheses are that (1) RHI/TBI will be associated with worse cognitive and neuropsychiatric function and compromised structural gray/white matter in Black former football players; (2) impoverished SDOH will increase risk and reduce resilience to the late-life effects of RHI/TBI; and (3) impoverished SDOH will mediate the effects of RHI on late-life neurological outcomes. This R01 will discover the role of RHI/TBI and SDOH in older Black men. We will address racial disparities present in data on late life neurological outcomes from RHI/TBI to facilitate accurate disease detection and diagnosis at the individual-level.

抽象的。黑人美国人几乎面临着阿尔茨海默氏病（AD）及相关风险的两倍 与白人相比。黑人美国男性可能会增加与与之相关的晚期神经系统疾病的风险 接触运动参与的重复性头部撞击（RHI）和创伤性脑损伤（TBI） 和其他风险因素。暴露于RHI/TBI与晚期认知障碍，神经精神病学有关 干扰和结构性大脑变化。黑色的种族身份和对RHI/TBI的暴露已显示为 对萎缩和脑脊液神经退行性疾病蛋白的MRI指标有其他影响。 这些神经系统差异可能由健康的社会决定者（SDOH）解释（例如，教育 访问和质量，医疗保健访问和质量，邻里环境），这可能会影响抵抗力 RHI/TBI对其他神经系统疾病的韧性。 SDOH因素确实可能有助于 成年黑人男性的神经结局，不论RHI/TBI。然而，持续的不足 黑人在生物医学和健康研究中的代表，包括在后期影响的研究中 美国足球比赛的RHI。这项研究的总体目标是检查RHI/TBI的影响 从美式足球以及早期生活的SDOH对后期认知功能的贡献，神经精神病学 黑人男性前美国足球运动员的症状，结构性MRI功能和等离子体生物标志物 非RHI/TBI暴露了黑人。我们将招募100名黑人男性前美国足球运动员 游戏水平和认知连续性水平，50岁以上）和100个没有RHI/TBI的年龄匹配的黑人男性。 参与者将注册以完成统一的认知和神经精神检查，MRI和血液抽血 评估神经退行性疾病蛋白。一系列问卷（例如，不利的童年经历， 儿童经验调查，共享生命调查）将进行评估。在AIM 1中，我们将 研究黑色的RHI/TBI与后期生活认知和神经精神症状之间的关联 男性前美国足球运动员。 AIM 2将研究RHI/TBI与后期生活之间的关联 黑人男性前美国足球运动员的Aß，P-TAU和神经退行性成果的生物标志物。目的 3将检查SDOH对后期生活认知和神经精神症状的贡献以及后期生活 Aß，P-TAU和神经退行性结果的生物标志物。我们的假设是（1）RHI/TBI将是 与较差的认知和神经精神科功能以及结构性灰色/白色质量差有关 黑人前足球运动员； （2）贫困的SDOH将增加风险并降低对晚期的韧性 RHI/TBI的影响； （3）贫困的SDOH将介导RHI对晚期神经系统结果的影响。 该R01将发现Rhi/TBI和SDOH在老年黑人中的作用。我们将解决种族分布 在RHI/TBI的后期神经系统结局的数据中存在，以促进准确的疾病检测和 在个人级别的诊断。