Resilience, cultural alignment, and social support in brain aging: Data from the Strong Heart Study

大脑衰老过程中的复原力、文化一致性和社会支持：来自强心研究的数据

• 批准号: 10264169
• 负责人: Astrid M Suchy-Dicey
• 金额: $ 59.02万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10264169
• 关键词: Address; Adult; Age; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American Indians; Anger; Anthropology; Behavioral; Cardiovascular Diseases; Characteristics; Chronic; Chronic stress; Classification; Clinic; Clinical; Cognition; Cohort Studies; Communities; Consent; Contracts; Data; Data Analyses; Data Collection; Dementia; Development; Discrimination; Emotional; Emotions; Environment; Epidemiology; Event; Failure; Family; Female; Funding; Health; Heart; Hostility; Impaired cognition; Individual; Inflammation; Knowledge; Life; Life Stress; Link; Longitudinal cohort; Machine Learning; Mediating; Medical Genetics; Mental Depression; Methods; Modeling; National Heart, Lung, and Blood Institute; Navajo; Nerve Degeneration; Neuropsychology; Outcome; Participant; Patient-Centered Care; Persons; Philosophy; Population; Poverty; Protocols documentation; Psychosocial Factor; Public Health; Quality of life; Recording of previous events; Reporter; Research; Resources; Risk; Social Network; Social support; Socioeconomic Factors; Spirituality; Stress; Time; Trauma; Tribes; Underserved Population; United States National Institutes of Health; Work; Youth; aging brain; base; bullying; clinical examination; cognitive function; cognitive reserve; cohort; disability; eligible participant; epidemiology study; experience; healthy aging; heterogenous data; improved; instrument; intergenerational; male; mortality; novel; optimism; practical application; psychosocial; public health intervention; recruit; resilience; screening; sex; sociodemographics; socioeconomics; theories; trait; tribal community

ABSTRACT When life stresses are especially intense, chronic, or overwhelming, deleterious health effects can occur, including inflammation, cardiovascular disease, disability, depression, low quality of life, and dementia. In this context, resilience can be defined as the ability to maintain a healthy aging trajectory despite adverse conditions of stress. American Indians (AI) have a unique history and ongoing experience of trauma and disparities in environmental and socioeconomic conditions, which amplify daily stresses and contribute to health risks. Despite these adverse circumstances, remarkable resilience has been described in AI populations. Recent work by our group suggests that social support and alignment with Native culture correlate with lower levels of stress, negativity, anger, hostility, depression, mortality, and cardiovascular disease. However, our findings on cultural alignment are limited, and none has yet explored associations of resilience and social support. It remains an open question whether neurodegenerative conditions such as Alzheimer's disease and related dementias (ADRD) can result from chronic stress, or whether individual psychosocial characteristics such as resilience can mediate such risk. We propose to address these knowledge gaps by efficiently leveraging an existing effort funded by the NHLBI in the Strong Heart Study, a longitudinal cohort of AI adults from 13 tribal communities across the US. The existing contract covers recruitment, consenting, and basic clinical examination of 3,000 eligible participants in 2022-2024; we propose to augment the limited protocol by administering additional psychosocial and neuropsychological instruments on resilience, social support, cultural identity and alignment, and cognition. Our Specific Aims are to: describe associations of individual resilience among AI adults with identity and self-regard, social support, and cultural alignment, by age and sex; evaluate resilience, social support, and cultural features in relation to ADRD; and use machine learning to develop explanatory models of resilience and dementia. Our study has the potential to advance epidemiologic knowledge of modifiable psychosocial conditions in a vulnerable, underserved population, and consequently to offer a clearer picture of the relative contributions of psychosocial, behavioral, interpersonal, and socioeconomic factors related to ADRD.

抽象的 当生活压力特别强烈、长期或压倒性时，可能会发生有害的健康影响， 包括炎症、心血管疾病、残疾、抑郁、生活质量低下和痴呆。在这个 在上下文中，复原力可以定义为在不利条件下保持健康老龄化轨迹的能力 的压力。美洲印第安人 (AI) 有着独特的历史和持续经历的创伤和差异 环境和社会经济条件会加剧日常压力并增加健康风险。尽管 在这些不利的环境下，人工智能群体表现出了非凡的适应力。我们最近的工作 研究小组认为，社会支持和与本土文化的一致性与较低的压力水平相关， 消极、愤怒、敌意、抑郁、死亡和心血管疾病。然而，我们对文化的研究结果 一致性是有限的，而且还没有人探索复原力和社会支持之间的联系。它仍然是一个 阿尔茨海默病和相关痴呆等神经退行性疾病是否存在悬而未决的问题 (ADRD) 可能是由慢性压力引起的，或者个人心理社会特征（例如复原力）是否可以导致 调解此类风险。我们建议通过有效利用现有的努力来解决这些知识差距 由 NHLBI 资助的“强心脏研究”是一项由来自 13 个部落社区的人工智能成年人组成的纵向队列研究 遍布美国。现有合同涵盖 3,000 名患者的招募、同意和基本临床检查 2022-2024 年符合资格的参与者；我们建议通过管理额外的内容来增强有限协议 关于复原力、社会支持、文化认同和一致性的心理社会和神经心理学工具， 和认知。我们的具体目标是： 描述人工智能成人中个体复原力与 按年龄和性别划分的身份和自尊、社会支持和文化一致性；评估复原力、社会 ADRD 相关的支持和文化特征；并使用机器学习来开发解释模型 复原力和痴呆症。我们的研究有潜力推进可修改的流行病学知识 弱势、服务不足人群的心理社会状况，从而提供更清晰的情况 与 ADRD 相关的社会心理、行为、人际和社会经济因素的相对贡献。