Latinos are one of the fastest growing minority populations in the US, and they are 1.5 times as likely to develop Alzheimer?s dementia as older non-Latino Whites. Culturally relevant factors such as acculturation, the process by which Latinos adapt to the US and potentially adopt its values and practices, may contribute to health disparities in brain aging and Alzheimer?s dementia in Latinos. While levels of acculturation have been linked to a number of health outcomes in Latinos, less work has been done in cognition and brain aging. Newer theories of acculturation suggest it is not a static, linear process but a dynamic exchange between Latinos and other members of society that emerges from and is reinforced by broader socioenvironmental determinants vital to a process now called ?acculturation in context? (AIC). Thus, in addition to traditional acculturation factors (e.g., language preference and/or years in the US), individual-level (e.g., perceived discrimination, family and/or cultural stressors) and neighborhood-level (e.g., crime rates) socioenvironmental determinants need to be integrated into research in older Latinos. We will incorporate advances in geospatial informatics to quantify neighborhood-level determinants of AIC, longitudinal multi-modal neuroimaging, and the digital capture of behavior in a well-characterized cohort of Latinos 60 years and older for the most comprehensive study of AIC as it relates to brain aging in Latinos. By 2030, the Latino population 65 and older will increase by ~225% compared to a 65% increase in non-Latino Whites; rates for Alzheimer?s dementias will also disproportionately increase for older Latinos. This R01, with its focus on AIC and brain aging in Latinos, may provide a more comprehensive understanding of the reasons for this disproportionate increase. To achieve the overall goal of the study ? to investigate the relationship of AIC to changes in cognition and brain MRI indices in older Latinos and determine whether these factors affect the well-documented relationships between other risk factors and changes in cognition or brain MRI indices ? we will conduct a comprehensive assessment of the AIC framework including the geocoding of neighborhood factors, repeat multi-modal MRI, and the digital capture of behavior in 350 older Latinos. We will leverage the infrastructure of two cohort studies at the Rush Alzheimer?s Disease Center to incorporate ongoing longitudinal data acquisition of cognition and other risk factors into this R01. When combined, this information will allow us to examine the relationship of AIC to change in cognition (Aim 1) and brain MRI indices (Aim 2) in older Latinos, and determine if levels of AIC modify the relationship of cardiovascular disease risk factor profiles to changes in cognition or brain MRI indices in this same population (Aim 3). Given that rates of Alzheimer?s dementia are disproportionately increasing for Latinos in the US, understanding modifiable contributors to this health disparity that may be specific to this population is critical.
By 2030, Latinos, one of the fastest growing minority populations in the US at risk for Alzheimer?s dementia, may see as much as an 832% increase in individuals living with Alzheimer?s dementia. While this health disparity may arise from multiple factors, less work has been done investigating culturally relevant information about the Latino experience in the US in studies of Latino brain aging. Applying the newly expanded theory of ?acculturation in context? that combines traditional acculturation factors (e.g., language preference and/or years in the US) with individual-level (e.g., perceived discrimination, family and/or cultural stressors) and neighborhood-level (e.g., crime rates) socioenvironmental determinants, this R01 will investigate changes in cognition and brain aging in older Latinos for the most comprehensive investigation of aging in Latinos to date.