Over the past 50 years, health and functional status of the American population has continued to improve but these improvements have not been equally distributed across races, ethnicities and socioeconomic groups. Perhaps nowhere is the challenge to reduce health disparities more apparent than in Alzheimer's disease (AD) and other dementias. Risk of AD is higher among ethnic minorities, and because many public and private insurers do not cover institutionalized or paid home health care services that individuals with these diseases require, the burdens faced by family caregivers from diverse racial, ethnic and socioeconomic backgrounds is high. The goals of this project are two-fold. First, we will estimate predictive models of cognitive decline, AD onset, other health and functional status changes of middle age and older Americans. We model caregiving for person with AD and analyze and quantify how health and other indicators of well being evolve over the life course for caregivers of family members with AD and contribute to health disparities. Second, we will utilize a dynamic micro simulation model of health, cognitive decline and economic outcomes to quantify health of future populations and burden of AD across diverse groups. Our ability to achieve the proposed aims is enhanced by use of the best data sets available for this research and that are established NIH-funded longitudinal cohorts: the Health and Retirement Study and its sub-study the Aging Demographics and Memory Study. It is further enhanced by a team of researchers with expertise in both dementia and microsimulation.

Public Health Relevance

The prevalence of Alzheimer's disease and other dementias is high and growing and its impact is not equally distributed across races, ethnicities and socioeconomic groups. We propose to analyze the burden of AD and its impact on family caregivers from diverse backgrounds. We will estimate the life course trajectories of health changes, cognitive and functional decline and AD onset of middle age and older Americans across racial and ethnic groups. We will analyze how well being diverges for caregivers of persons with AD and how it contribute to health disparities. Utilizing dynamic simulation, we project these burdens for future cohorts.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Small Research Grants (R03)
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Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Gerald, Melissa S
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University of Southern California
Schools of Arts and Sciences
Los Angeles
United States
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Chen, Cynthia; Zissimopoulos, Julie M (2018) Racial and ethnic differences in trends in dementia prevalence and risk factors in the United States. Alzheimers Dement (N Y) 4:510-520