The primary objective of this proposal is to investigate the association between perceived discrimination trajectories and cognitive functioning outcomes among middle-aged and older black adults. Psychosocial stress related to perceived discrimination has received less attention in the literature as a social exposure that may in part reflect racialized experiences for middle-aged and older black adults. While there are limited studies demonstrating an inverse association between higher levels of perceived discrimination and lower cognitive performance, even fewer have found a null association. The mixed results may be a function of differences in study design, attribution of discrimination, differential recruitment, selection, or survival bias. Prior work largely measured perceived discrimination at one-time point to predict cognitive health at a second time point. Moreover, a one-time cross-sectional assessment may mask significant heterogeneity in dynamic nature of repeated exposure to perceived discrimination. Further, the absence of studies accounting for frequency and variability in reported perceived discrimination may underestimate its impact on health. It is possible that patterns of cumulative exposure to perceived discrimination ? perceived discrimination trajectories ? may provide further insight on cognitive health risk and resilience. Yet, the identification of perceived discrimination trajectories and whether trajectories are associated with cognitive health outcome variability is unknown and merits systematic consideration. To address these gaps in the literature, we will investigate the association between perceived discrimination trajectories and cognitive health outcomes among a sample of middle-aged and older black adults using data from the Health and Retirement Study (2004 ? 2016) to: 1) identify perceived discrimination trajectories and predictors of trajectory membership; 2) examine the relationship between perceived discrimination trajectories and episodic memory; 3) examine the relationship between perceived discrimination trajectories and risk of cognitive impairment and dementia. This project has relevance for research and clinical settings and presents an opportunity to: improve measurement of perceived discrimination in the aging process and allow for greater precision in estimating the cognitive health consequences of cumulative exposure to perceived discrimination. If perceived discrimination trajectories differentially predict poor cognitive health, this project will lay the foundation for distinguishing key pathways linking cumulative experiences of psychosocial stress to physiological aging and inform the design of culturally-relevant interventions to delay the development and progression of cognitive impairment among middle-aged and older black adults.
The proposed study characterizes perceived discrimination trajectories and examines whether trajectory profiles differentially predict cognitive health outcomes among middle-aged and older black adults. Findings will lay the foundation for the design of culturally-relevant interventions to decrease cognitive impairment.
