African Americans (AAs) have a greater risk for poor cognitive aging compared to White Americans, whether measured as clinical dementia or as lower cognitive function in late life. Previous research indicates that while older AAs demonstrate poorer cognitive function, they do not have faster declines after age 65 compared to their White counterparts, indicating that perhaps differences emerge earlier in life. However, few studies have assessed cognition in both middle and late life in AA populations. Further, the cumulative, life course variability within high-risk populations has not been well studied, limiting our understanding of the mediators that drive risk for poor cognitive outcomes as well as the moderators that may act as resilience factors in these populations. AAs, particularly those living in disadvantaged neighborhoods, experience a disproportionate burden of stressors throughout life at both the individual (e.g., unfair treatment) and the neighborhood level (e.g., disorder and crime). This difference in cumulative stress burden is likely a key driver of disparities in cognitive outcomes. In response to PA-18-591, we propose to add measures of cognitive function and clinically adjudicated Mild Cognitive Impairment and Alzheimer's Disease to our ongoing NHLBI-funded study (HL131531) which is following a cohort of low-income, mid- to late- life African American residents. Building on the parent study's rich existing data, which includes repeated measures of blood pressure (2016 and 2018) and stored blood samples (2016 and 2018), we will use the supplement to address new aims concerning the role of individual and neighborhood-level stressors in contributing to cognitive function and clinically- adjudicated cognitive outcomes, and the role of poor vascular health and physiologic aging (telomere length assessed via stored blood) in explaining these associations. This new data collection and new aims will allow us to collect preliminary data to support a planned R01 submission focused on cumulative stress burden and cognitive decline/ Alzheimer's disease risk, in this high-risk cohort. Understanding the impact of cumulative, race-relevant stressors on cognitive outcomes is critical in order to identify individual and policy-level interventions to mitigate pervasive racial/ ethnic disparities in dementia and poor cognitive functioning in late life.
African Americans (AAs) have a greater risk for dementia and poorer cognitive function compared to White Americans, in late life and they also experience a disproportionate burden of stressors throughout life. This difference in cumulative stress burden is likely a key driver of disparities in cognitive outcomes. This study will add cognitive assessments to an ongoing NHLBI-funded study (HL131531) which is following a sample of low- income, mid- to late- life African American residents. Understanding the impact of cumulative, race-relevant stressors on cognitive outcomes is critical in order to identify individual and policy-level interventions to mitigate pervasive racial/ ethnic disparities in dementia and poor cognitive functioning in late life.
