ADRD risk and resilience among Black Americans: A 20-year longitudinal study

University Of Michigan At Ann Arbor, Ann Arbor MI

Investigators

Abstract

SUMMARY It is critically important to identify modifiable determinants of cognitive health and functioning, particularly among racial/ethnic minority groups that have elevated risk of Alzheimer’s disease and related dementias (ADRD). Black Americans have 2-4 times the age-adjusted incidence of ADRD, with significantly earlier age of onset, relative to non-Hispanic Whites (NHW). However, there is a dearth of longitudinal studies examining risk and protective factors in early and middle-adulthood within the Black population to inform culturally-relevant prevention and intervention efforts. The goal of this proposed research is to examine psychosocial risk and protective factors for cognitive functioning among middle-aged and older adults using the National Survey of American Life (NSAL), a nationally-representative sample of Black Americans originally interviewed in 2001/3. The original sample consisted of 5,191 Black adults, 1,170 Black adolescents (nested within the Black adult households), and 891 NHW adults who resided in Census tracts with ≥10% Black residents. The NSAL is unparalleled in terms of its ability to characterize the heterogeneity in psychosocial and environmental factors within the Black population in several ways: (a) the sample spans the US including urban, suburban, and rural areas; (b) the survey assessed a range of factors that vary within this group, including ethnic identity, skin tone, socioeconomic status, nativity, neighborhood characteristics, family/kin networks, religious participation, exposure to adversity and trauma (e.g., incarceration history, discrimination), coping resources, and detailed mental health history (e.g., major depression, anxiety disorders, substance dependence); and (c) these survey data have been geocoded to characterize neighborhood context (e.g., residential segregation, income inequality, social capital). The specific aims of this project are to: (1) Re-interview ~70% of surviving NSAL participants (~2,600 people (64% female), who will now be, on average, 62 years old) to collect longitudinal data (20-year follow-up) on a range of risk factors and culturally-relevant psychosocial resources for cognitive health and functioning. This re-interview will involve enhanced data collection with ~1,485 participants to directly assess physical functioning and collect a blood sample for biological, genetic, and epigenetic markers; (2) Identify and characterize pathways of risk and resilience for cognitive and physical functioning, including variation in these relationships by nativity, gender, and socioeconomic status; and (3) Explore contextual moderators of cognitive and physical functioning using geocoded survey data. Through this proposal we aim to create a cohort that can address key scientific questions about modifiable determinants of ADRD risk among Black Americans. We will leverage our partnerships with minority health and aging centers and programs, and our established track record of collaborating with and mentoring under-represented scholars, to create a high- impact scientific resource that will be available to researchers around the world.