# Multimorbidity Trajectories, Psychosocial Resilience and Stress, and Risk of Dementia and Poor Cognitive Functioning

> **NIH NIH R21** · UNIV OF MARYLAND, COLLEGE PARK · 2022 · $226,081

## Abstract

PROJECT SUMMARY / ABSTRACT
 Alzheimer’s Disease (AD), the sixth leading cause of death in the US, is the most common form of
dementia in later life. Substantial heterogeneity in the course of disease progression, AD prevalence, and
mortality exist by gender and race. Yet, variations in the distribution and the relative importance of risk factors,
such as multimorbidity, that may inform gender and racial differences in AD risk and cognitive change over
time are not well understood. Data-driven strategies capturing the dynamic nature of chronic disease
accumulation may offer critical insight regarding differences in dementia risk and cognitive functioning by
gender and race. Further, a robust literature hypothesizes linkages between psychosocial resilience and stress
with dementia risk and cognitive functioning. However, the extent to which these factors enhance or attenuate
dementia risk and poor cognitive functioning merits systematic investigation and is in alignment with new
priorities for AD and aging research. To address these gaps the proposed work will investigate the association
between multimorbidity trajectories, psychosocial resilience/stress, dementia risk and changes in cognitive
functioning using data from the Health Retirement Study (2000-2018). We propose two aims: 1) assess the
effect of psychosocial resilience (e.g., perceived social support, self-efficacy, and mastery) on the relationship
between multimorbidity trajectories and change in cognitive functioning and incident dementia; and 2) assess
the effect of psychosocial stress (e.g., discrimination, chronic stress, social isolation) on the relationship
between multimorbidity trajectories and change in cognitive functioning and incident dementia. Specifying
multimorbidity trajectory classes that differentially predict dementia risk and poor cognitive functioning
represents a valuable contribution in: clarifying factors that propagate gender and racial disparities in late life
progressive cognitive decline and dementia risk; informing the design of interventions and preventive strategies
targeting psychosocial resilience and stress among populations at greatest risk; and improving precision in
stratifying risk for poor cognitive function to delay the development and progression of AD.

## Key facts

- **NIH application ID:** 10524911
- **Project number:** 1R21AG079233-01
- **Recipient organization:** UNIV OF MARYLAND, COLLEGE PARK
- **Principal Investigator:** Kellee White Whilby
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $226,081
- **Award type:** 1
- **Project period:** 2022-09-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10524911

## Citation

> US National Institutes of Health, RePORTER application 10524911, Multimorbidity Trajectories, Psychosocial Resilience and Stress, and Risk of Dementia and Poor Cognitive Functioning (1R21AG079233-01). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10524911. Licensed CC0.

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