Racial Disparities in Alzheimer's Disease and Related Dementias: The Role of School Segregation and Experiences of Discrimination

NIH RePORTER · NIH · F31 · $33,808 · view on reporter.nih.gov ↗

Abstract

PROJECT SUMMARY Alzheimer’s disease and related dementias (ADRDs) are a major public health burden and disproportionately affect Black individuals. Although socioeconomic and cardiovascular risk factors partially account for this, experiences of structural (e.g. school segregation) and interpersonal racism (e.g. discrimination) could be important drivers of cognitive inequities. The racialized experience of school segregation can have pervasive effects on sustained discriminatory events and poor health outcomes because of stress-response activation, in addition to decreased socioeconomic opportunities, which may contribute to increased ADRDs risk. Limited studies on the impact of school segregation on late-life cognitive outcomes have produced mixed findings and did not consider incident dementia risk. Additionally, prior studies have not considered mid or late-life mediators of the association between school segregation or quantified the timing of school segregation. Thus, the rationale for the proposed research is to delineate the association of school segregation and resulting experiences of interpersonal discrimination on ADRDs risk to explain why Black individuals have a higher ADRDs burden than other racial and ethnic groups and to identify potential strategies to prevent ADRDs and reduce ADRDs disparities (e.g. organization and occupational policies to reduce racism). The analysis will leverage the Study of Healthy Aging in African Americans and Kaiser Healthy Aging and Diverse Life Experiences, NIA-funded longitudinal cohorts of older adult populations in the United States. The overall objective of this application is to examine the effect of school segregation on ADRDs inequities among older Black and White adults (ages 50-89). This project will also address how experiences of discrimination across the lifecourse impact cognitive trajectories and ADRDs risk. Specifically, this study will evaluate the association between attendance at a racially segregated school on cognitive decline and ADRDs risk among Black individuals (Aim 1) and evaluate the role of everyday and major life discrimination as mediators of this association (Aim 2). Finally, the proposed study will estimate the extent to which racial differences in cognitive decline and ADRDs risk are contributed by differential exposure to school segregation, everyday discrimination, and major life discrimination among Black and White individuals (Aim 3). Examining the roles of sociocontextual factors on ADRDs risk in a large, diverse cohort of Black and White individuals will provide valuable insight into the sustained effects of structural and interpersonal racism on ADRDs risk and will inform population interventions to reduce ADRDs inequities including the targeting of intermediate or proximal mechanisms (e.g. improving neighborhood and educational quality, enhancing access to additional income and employment opportunities). The proposed training, guided by an exemplary mentorship t...

Key facts

NIH application ID
10823219
Project number
5F31AG081071-02
Recipient
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Principal Investigator
Sirena Celeste Gutierrez
Activity code
F31
Funding institute
NIH
Fiscal year
2024
Award amount
$33,808
Award type
5
Project period
2023-02-01 → 2024-08-31