Document text
Principal Investigator: Lisa L Barnes
Organization: RUSH UNIVERSITY MEDICAL CENTER
Fiscal Year: 2024
Award: $2,287,199
Funding agency: National Institute on Aging
ABSTRACT
The prevention of Alzheimer’s dementia and cognitive decline in our aging population is a major public health
priority. Older Black adults are disproportionately burdened by Alzheimer’s dementia compared to other racial
and ethnic groups. Reasons for the increased burden are unknown and traditional factors, including vascular,
socioeconomic, and healthcare utilization, do not fully account for the disparity. Two important research
directions are needed to fill the current gap in knowledge regarding Alzheimer’s dementia and cognitive decline
for older Black adults, one of the most vulnerable segments of our older population. First, studies which collect
ante- and postmortem biospecimens from well-characterized older Blacks with sufficient cognitive follow-up are
needed to advance our understanding of the pathologic substrates underlying dementia. Second, the
investigation of novel factors uniquely tied to the lived experience of Blacks is essential to identify new targets
for intervention, policy, and therapeutics. The devastating effects of COVID-19 on Blacks coupled with the
increased awareness of interrelated systems of structural racism, have shone a spotlight on the importance of
race-specific stress as an understudied risk factor. It is well-documented that general stress has a negative
impact on the psychological and physical health of older Blacks, but few studies have examined the impact of
race-specific stress on brain health. The overall goal of the proposed continuation of the Minority Aging
Research Study (MARS) is to measure individual- and environmental-level race-specific stressors and identify
the biologic mechanisms linking them to late-life cognitive decline, incident AD, and other poor health
outcomes in aging. Leveraging harmonized clinical and neuropathological data from two other ongoing studies
at Rush, we will increase our sample size of Blacks to more than 1200 persons to address new Specific Aims.
We propose to continue collecting clinical and postmortem data on MARS participants, test the association of
novel race-specific stressors with cognitive decline and AD, and quantify inflammation and vascular pathology
in blood and brain, respectively, to test two potential biologic pathways linking stress to brain health in older
Blacks. Aim 1 will examine the relationship between individual and environmental race-specific stressors with
incident AD and cognitive decline. Aim 2 will leverage Medicare claims data to examine the relationship of
these stressors with other chronic vascular-related health conditions. Aim 3 will employ proteomics to measure
inflammatory proteins in plasma and examine their association with stressors and AD. Finally, Aim 4 will
examine the association of stressors with vascular neuropathologies and microglia measured in the brain, and
test whether these pathologies account for the association of race-specific stress with AD. The proposed study
provides a unique opportunity to answer critical questions about a large understudied segment of our aging
society and incorporates race-specific risk factors that have not been examined in clinical-neuropathologic
studies.
Terms: <21+ years old><AD dementia><AD prevention><Active Follow-up><Address><Adult><Adult Human><African American><Afro American><Afroamerican><Aging><Alzheimer Type Dementia><Alzheimer disease dementia><Alzheimer disease prevention><Alzheimer prevention><Alzheimer risk factor><Alzheimer sclerosis><Alzheimer syndrome><Alzheimer's><Alzheimer's Disease><Alzheimer's disease risk><Alzheimers Dementia><Amentia><Arterioloscleroses><Atherosclerosis><Atherosclerotic Cardiovascular Disease><Autopsy><Awareness><Behavior><Biological><Black><Black Populations><Black group><Black individual><Black people><Black race><Blacks><Blood><Blood Plasma><Blood Reticuloendothelial System><Blood Vessels><Brain><Brain Nervous System><Brain Pathology><Brain Vascular><COVID crisis><COVID epidemic><COVID pandemic><COVID-19><COVID-19 affected><COVID-19 consequence><COVID-19 crisis><COVID-19 effect><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 impact><COVID-19 impacted><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><CV-19><Cardiovascular Diseases><Cerebral Amyloid Angiopathy><Chronic><Clinical><Cognition><Cognitive><Cognitive Discrimination><Cognitive Disturbance><Cognitive Impairment><Cognitive decline><Cognitive function abnormal><Cohort Studies><Concurrent Studies><Congophilic Angiopathy><Coronavirus Infectious Disease 2019><Coupled><Data><Data Collection><Decrease disparity><Dementia><Discrimination><Disease><Disorder><Disparities><Disparity><Disturbance in cognition><Education><Educational aspects><Encephalon><Epidemiology><Ethnic Group><Ethnic People><Ethnic Population><Ethnic individual><Ethnicity People><Ethnicity Population><Funding><Goals><Health><Health Care Utilization><Hortega cell><Impaired cognition><Individual><Inequity><Infarction><Inflammation><Inflammatory><Intervention><Intervention Strategies><Investigation><Knowledge><Lead><Link><Lived experience><Lived experiences><Lower disparity><Measures><Medicare claim><Memory><Mental Health><Mental Hygiene><Microglia><Minority><Neighborhoods><Neurobiology><Older Population><Participant><Pathologic><Pathology><Pathway interactions><Pattern><Pb element><Persons><Physical activity><Plasma><Plasma Serum><Policies><Population><Prevention><Primary Senile Degenerative Dementia><Proteins><Proteomics><Protocol><Protocols documentation><Psychological Health><Psychological Impact><Race><Races><Racial Group><Reproducibility><Research><Research Resources><Resources><Reticuloendothelial System, Serum, Plasma><Risk Factors><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Sample Size><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Social Impacts><Societies><Source><Stress><Structural Racism><System><Testing><Therapeutic><Violence><access to health care><access to healthcare><accessibility of health care><accessibility to health care><accessibility to healthcare><active followup><adulthood><aged group><aged groups><aged individual><aged individuals><aged people><aged person><aged persons><aged population><aged populations><aging population><alzheimer risk><atheromatosis><atherosclerotic disease><atherosclerotic vascular disease><biologic><brain health><brain tissue><cardiovascular disorder><cerebral vascular><cerebro-vascular><cerebrovascular><cerebrovascular amyloidosis><cognitive dysfunction><cognitive loss><cohort><coronavirus disease 2019><coronavirus disease 2019 consequence><coronavirus disease 2019 crisis><coronavirus disease 2019 effect><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 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access><healthcare service availability><healthcare service use><healthcare service utilization><healthcare utilization><heavy metal Pb><heavy metal lead><hospitalization rates><inequality due to race><inequity due to race><infarct><interventional strategy><late life><mesoglia><microglial cell><microgliocyte><mitigate disparity><necropsy><neurobiological><neuropathologic><neuropathological><neuropathology><novel><older groups><older individuals><older person><pandemic><pandemic disease><pathway><perivascular glial cell><physical conditioning><physical health><poor health outcome><population aging><postmortem><primary degenerative dementia><public health priorities><race based differences><race based disparity><race based inequality><race based inequity><race differences><race disparity><race related differences><race related disparity><race related inequality><race related inequity><racial><racial background><racial difference><racial disparity><racial inequality><racial inequity><racial origin><racial population><racial subgroup><racially different><racially unequal><reduce disparity><reduced health outcome><reduction in disparity><research study><residential segregation><risk factor for dementia><risk for dementia><senile dementia of the Alzheimer type><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><social vulnerability><socio-economic><socio-economically><socioeconomically><socioeconomics><stressor><vascular><vascular risk factor><violent><violent behavior><worse health outcome>